PTSD and Suicide Ideation in Veterans

trader32176
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Re: PTSD and Suicide Ideation in Veterans

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This May Be First Step In Curing PTSD With A Pill

A start-up, funded in part by the U.S. Army, could be on track to revolutionizing what we know about PTSD.

9/3/21


https://www.defenseone.com/technology/2 ... ll/185131/

A start-up, funded in part by the U.S. Army, could be on track to revolutionizing what we know about PTSD.



A new company, with funding from the U.S. Army, may have found the secret to treating PTSD with a pill or some other direct form of medicine.

Right now, treatments for PTSD range from virtual reality to electronic brain stimulation to hallucinogens and ecstasy. But while these can lessen symptoms, they don’t offer a direct cure.

Dr. Jennifer Perusini, founder of Neurovation Labs, says PTSD has a unique biomarker called GluA1. It's a protein that is part of a glutamate receptor system, which helps memory formation. But trauma can also spur the creation of GluA1.

In 2014, during experiments for her doctoral thesis, she found that rats subjected to traumatic experiences had more GluA1. They also experienced anxiety and symptoms associated with PTSD, even when they weren’t experiencing threatening noises and lights.

Blocking the protein removed the anxiety, but the rats still displayed a healthy reaction to new frightening stimuli. That’s key, because it’s important to retain the ability to be scared by actual threats.

Perusini is currently in pre-clinical trial mode for a medicine that can block GluA1, and the clinical trial process could take years. But she already has financial support from the Air Force and from the Army through the Army’s xTech program, which awarded her $145,000 to develop her model that targets the protein.

Neurovation Labs was one of five companies xTech featured this week as part of a showcase of finalists that had passed through the program.

Zeke Topolosky, chief of the strategic partnerships office at the DEVCOM Army Research Laboratory, told Defense One that the competition to get into the xTech program is strong.

“We get about 300 to 400 proposals. We select about 50 to do a live pitch… That’s when we do really technical vetting: ‘OK, this solution is really viable. It works. It solves a problem the Army needs solving.’ Those are the companies that make it out of the pitch round,” he said.

In addition to funding, the program also helps companies navigate the Army’s acquisition process to speed new technology development and deployment.
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Re: PTSD and Suicide Ideation in Veterans

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After the Physical War Is Over, the Invisible War Begins

After 20 years of war, veterans will now fight the mental health war.

Posted September 9, 2021 | Reviewed by Tyler Woods


https://www.psychologytoday.com/ca/blog ... war-begins


Veterans do not know how long they will fight on the invisible battlefield.
With the proper treatment, a great support system, and avoiding self medicating, veterans can heal and leave the invisible battlefield.
There is no demographic of individuals that have been impacted more by suicide than veterans.

After 20 years, war is over, officially. On Sept. 12, 2001, I was 14 years old and found out about the twin towers on my way to high school in my hometown of Rochester, New York. On Sept. 7, 2005, at 18 years old, I was officially sworn into the United States Army as a Cavalry Scout in Buffalo, New York. June 17, 2007, I was shot by a sniper while serving in Iraq at 20 years old. And this month, September 2021, I am still suffering from PTSD at 34 years of age.

That’s 14 years of mental trauma after I left the physical battlefield in Iraq. The front lines in Iraq were riddled with Improvised Explosive Devices (IEDs), enemy combatants, and sniper fire. The invisible battlefield is full of bad memories, nightmares, and, sometimes, the urge to commit suicide. These are the injuries that cannot be seen. Casualties on the invisible battlefield show up in the military members who commit suicide after dealing with the mental trauma they faced years after leaving the physical battlefield.

When I was at the gym in Iraq in 2007 we received a warning of a mortar attack. My friends and I rushed into a bunker while mortars rained down on us from overhead. A mortar struck the bunker while we all were inside. From the sound wave that hit the bunker, I received a concussion and my left eardrum was ruptured. For the rest of my deployment, I was afraid to go out at night in fear of getting hit with another mortar, but Cavalry Scouts have to make sure that the mission is complete, so I soldiered on.

Many soldiers have hit multiple IEDs and there are many others who have been exposed to multiple blasts that caused injuries to the head. These head trauma can result in a medical condition called Chronic Traumatic Encephalopathy, also known as CTE. According to concussionfoundation.org “Most people diagnosed with CTE suffered hundreds or thousands of head impacts over the course of many years playing contact sports or serving in the military.” Like veterans, football players are exposed to repeated trauma over the course of multiple years.

Those football players suffering from CTE have one unfortunate thing in common with veterans: suicide. Junior Seau is one of the most notable NFL athletes diagnosed with CTE that committed suicide, but not the only one. After a career as a linebacker in the NFL his brain was severely damaged, which resulted in CTE. Like many veterans, he was fighting with himself due to an injury that affected his brain.

This week is National Suicide Prevention Week. There is no demographic of individuals that have been impacted by suicide more than veterans. I was injured in 2007 and there are some moments of my life that feel as if they just happened yesterday. Certain triggers, like a clap of thunder or driving by a bag of trash in the street, can take me right back to the day I was injured. There are days after a flashback where suicide crosses my mind. I think to myself, “How long do I have to deal with this”?

The combination of the physical injuries with the mental injuries can be a bit much at times. I was shot by an AK-47 sniper rifle. The bullet shattered my femur and caused severe damage to my left leg. Since 2007 I've never gotten a break from the physical pain. Like many of my fellow veterans, the physical pain from injuries sustained on the battlefield is enough to make one consider suicide.

There are days that it seems like my invisible battlefield is harder to fight on than the physical one that I actually did fight on. When a unit receives orders for deployment, they know in advance for how long. However, there is no amount of time that anyone can tell veterans how long they will fight on the invisible battlefield. I’ve been going to therapy for years, I've been on the same medication for years, and I’ve been speaking out about mental illness for years.

According to the American Psychological Association, “[the] length of treatment also varies with the type of treatment provided; cognitive behavioral treatments, which focus on a specific problem, are generally briefer than are psychotherapies with a broader focus.” There were times that I quit my therapy because I just didn’t think I’d ever get better. I was still having nightmares, still having flashbacks, and still dealing with anxiety. I used to get tremendously upset by it all: the individual therapy, the group therapy, the EMDR, the medications.

“Was it even worth it?” I used to ask myself after a bad flashback. Did I even make a difference when I was in the Army? Did I make a mistake by joining? Like we are seeing after fighting 20 years of war in Afghanistan, once one threat is eliminated a new one can soon take its place. After 20 years we have lost many lives and many others were injured while on the battlefield.

Things can get better on the invisible battlefield. Such healing requires the proper psychological and psychiatric treatment, a great support system, and avoiding self-medicating with drugs and alcohol. Veterans can come home from the invisible battlefield. That means no suicides, no interactions with law enforcement, and no nightmares or flashbacks. Especially during this week, but during the other 51 as well, we must remember those fallen on the battlefields—both visible and invisible—and do whatever we can to support those still fighting the enemies in our minds.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or the Crisis Text Line by texting TALK to 741741. To find a therapist near you, see the Psychology Today Therapy Directory.
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Re: PTSD and Suicide Ideation in Veterans

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Afghanistan And Iraq War Veterans Face Special Challenges As 20th Anniversary Of 9/11 Approaches

Dr. Ray Love, who leads the post-deployment clinic for Afghanistan and Iraq War veterans at Houston’s Michael E. DeBakey VA Hospital, expects the anniversary to be potentially triggering for his patients.

Andrew Schneider | Posted on September 9, 2021, 8:40 AM

https://www.houstonpublicmedia.org/arti ... pproaches/


The upcoming twentieth anniversary of 9/11 is a somber moment, particularly for veterans who enlisted in the wake of the terrorist attacks.

To better understand the challenges facing such individuals, Houston Public Media spoke with Dr. Ray Love, who leads the post-deployment clinic for Afghanistan and Iraq War veterans at Houston's Michael E. DeBakey VA Medical Center.

This interview has been edited for length and clarity.


What problems do post-9/11 veterans face that are distinct from prior generations of veterans?


It’s vastly different from the Vietnam-era veterans and the Desert Storm-era veterans or the World War II veterans. Typically, everybody thinks it’s PTSD, but it really is not. Traumatic brain injury is actually a bigger or more signature issue from the wars.

I’m not a psychiatrist, and obviously a lot of our patients have PTSD. I deal with what I would call the more medical manifestations that would be involved with the traumatic brain injury, PTSD, and musculoskeletal injuries. And so, these actually come together when you’re looking at something like the twentieth anniversary of 9/11.

How do you expect the upcoming twentieth anniversary of 9/11 to affect your patients?


I took the liberty to ask some of my patients how they were kind of addressing the upcoming anniversary, and this was before the recent events in Afghanistan. And they mentioned it as being potentially very triggering. They weren’t really sure how they were going to deal with it.

But most of them thought that it was likely just going to bring back everything that might have inspired them to initially enlist, some of the survivor guilt, some of the things that they encountered when they were actually in deployments in Iraq and Afghanistan. Kind of like many of our vets on 4th of July are not necessarily out celebrating because the fireworks can be triggering, the large crowds can be triggering.

Many of the veterans that I take care of have significant problems with large crowds, so the recent COVID actually has been a blessing for many of them.

Are you a veteran yourself?

I am not. I'm actually pretty unique. For someone who was not in the military, I may have as much military exposure as you might have. I’m the son of a 31-year career Army veteran.

So, my father was a command sergeant major in the Army. My sister was in the Army. I’ve uncles that were in the Marines. My roommate in medical school was in the Army and actually just came to our clinic. Almost everywhere you look there are our veterans, so it kind of made sense for me to actually end up here.

As luck would have it, I’m actually a post-deployment baby. So, I work in a post-deployment clinic, and I was born approximately nine months after my father returned from Vietnam.

What have you learned from talking to post-9/11 veterans?

I think I learn more from them than they learn from me. I can teach them medical stuff, but they taught me to understand what goes on and why they see things the way they see them. They like people to maybe listen to them, rather than asking them specifically about their activities while they were at war, if they want to talk about it, and many of them don't really want to even talk about it. Just listen to them, and let them tell you about what they want to tell you about.

Our veterans love to be appreciated. If you've ever stopped and said, "Thank you for your service," they may tell you all about it. You know, appreciation is a really, really big thing, and it can't be overstated that everyone loves to be appreciated, but our veterans, particularly after having volunteered to go into service for the country, they really love to be appreciated. I don't think it ever gets old for anyone.
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Re: PTSD and Suicide Ideation in Veterans

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How post- 9/11 veterans are helping each other find healing

VetStrong is growing, and has launched chapters in cities across Texas, Hawaii and Kansas City.

September 9, 2021


https://www.ksat.com/news/local/2021/09 ... d-healing/


SAN ANTONIO – James Pobanz spent 17 years in the U.S. Army. He got out in 2013 and changed his career field to social work to continue serving his country by helping veterans like himself.

“As more veterans, especially post-9/11 veterans, are going into the counseling field, whether it’s social work or professional counseling or psychology, I think we’re seeing an increase in the amount that want to be involved, or they can realize that they can bond with their fellow veterans in those same situations and help them so they can understand that they’ve been in the same place that they have,” Pobanz said.

With deployments to Iraq and Afghanistan himself, some find it easier to open up to Pobanz. In his opinion, post-traumatic stress disorder is more accepted and talked about in ways that were not there when the first soldiers returned home from the Iraq and Afghanistan wars.

But the social worker said he wanted to do more. He got several veteran friends with trucks involved in helping veterans in transition, finding them furniture and home goods.

Four years ago, the nonprofit VetStrong was created, and with it came an organic form of therapy.

“Some of these veterans are looking for that new identity. And they want to be able to do some work here in the U.S. that can help improve the community, give them a sense of self-worth and being able to help one another,” Pobanz said.

Pobanz said calls for connection are even more crucial recently after the Taliban took over Afghanistan. He said the aspects of mental health for veterans experiencing this is unchartered.

“Folks like myself that were deployed to Afghanistan and to Iraq in real-time can see a lot of work that they did and a lot of time they spent basically crumble right before their eyes. That’s going to have some type of significant impact for PTSD, for veterans’ mental health,” Pobanz said.

Pobanz says 9/11 changed many lives, including his, and the aftermath of the wars that followed.

VetStrong is growing. Other chapters in cities across Texas, Hawaii and Kansas City have launched.

According to a study released by Brown University in June 2021, more than 30,000 active duty and veterans of the post-9/11 wars have died by suicide compared to the more than 7,000 service members kill-ed in those war operations.
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Re: PTSD and Suicide Ideation in Veterans

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New Research Evaluates Patient Preferences For 5 Types Of PTSD Treatments

9/12/21


https://www.forbes.com/sites/traversmar ... dd0a2f4d5b


A new study published in Frontiers in Psychology examines five forms of treatment for PTSD and offers insight into the types of patients that prefer each one. For instance, results suggest that cognitive behavioral therapy (CBT) and prolonged exposure therapy are the two most preferred treatment forms overall, but that older patients prefer psychodynamic treatments.

“Psychotherapies for the treatment of PTSD can be broadly divided into two categories: trauma-focused interventions and non-trauma-focused interventions,” say the researchers, led by psychologists Meike Müller-Engelmann and Laura Schwartzkopff of Goethe University Frankfurt in Germany. “The first group includes those treatment approaches that directly address the traumatic event (for example, eye movement desensitization and reprocessing, exposure therapy, and cognitive behavioral therapy), whereas non-trauma-focused treatment approaches seek to treat PTSD symptoms without directly focusing on the traumatic event (e.g., stabilization therapy).”

The researchers recruited 104 traumatized German adults to participate in an online survey that measured their preferences for five forms of PTSD treatments, described by the researchers below:

1) Exposure therapy

“This treatment is based on the assumption that posttraumatic stress disorder is essentially maintained by avoiding trauma-related thoughts, feelings and memories. During this treatment, the symptoms should be reduced by directly addressing (confronting) the memories of the traumatic experience. First, you work out with your therapist why this procedure is useful for reducing your symptoms. After you are sufficiently stabilized to become involved with this procedure, confrontation of traumatic memories takes place in several stages.”

Advantages: “The effectiveness of this treatment has been proven in scientific studies. Overall, this treatment is very effective and has lasting positive effects. You will have the experience of being able to deal with the memories and being able to process the traumatic experience.”
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Disadvantages: “The treatment can be very stressful because it requires dealing with memories and situations that you have previously avoided. Before a significant reduction in stress occurs, a temporary increase in burden may occur.”

2) Eye movement desensitization (EMDR)


“This treatment was named after right-left eye movements, which, like any back-and-forth movement, can have a calming and integrating effect. This effect can also be achieved by (right-left) alternating touches, e.g., of the hands, or listening to bilateral music (with sounds alternating between the right and left ear). Your therapist asks you, for example, to follow the movements of his finger with your eyes while thinking of the worst moment of traumatization. A stop signal is agreed upon, with which the exercise can be interrupted at any time. In a typical EMDR session, the therapist initially asks you to think about the worst moment you remember, a stressful thought about yourself, as well as a corresponding positive thought (e.g., "Today, I can defend myself"). After attention has been directed to feelings and body sensations, space is created for new inner images, thoughts, feelings and body sensations that may emerge spontaneously. The former experience can thus be experienced and placed in a new context. Each session ends with a deepening of the positive thoughts, e.g., "Today, I can defend myself" and the deepening of the positive body sensation.”

Advantages: “The effectiveness of this treatment has been proven in scientific studies. This treatment is generally very effective and has lasting positive effects for most people. This treatment does not require dealing with all details of the traumatic experience.”

Disadvantages: “Whether special eye movements or even mutual stimulation are necessary for the therapeutic effect is a controversial issue. The treatment can lead to slight headaches or nausea.”

3) Cognitive behavioral therapy (CBT)

“In this treatment, you will analyze, with the help of the therapist, stressful thoughts related to the trauma. People who have been traumatized often suffer from distorted distressing views, e.g., "I am to blame for the rape/attack", "I am not safe", and "My life is destroyed forever". These thoughts lead to feelings of guilt, shame, fear, etc. In the treatment, you will learn to recognize and challenge these beliefs and to find more balanced, appropriate beliefs again. Initially, you will receive substantial support from the therapist, but over the course of the treatment, you will gradually become an expert on your own problems. This procedure usually leads to a reduction in stressful feelings and thus of the symptoms of posttraumatic stress disorder.”

Benefits: “The effectiveness of this treatment has been proven in scientific studies. This treatment is overall very effective and has lasting positive effects. Although the traumatic experience is discussed in the treatment, the aim is not a direct and repeated confrontation with details of the trauma. Through the treatment, you will learn tools that will enable you to become your own therapist in the long term.”

Disadvantages: “It takes considerable effort to recognize and change distorted beliefs. This requires regular independent written homework between sessions. Often, challenged beliefs are understood from a rational point of view, but it takes a long time until the new thoughts feel right. Cognitive procedures are related to a certain amount of stress since traumatic experiences must be discussed to understand and change distorted thoughts.”

4) Stabilization

“Often, this treatment does not directly deal with the traumatic experience but rather aims to stabilize your psychological state. The aim of this is to make the burden bearable. This is achieved, for example, by working out techniques with your therapist to deal with strong tension, stress and burdensome feelings. In concrete terms, this may involve learning calming actions that help you distract yourself. It is also important to learn to recognize tension at an early stage and to deal with it actively. Furthermore, fantasy journeys or relaxation exercises can be used. For example, one exercise is the "safe place" exercise, in which you imagine a place where you feel safe and secure and to which you can return in your imagination when you are under heavy strain. Another exercise is the "thought stop", which is used to control recurring unpleasant thoughts.”

Benefits: “Pure stabilizing therapy involves very little stress, as there is no direct confrontation with traumatic experiences. This can make it easier to become involved in the treatment.”

Disadvantages: “In the treatment, the traumatic experience is not dealt with directly. According to studies, treatments that exclusively consist of stabilization have a low effectiveness and do not allow for long-term healing.”

5) Psychodynamic therapy

“The focus of psychodynamic trauma therapy is to identify and treat the unconscious effects of trauma on the patient. For example, it is determined how the trauma has changed the patient's personal values and what meanings are attributed to the experiences. It is assumed that the trauma is such an overwhelming experience that it could not be processed in the moment. In therapy, the conditions for processing are regained. Together with the patient, the therapist tries to understand to what extent current situations trigger trauma-related stress reactions, even though the traumatic event belongs to the past. The therapy will not focus mainly on symptoms but will primarily be concerned with establishing insight, which involves recognizing a connection between the burden of today and traumatic experiences. Here, the therapeutic relationship is of utmost importance, which means that feelings and behaviors that emerge within this relationship reflect problems in the patient’s daily life that can be addressed within the therapeutic relationship. Therefore, the therapist treats the patient with respect and support. Usually, such therapies take a long time.”

Advantages: “Psychodynamic therapies are widespread and do not require a detailed focus on traumatic memories.”

Disadvantages: “The therapy is long lasting. Currently, there is a lack of studies demonstrating the effectiveness of this treatment.”

Participants read about the five PTSD treatments and were asked which type of treatment they would like to pursue and why. The researchers found that approximately 30% of participants preferred prolonged exposure therapy or cognitive behavioral therapy, 20% of participants preferred eye movement desensitization and reprocessing therapy or psychodynamic therapy, and only a fraction of participants (<5%) preferred stabilization therapy.

The researchers take this as evidence that people who have experienced traumatic events prefer to engage in psychotherapies that challenge them to process the traumatic event as opposed to ignoring it or engaging in distraction techniques. Moreover, people’s preferences for trauma-focused interventions are based on the belief that these types of treatments are more effective. For instance, when the researchers asked participants why they chose the PTSD treatment option they did, many cited a belief in the perceived treatment mechanism (for example, “Confronting the trauma seems important to me”) as well as a belief in the treatment efficacy (“This treatment is scientifically sound”) as the most important reason.

The authors found scant evidence to suggest that patient preferences for PTSD treatments were based on an individual’s psychological and/or demographic profile.

“We did not find individual differences, such as demographic and clinical factors, to be associated with treatment preference, except for age: people who preferred psychodynamic psychotherapy were significantly older than patients who preferred CBT,” say the researchers.

Overall, this research points to the importance of educating patients on the different treatments available for PTSD.

“Based on our study, which indicates that PTSD patients differ in their treatment preferences, comprehensive patient education and preference assessments may improve care of PTSD patients,” say the researchers. “Certainly, it must be kept in mind that clinical institutions cannot cover and offer all PTSD treatment options. However, considering patient preferences may increase treatment compliance and thus outcome and treatment completion.”

A full interview with psychologists Meike Müller-Engelmann and Laura Schwartzkopff discussing their new research on PTSD can be found here: Why treatment education is an important part of PTSD treatment
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Re: PTSD and Suicide Ideation in Veterans

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How 9/11 changed the nature of American war — and how it shaped those who fight it

For a time before Sept. 11, 2001, America seemed invincible.

By Jeff Schogol | Published Sep 12, 2021 9:00 AM


https://taskandpurpose.com/pentagon-run ... -veterans/


It would be very difficult for a generation of service members and veterans who have known nothing but war to comprehend what life in America was like before Sept. 11, 2001.

There was a time from when the Berlin Wall fell to when the World Trade Center’s twin towers fell that the United States appeared to be invincible.

The conflicts fought during the 1990s were relatively quick and mostly decisive, with the notable exception of the U.S. military’s mission to Somalia that resulted in the Battle of Mogadishu later made famous in the book “Black Hawk Down.”

Following the crushing defeat of Saddam Hussein’s forces in the first Gulf War, then-President George H. W. Bush proclaimed to a group of conservative state lawmakers in March 1991, ”By God, we’ve kicked [the] Vietnam syndrome once and for all.”

With the fall of the Soviet Union later that year, America’s defeat in Vietnam suddenly looked like an anachronistic speed bump on the road to ultimate victory in the Cold War. The U.S. military, which had been greatly strengthened under former President Ronald Reagan, was clearly without peer. Any country insane enough to challenge the United States militarily would be smashed in a matter of weeks, if not days.

Throughout the 1990s, U.S. troops were dispatched to the former Yugoslavia on missions that seemed to underscore America’s military might. NATO’s campaign to assist Kosovar Albanians against the Serbs was conducted entirely from the air. Even though the airstrikes were far from crippling, the notion of ground combat no longer seemed relevant.

The myth of America’s invincibility did not wear off immediately after the Sept. 11 attacks. Initially, the United States was able to rout the Taliban with a handful of special operators and CIA officers backed by overwhelming airpower.

America had seemingly avoided the trap of sending thousands of troops to the “Graveyard of Empires,” and we all had a good laugh at the Russians.

Things began to change with the March 2003 invasion of Iraq. This was not the Gulf War, where Americans were awed by grainy television images of smart bombs blowing up targets with God-like accuracy. This became a war of ambushes, roadside bombs, and enemies who did not wear uniforms.

Troops on the ground stacked up to clear rooms as the war devolved into urban fighting. Every trip outside the wire became as suicidal as going over the top in World War I. The term “Improvised Explosive Device” – or “IED” – became synonymous with death and severe injury.

America seemed less awe inspiring as multimillion dollar equipment was destroyed by bombs detonated with 19th Century technology. Eventually, Afghanistan too became a war of IEDs, suicide bombers, terrorists, and invisible wounds.

Advances in technology saved the lives of countless troops who would have died in previous wars, but they also had to endure blast-related injuries that left them in soul-crushing pain. It would take years for the military to acknowledge that service members who survived blasts seemingly unscathed were actually suffering from mild Traumatic Brain Injury.

The military and Department of Veterans Affairs gave the Forever War generation dozens of pills – too many to count – to keep them whole. Many washed down their meds with alcohol, a potentially fatal combination.

Suicide has been the scourge of the Forever Wars. More than 30,000 service members and veterans have died by suicide since Sept. 11, 2001, and that is more than four times the number of troops killed in combat.

The Global War on Terror has been a bleeding wound for much of the world. Since 2001, at least 801,000 people have died across the globe, of which 42% were civilians, a 2019 study by Brown University found.

The enduring legacy of Sept. 11 is how the American concept of war has changed. Wars are no longer quick and easy. They are endless, and while troops deploy to combat zones over and over again, most civilians have no idea who they are fighting or why.

For those who have taken part in the post Sept. 11 wars, cynicism runs deep. Many veterans took part in the Jan. 6 Capitol Hill riot, showing the painful divisions among troops and veterans about whom they trust and which facts they believe.

It will be up to the Forever War generation to begin the healing. Those who have survived have an obligation to succeed where the Baby Boomers failed and stop the United States from sending its sons and daughters into harm’s way for unattainable goals.

Your task will be to prevent future generations from being treated as if they were expendable.
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Re: PTSD and Suicide Ideation in Veterans

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Post-9/11 war vets go to Mexico to treat trauma with a psychedelic that's illegal in the US

September 12, 2021


https://www.stripes.com/veterans/2021-0 ... 58537.html


BAJA CALIFORNIA (Tribune News Service) — After Marcus Capone completed seven tours of duty, including Afghanistan and Iraq, he seemed like "a ticking time bomb," his wife Amber says.

Capone suffered traumatic brain injuries as a specialist in setting explosive charges for U.S. Navy SEAL Team 6. After retiring in 2013, he suffered from depression, anger, debilitating headaches and violent dreams. Brain doctors and psychologists treated him with pills, which he mixed with alcohol. Neither worked.

Amber was at a breaking point. "I was just preparing myself for what my life would be like as a widow of suicide because I felt like it was inevitable," she said.

Then they discovered psychedelics.

The couple went to one of the treatment centers in Baja California that offer an underground therapy using ibogaine, a highly potent alkaloid traditionally extracted from the root of a plant native to Gabon in Africa. After the therapy, Marcus said he was able to let go of everything that had happened to him, including pain from his early childhood.

In its whole-plant form, the Tabernanthe iboga shrub has been used for centuries in religious ceremonies by the Bwiti people, who say the plant heals them and allows them to talk to God. Users describe their experience with the ibogaine extract as being in an intense waking dream. The plant and its effects have taken root among retired special operations combat veterans who may be suffering from blast related injuries or post-traumatic stress disorder.

But the drug is illegal in the U.S., and it poses cardiovascular health risks. Ibogaine may block channels in the heart's system, slowing down the heart rate, which can cause fatal arrhythmias.

A 2006 medical journal article noted that at least eight people have died from taking ibogaine. Experts say the true number is likely much higher because its use is unregulated.

"Of all the psychedelics, it's probably the one that carries the largest risk because of its arrhythmogenic (ability to cause arrhythmias) potential," said Dr. Ken Adolph, a cardiac anesthesiologist in Austin, Texas.

In 1970, the U.S. Food and Drug Administration grouped ibogaine together with LSD and psilocybin making them all schedule I substances — illegal drugs which have no medical application and are not safe for use even under medical supervision.

In Mexico, ibogaine use falls into a gray zone — not exactly legal, and not exactly regulated, either.

State health authorities say people can obtain licenses to use it, but it remains unclear whether they can administer it to others or what qualifications they would need to give it to someone else. There are no clinics licensed to provide medical treatments with ibogaine, according to Marco Gámez, the director of the Comisión Estatal de Protección contra Riesgos Sanitarios, or COEPRIS , a state health agency.

Very little data exist about ibogaine's effectiveness as a treatment of trauma-related psychological issues and cognitive impairment. Because the drug is illegal in the U.S., it can't be administered to study its effects.

One peer-reviewed study, in the Journal of Chronic Stress, found that the psychedelic-assisted therapy holds "unique promise." In looking at 51 military veterans who had gone to Mexico for a psychedelic clinical program between 2017 and 2019, the study found large reductions in their suicidal ideation, cognitive impairment, symptoms of post-traumatic stress disorder, depression and anxiety.

Ibogaine is currently undergoing clinical trials abroad for its viability as a treatment for addiction, which can often occur simultaneously with traumatic brain injuries and PTSD.

A 2018 study from New Zealand interviewed 11 people a year after undergoing a single ibogaine treatment and found eight of them had cut back or stopped using opioids. One of them died.

Another 2017 peer-reviewed study published in the Journal of Psychedelic Studies surveyed 88 patients, who were mostly daily opioid users, who received ibogaine treatment in Mexico between 2012 and 2015. Fifty percent reported that ibogaine reduced opioid craving and 30% of participants reporting never using opioids again.

Critics point out that of that 30%, only half were interviewed a year or more after their treatment, that the data was self-reported, and that the clinic was calling its own former patients.

Dr. Dan Engle, the founder and medical director of Austin's new Kuya Institute for Transformational Medicine, and author of "The Concussion Repair Manual: A Practical Guide to Recovering from Traumatic Brain Injuries," said more research is needed on ibogaine.

The success rate of traditional U.S. drug rehabs hovers around 10 to 20%, he pointed out. He said when the proper support systems are set-up after a ibogaine treatment, the success rate for addiction recovery he has witnessed is between 60 to 70%.

"The standard of care hasn't changed in the last five years," Engle wrote in an email. "Those numbers 10 to 20 percent are more accurate for the standard of care when aftercare and recovery coaching are not successfully engaged" after traditional rehabs.

Alternative medicine and psychedelics have a long history in Mexico. If you've got an ailment, there's probably a Mexican tea or herb for it.

Mushrooms were considered sacred in the mountainous region of the Sierra Mazatec in the northern part of the state of Oaxaca. A Mazatec curandera (medicine woman), María Sabina, introduced "magic mushrooms" to a vice president for J.P. Morgan in 1955, prompting U.S. tourists by the thousands to make long, strange trips to Oaxaca.

In recent years, medical tourism in Tijuana has exploded with brand new, state-of-the-art medical skyscrapers and billboards promoting weight loss, cancer centers and chiropractic services.

Many of the estimated 1 million Americans who cross each year into Mexico for medical treatment are looking for lower-cost options. But some are seeking treatments they wouldn't be able to get in the United States.

Homeopathic shops offering herbs and botanicals are everywhere in Tijuana. Gámez, the head of the state health agency, cautioned tourists to investigate any homeopathic procedure they may undergo to make sure it is authorized by Baja California.

José Inzunza, the director of Nouvelle Vie Holistic & Wellness Center in Tijuana, says he's not interested in ibogaine treatment becoming part of that medical tourism boom, but rather in helping people who really need the treatment.

"We don't want to create Mexico as a tourist destination for ibogaine where people think 'Go and have fun with ibogaine,' because you're not going to have fun," Inzunza said.

He said proper screening procedures have helped prevent any deaths because of ibogaine in Baja California for 12 years, but he stressed the treatment cannot be given to everyone because those stringent screening guidelines must be followed.

In Baja California, ibogaine patients typically pay around $5,000 to stay in a large, rented villa or house that has been converted into a clinic. Depending on what the person is being treated for, those stays can range from four days to a few weeks.

Some clinics are more like spas with saunas, massage rooms and other amenities, whereas others incorporate a more traditional Bwiti ritual into the experience.

Inzunza and others stressed the importance of clinics having proper medical equipment, including EKG's and other equipment to monitor the patient's heart rate and vitals during their trip.

At first, Marcus Capone was reluctant. He had never taken drugs, especially psychedelics.

"He was like 'Uh-uh. No way. That's weird. That's crazy. I'm not doing drugs. I'm not going to Mexico,'" Amber recalled.

But then, Amber convinced him, she says by approaching him with compassion and telling him she wouldn't stop fighting for his life.

"I wanted my depression to go away. I wanted my anxiety to go away. I wanted my anger to go away ... I just wanted to be normal again," Marcus said from the couple's San Diego home. (Before retirement, Marcus worked as a Basic Underwater Demolition/SEALs, or BUD/S, training instructor in Coronado. The family now divides time between Texas and San Diego.)

He said it worked.

"Think of it as the individual is carrying around a backpack of 1,000 pounds of bricks. And it's just heavy; it's weighing on you. You have trouble walking and doing simple tasks because of that weight that is on your back and on your shoulders," Marcus said.

"As you go through your ibogaine experience, you just take those rocks out one at a time, and by the end, you have an empty bag. You feel like all the weight has been lifted," he said.

The couple has since become big proponents of ibogaine treatment, starting a nonprofit called VETS that funds ibogaine research at Stanford and helped with the initial study in the Journal of Chronic Stress. They send other struggling combat veterans abroad for psychedelic therapies illegal in the United States and lobby for legal therapeutic use of psychedelics.

Bobby Laughlin, 32, who owns a private equity firm in Los Angeles, described his ibogaine experience as undergoing years of intense therapy in just a few hours.

At the time, Laughlin was a 23-year-old daily intravenous heroin user. Five rehabs in the U.S. were not completely useless, he said, but he was still addicted to heroin until he tried ibogaine.

"I felt a very intense, real feeling of free falling ... It felt like a gigantic hand reached up through the earth and grabbed my entire body and just pulled me down ... and I could feel myself going through the mattress and through the concrete violently," said Laughlin about his experience.

During his hallucination, Laughlin said he saw demons and dragons yelling at him about the choices he'd made. He was finally able to break his spirit free from this underground hell, as part of the soundtrack of the movie "Mortal Kombat" played in his head. When he came out, Laughlin said he felt a love, acceptance and a self-compassion for himself he had never felt before.

Laughlin says he has been sober since his treatment in 2013 and has remained involved in the recovery community.

Inzunza and Laughlin both said there isn't much concern about people becoming addicted to the ibogaine because the experience is "brutal" — not something anyone would do for recreation.

There's growing pushback against the U.S. ban on psychedelics. Last year, Oregon became the first state to legalize the therapeutic use of psilocybin, the psychedelic ingredient in magic mushrooms. Denver, Oakland and Washington, D.C., have decriminalized it.

Last month, the California state Legislature sidelined a similar bill that would have removed criminal penalties for the possession, use and cultivation of certain psychedelics.

In June, Texas and Connecticut enacted laws allowing research into how psilocybin might help people with post-traumatic stress disorder. Meanwhile, investment money is pouring into the hallucinogens market.

But ibogaine, considered one of the most powerful psychedelics on the planet, isn't likely to be at the front of the line for legalization.
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Re: PTSD and Suicide Ideation in Veterans

Post by trader32176 »

Why veteran says 'getting it out and unpacking it' is key for mental health

Brian Helm: 'The Afghanistan pull out, I think how that went down has been very difficult for some'

9/12/21


https://www.wtvr.com/news/local-news/me ... tion-month


RICHMOND, Va. -- Suicide rates have been higher among veterans compared to nonveterans in recent years, according to data from the U.S. Department of Veterans Affairs. That's why advocates are placing a big emphasis on mental health support for former service members this Suicide Prevention Month. This comes after the anniversary of 9/11 and the crisis in Afghanistan may be causing heavier emotions for some.

"You always think about your service, especially during times like this," said James Howard. "Was it worth it?"

It's an easy answer for him.

"I always say 100% worth it." Howard said. "We were an all-volunteer military. Even those who made the ultimate sacrifice knew what they were getting into."

The Richmond man began serving our country in 2002, the year following the attacks on 9/11. After medically retiring in 2010, Howard founded the non-profit Veterans and Athletes United.

He explained the goal is "to help other disabled veterans and people in the community to get back on their recovery paths."

While the organization focuses on exercise and adaptive sports, Howard knows his mission helps veterans reap more than just physical benefits.

"Getting involved where they give back and have a good purpose keeps their minds busy," he said. "I think it just does a world of good for your mental health."

difficult for some'
"There's some stigma. I think that the stigma is definitely changing over time, but it's still there."
By: Tyler Layne
Posted at 8:21 PM, Sep 12, 2021
and last updated 9:37 PM, Sep 12, 2021

RICHMOND, Va. -- Suicide rates have been higher among veterans compared to nonveterans in recent years, according to data from the U.S. Department of Veterans Affairs. That's why advocates are placing a big emphasis on mental health support for former service members this Suicide Prevention Month. This comes after the anniversary of 9/11 and the crisis in Afghanistan may be causing heavier emotions for some.

"You always think about your service, especially during times like this," said James Howard. "Was it worth it?"

It's an easy answer for him.

"I always say 100% worth it." Howard said. "We were an all-volunteer military. Even those who made the ultimate sacrifice knew what they were getting into."


The Richmond man began serving our country in 2002, the year following the attacks on 9/11. After medically retiring in 2010, Howard founded the non-profit Veterans and Athletes United.

He explained the goal is "to help other disabled veterans and people in the community to get back on their recovery paths."

While the organization focuses on exercise and adaptive sports, Howard knows his mission helps veterans reap more than just physical benefits.

"Getting involved where they give back and have a good purpose keeps their minds busy," he said. "I think it just does a world of good for your mental health."

"There's some stigma," Brian Helm said about the conversation surrounding mental health in the military community. "I think that the stigma is definitely changing over time, but it's still there."

Helm works as a clinical coordinator for Cohen Veterans Network at The Up Center in Virginia, which offers mental health care to post 9/11 veterans.

As a former service member of the Army, Helm understands the anniversary of America's darkest day can trigger a whirlwind of emotions for veterans and their families.

"When September 11th happened, it changed everything. It really did change the trajectory of the United States, and it definitely changed the military," Helm said. "And I think the emotions that come up with men and women that are either veterans or active duty, it's a real mixed bag."

This year, Helm said those feelings are compounded by the crisis unfolding in the Middle East.

"With the war and the Afghanistan pull out, I think how that went down has been very difficult for some."

Helm went on to explain that the terror attack at the Kabul airport that killed thirteen service members has affected the entire military community.

"Especially for the people I've worked with that have been there and have seen lives lost, have wanted to save people but they couldn't, and have had to take lives," he said.

For veterans feeling the toll right now, Cohen offers this advice:

Acknowledge that your feelings are valid.
Unplug from your phone and TV.
Ground yourself in things you can control.
Seek support and connection.
Recognize changes that need to be made.

"Getting it out and unpacking it can be the best help," Helm said.

For Howard, healing means living a life filled with purpose to honor those who risked it all.

"We all believed in what we were doing and still do," Howard said. "It stands for this American flag right here with all the names that are on it."

Helm wants people to know that while each service member wears the same uniform, they all have different experiences. He said the best way to be an ally is to open the door for communication and give them the space to share if they'd like to.
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Re: PTSD and Suicide Ideation in Veterans

Post by trader32176 »

New facility for K9s for Warriors in San Antonio pairs service dogs with veterans battling PTSD

The organization will save dogs from ACS and train them to be therapy dogs

9/14/21


https://www.ksat.com/news/local/2021/09 ... ling-ptsd/


SAN ANTONIO – K9s for Warriors is a nonprofit organization that partners service dogs with veterans to help treat service-connected trauma like PTSD.

The goal of the organization is to prevent veteran suicides.

K9s for Warriors has a new facility here in Military City U.S.A. and hopes to help as many local veterans as possible.

“I served in the Army for 20 years, just shy of 27 years, served all over the world, basically. But (in) combat I was in Afghanistan,” Army veteran Bob Jones said.

Jones goes few places without his service dog, Grace.

“She has been my lifeline,” he said. “She alerts me when I’ve been triggered by something and I don’t realize I’ve been triggered, whether it’s been a memory or something I see along the side of the road or something. She grounds me and brings me back to the here and now.”

Jones met Grace through the K9s for Warriors program about five years ago — and she changed his life.

“It is a proven, scientifically proven service. Dogs reduce symptoms of PTSD. I am off all my medications now and I am reengaged with society,” Jones said.

This new facility is on Highway 151 right next to the Animal Care Services.

“We’re going to be saving dogs from Animal Control Services, training them to be amazing service dogs and pairing with warriors right here in San Antonio,” Rory Diamond, the CEO of K9s for Warriors, said.

The program gets the pups to full health then trains them for six to eight months to be a service dog.

“We can save about 30 dogs at a time, so maybe 200 in a year,” he said. “And that’ll probably turn out to be about 80 service dogs for veterans right here in Texas.”

The hope is to form 80 relationships just like the one between Jones and Grace.

“She literally saved my life. Approximately 20 veterans a day are committing suicide to PTSD symptoms. And this is a challenge of that. And hopefully we can reverse that,” Jones said.
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Re: PTSD and Suicide Ideation in Veterans

Post by trader32176 »

The Crucial Relationship Between PTSD and the Body

A large study of military personnel suggests needed diagnostic updates.

9/15/21

https://www.psychologytoday.com/us/blog ... d-the-body

Key points

Trauma is common, and leads to PTSD in a significant fraction of traumatized people.
PTSD includes familiar symptoms including intrusions, avoidance, changes in mood and thinking, and hyperactivation, less so body symptoms.
Research on military personnel with various levels of PTSD finds a strong correlation with specific physical symptoms.
Trauma, which affects our basic sense of safety in the world, undermines a healthy, integrated relationship with the body.

By Grant Hilary Brenner

Post-traumatic Stress Disorder (PTSD) is a psychiatric disorder diagnosed in patients with multiple symptoms following exposure to trauma. According to the National Center for PTSD, about 50 percent of people experience at least one traumatic event in their lifetime, and about 6 percent of people will experience PTSD, although some other estimates are higher. Women are more likely than men to be diagnosed with PTSD. The National Institute of Mental Health reports that about 3.5 percent of U.S. citizens had PTSD in the past year and that the lifetime prevalence of PTSD was about 7 percent.

Is PTSD a hidden epidemic?


As the stigma surrounding mental illness gradually fades, there is growing recognition of the role of trauma across the lifespan. In spite of advances in research and clinical practice, and public education, a full integration of how trauma impacts individuals and groups has been quite slow, partly because so much of trauma is perpetrated by people against one another, because trauma is often accompanied by shame, avoidance and withdrawal, and because a great deal of trauma is built into social systems.

Trauma remains split off, or dissociated, from the identity and worldview of many, preventing progress. On a deep level, fear of—and inability to deal with—death anxiety interferes not only with individual fulfillment, but also may impede cultural evolution as society grapples with terror.

The symptoms of PTSD are diverse, often appearing to be a collection of different conditions unless the role of trauma is realized. They include intrusive thoughts, memories, and nightmares; avoidance of activities, memories, thoughts, places, and people related to a trauma (this can become generalized, leading to severe isolation); changes in mental clarity (cognition and memory); mood disturbances (which can resemble depression or mania); changes in activation level, including irritability, anger, or rage; and dysregulation of emotions and behavior, including potentially risky behaviors putting oneself and others in harm’s way.

People with PTSD may also experience dissociative symptoms, ranging from out-of-body experiences to the sense that oneself or the world isn’t real (depersonalization and derealization) to profound disturbances in identity and sense of self.

Mood and cognitive symptoms were only recently added to the diagnostic criteria for PTSD, in recognition that depression and thinking difficulties, rather than being separate, may be integral to the disorder. PTSD can be chameleon-like, appearing as attentional problems like ADHD, or with mood instability like Bipolar Disorder. Careful diagnostic evaluation is essential to guide treatment and avoid misdiagnosis.

The body keeps the score

However, while many people recognize that trauma affects our bodies, only a subset of physical symptoms are recognized in the formal diagnostic model. Yet—as was so well articulated by Bessel van der Kolk in his book The Body Keeps the Score—people who live with and treat trauma know that PTSD is associated with a variety of physical complaints affecting all body systems. Very often—especially for those for whom the body was the target of abuse or neglect, or for those who felt betrayed by their bodies in the face of trauma—these physical or “somatic” complaints are of prime importance. More and more, body-centered approaches have become a key component of trauma therapy, and addressing the dissociative fragmentation between mind, spirit, and body is a key part of healing.

In order to gain a clearer formal understanding of the role of somatic symptoms in PTSD, and determine if there is a case to include bodily symptoms in the formal diagnostic framework, McFarlane and Graham (2021) conducted a large study of veterans with PTSD, published in the Journal of Psychiatric Research. They review ample reports that among combat veterans and other survivors of trauma, physical symptoms are significant, even when the remainder of symptoms are not sufficient to meet full diagnostic criteria.

They analyzed data from over 14,000 predominantly male participants from the Mental Health Prevalence and Well-Being Study of active Australian Defence Force troops. They measured PTSD symptoms using the PTSD Checklist (PCL), a range of somatic symptoms with the Personal Health Questionnaire (PHQ-15), and lifetime traumatic experiences including non-interpersonal events like accidents and disasters, intimate relational trauma including rape, domestic violence, sexual and emotional abuse in childhood and adulthood, “non-intimate” trauma including physical abuse and assault, threat, torture, capture, and witnessed violence.

They found that about half of survey respondents had deployed to combat zones, with an average age of about 35 years. Average PCL and PHQ-15 scores were normal across the whole group, and the average number of lifetime traumatic events was 3.5.

Among those with full PTSD, there was nearly a 60 percent rate of “somatoform disorder," twice as high as the 26.5 percent in the partial PTSD group. Less than 3 percent in the non-PTSD group had significant somatic symptoms. Somatoform disorder (now called “Somatic Symptom Disorder” or SSD) is a psychiatric condition which includes at least one, and often several, physical symptoms which may not have a clear medical cause, including pain symptoms, neurological issues, gastrointestinal complaints, and sexual problems.1

Somatic symptoms included: stomach and bowel problems, nausea, back issues, pain in the joints or limbs, headaches, dizziness, feeling faint, heart symptoms like palpitations or racing heartbeat, shortness of breath, tiredness and sleep difficulties.

Integrating mind and body into PTSD evaluation

While follow-up research is needed, this study strongly supports the notion that somatic symptoms are a core part of PTSD for a majority of patients. As has historically been the case, military psychiatric research is at the vanguard of understanding how trauma affects people.

As with cognitive and mood symptoms, which were only in the last several years included in the diagnosis of PTSD and which formerly might have been seen as separate conditions for many patients potentially interfering with comprehensive care, one can make a strong case that somatic symptoms should be included under the umbrella of PTSD for many patients. Future work can look not only at groups other than military members, but also at other at-risk patient populations, and take into consideration the presence of other conditions often co-occurring with trauma, including eating and substance-use disorders.

This is more than an academic distinction, because properly formulating a diagnosis is key for developing effective and personalized treatment plans. Especially given how easy it still is to downplay trauma, not only is it important to consider treating somatic symptoms when PTSD is present, it is also critical to assess for trauma in people with somatic symptoms.

Of crucial importance is the recognition that trauma is a triple-threat to mind, body and community. Going beyond understanding and treating the physiological and neurological consequences of trauma which cause somatic symptoms, recognizing the core role of somatic symptoms in PTSD underlines how important is our relationship with our bodies, and how key to healing is to right that relationship.

References


Note

1. SSD can only be diagnosed after investigating conventional medical causes, so is a “diagnosis of exclusion”. Somatoform disorders are common, and related to Illness Anxiety Disorder (previously called “Hypochondriasis” and Conversion Disorders (also called Functional conditions), in which people may have sudden unexplained neurological symptoms, including movement abnormalities, numbness, paralysis or weakness, or seizures.

These symptoms often do not have any significant findings on conventional medical testing, but as with pain syndromes like Fibromyalgia, newer imaging studies show a “central” component, meaning that there are abnormalities in how the brain processes information related to the body. Unfortunately, though there is progress, people with unexplained medical symptoms often have negative experiences with healthcare providers who are dismissive, unsympathetic or worse.

McFarlane Ao A, Graham DK, The ambivalence about accepting the
prevalence somatic symptoms in PTSD: Is PTSD a somatic disorder?, Journal of Psychiatric Research
(2021), doi: https://doi.org/10.1016/j.jpsychires.2021.09.030.

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