Tuesday, February 5, 2013

TREATMENT OPTIONS FOR PTSD COMBAT SOLDIERS


TREATMENT OPTIONS FOR PTSD COMBAT SOLDIERS    
Introduction
In the world today, there are increasing number of military actions and interventions both within and in other foreign countries. Soldiers returning from these operations are faced with a myriad of problems among them, the Post Traumatic Stress Disorder (PTSD). This disorder results from the nightmares of war that are characterized by cries from innocent civilians, agony due to injuries, death of colleagues and harsh conditions among others. This situations there call for an integrated intervention strategy that will contain the stress and assist them integrate well within the society. This essay seek to explain the various options the care givers and the families of the combat soldiers have in assisting them cope with the stress.
Understanding PTSD
Reger et al (2012) posit that posttraumatic stress disorder has remained a common problem among soldiers returning from deployment. Interest in this area came on the increase since the start of the 1980s. Beginning from that time, various researchers have investigated different aspects of the disorder. Scientific literature is at present huge, challenging ready mastery, and even the finest; most determined works of research are inescapably synoptic. A number of researches have been carried out in this area, but with development, various controversies have come up. Yet, this field has remained a significant one as cases of posttraumatic disorder increase among veterans. Psychiatrists have in the past suggested that stressing or traumatizing events could cause severe stress symptoms even in previously well-adjusted persons. Among soldiers returning from deployment, interest in the disorder has increased as more and more cases are being reported. Stress among returning soldiers is a lot and so is the prevalence of posttraumatic stress disorder. This paper reviews the available research on treatment options for combat soldiers suffering from posttraumatic stress disorder.
Kim, et al (2012) asserts the posttraumatic stress disorder emanates from exposure to events that cause psychological trauma. Therefore, posttraumatic stress disorder is an emotional disorder which is grouped among anxiety disorders. Kim, et al (2012) continues to suggest that individuals with the disorder re-experience the traumatic events and may respond by avoiding places, people, or anything else reminds them of the events. Avoidance and hyperarousal are widespread symptoms of posttraumatic stress disorder. While the symptoms of posttraumatic stress disorder have been presented since people began to experience traumatic situations, it has been grouped as a disorder only in the 80s. Nevertheless, it has been known by other terms prior to the coining of the term posttraumatic stress disorder, even at the time of the American Civil War. Soldiers were argued to suffer from “soldier's heart” during the American Civil War. Even at the time of the First World War, soldiers were seen to suffer symptoms that were consistent with the disorder. The soldiers were said to have “combat fatigue.” “Gross stress reaction” was the term that was used for PTSD during the Second World War. The term “post-Vietnam syndrome” was developed during the Vietnam War in reference to the symptoms that were consistent with the disorder. It was after the Vietnam War that the term posttraumatic disorder was used.
Research has also been carried out in assessing the treatment ability of the prevailing health care system and approximated the cost of offering quality health care for returning soldiers. The research revealed that there is a major problem in terms of mental health of the returning soldiers. However, there have been efforts in addressing the health problems for the military veterans. The country has invested in programs for helping soldiers suffering from posttraumatic stress disorder. The returning soldiers suffering from posttraumatic stress disorder and trauma can access help from centers such as VA hospital or Vet Center. Such soldiers get treatment for the disorder as well as counseling to the soldiers and their families. In addition, every military department has programs for its members that help in counseling members in order to relieve the posttraumatic stress disorder symptoms (Novaco, et al. 2012).
Treatment Options for PTSD
There are various identified treatments for posttraumatic stress disorder, which include: Trauma-focused cognitive-behavioral therapy; Family therapy; Medication; and Eye Movement Desensitization and Reprocessing. The United States government has put efforts in helping those veterans suffering from Posttraumatic stress disorder. This has been achieved through the establishment of counseling and treatment centers for both the victims and their family members, most of them being free. These centers include VA hospital or Vet Center and the National Center for PTSD, additionally every branch of military in the country has its own center where counseling services are provided for free for the veterans and their families.
Treatment for posttraumatic stress disorder alleviates the symptoms by helping the individual affected to deal with the trauma that they have experienced. Instead of circumventing the trauma and anything that reminds the person about it, in the treatment the person is encouraged to remember and process the events, emotions and feelings that were felt during the time when the trauma took place (Kim et al. 2012). Together with being provided with an outlet for feelings that the person has been hiding inside, treatment for posttraumatic stress disorder helps in restoration of the individual’s sense of control and lowering the strong hold the reminiscence of the trauma has on the life of the victim. In the treatment of posttraumatic stress disorder, the individual is required to explore the thoughts and emotions related to the trauma; work through emotions of self-blame, guilt and distrust; learn the ways of coping with and controlling invasive memories; and deal with the problems posttraumatic stress disorder has led to in life and relationships (Kim et al. 2012).
Trauma-focused cognitive-behavioral therapy
Cognitive-behavioral therapy in the treatment of posttraumatic stress disorder entails carefully and progressively exposing the individual suffering from trauma to his emotions, thoughts and circumstances which acts as a reminder of the trauma. The therapy also entails recognition of stressing thoughts about the traumatic experience, particularly the thoughts that are indistinct and illogical, and substituting them with one that are more logical and balanced image (Rauch, Eftekhari and Ruzek, 2012).
Family therapy
It has emerged from research that posttraumatic stress disorder affects both the victim and the people around him. From this perspective, Sloan, Bovin and Schnurr (2012) propose group therapy as a treatment option for an affected soldier. This involves therapy provided to groups rather than individuals. Family therapy is a form of group therapy and can be very effective and productive. This kind of treatment can also assist the people close to the victim in understanding what he is undergoing. It can also assist all the people in the family to communicate in a more relaxed manner and work through issues in their relationships cope. The use of this kind of therapy is important owing to the fact that posttraumatic stress disorder has been found to have detrimental effects on the family.
Eye Movement Desensitization and Reprocessing (EMDR)
This form of treatment incorporates elements of cognitive-behavioral therapy with movements of the eyes or other kinds of rhythmic, left-right prompt, like sounds or hand taps. Eye movements as well as other kinds of lateral movement stimulations are argued by researchers to be effective by “unfreezing” information processing region of the brain. This is especially important given that this part of the brain is interrupted at the time that the person is exposed to trauma. The interruption leaves behind frozen psychological fragments which are able to return to their original intensity after the treatment. Once these fragments are freed by Eye Movement Desensitization and reprocessing, they can be corporate into a consistent memory and then processed (Rauch, Eftekhari and Ruzek, 2012).
Medication
Drugs are sometimes used in the treatment of individuals suffering posttraumatic stress disorder. The drugs are used in relieving accompanying symptoms of anxiety or depression. Some of the commonly used drugs for posttraumatic stress disorder are anti-depressants such as Prozac and Zoloft. In spite of the fact that these drugs may come in handy in relieving stress and anxiety, they do not offer a treatment for the causes of posttraumatic stress disorder.
PTSD can also be treated through Behavioral activation where the combat soldier’s behavior is assessed by the health care provider. In this context, the care provider is able to help the soldier realize how the behavior will lead to impair the general treatment. Soldiers are helped to accept the situations that occurred and help them understand that everything occurred in the past, a situation that help them full integrate with other society members.
Among the most effective method of managing the PTSD is the use of Prolonged Exposure (PE) therapy where the combat is exposed to a prolonged imagination of the traumatic events and other safe situations that were avoided in the field. By doing so, the soldier will learn to come to terms with the situations. Related to this is the Cognitive Processing Therapy (CPT) where the soldier is exposed to different events that require his overall thinking of the events and how to deal with such situations. Both PE and CPT are aimed at assisting the combat soldier to think independently in assessing the situations thus help in his development.
There are situations where the PTSD comes with the physical disability that could be due paralysis, damage to the bones among others. Treatment of these physical inabilities will help the soldier to assume normal duties and integrate well with the society.
Psychotherapy
Drugs used in the treatment of posttraumatic stress disorder are just used with the aim of relieving the very distressing symptoms of the disorder. This is done to allow the person suffering from the disorder to concentrate on psychotherapy. Any treatment with the use of drugs should be used as part of psychotherapy. Focus on different issues such as anger (Novaco, et al. 2012) and the effects on family, education on the problem and options for treatment are looked into in this process.
The combat soldiers are assigned psychiatrists to help them ascertain the level of mental torture experienced by the soldiers. These mental health providers should engage the soldier to ascertain the extent of effect of the traumatic events. Traumatized soldiers tend to change there lifestyles with an aim of forgetting the events but in the process exacerbate the symptoms. The unhealthy lifestyles they engage in involve smoking, fail to visit care providers, over eating and inadequate sleep among others.
The main objective of therapy is breaking down the patterns of self-defeat by re-examining the traumatic events and the reaction of the patient to the events. Coming to terms with the disease and the understanding of its management is important in this case. Some of the techniques which are used in enhancing the coping mechanisms of the patient include relaxation techniques which are used in fostering the relationship between the patient and those around him (Bradley et al, 2005).
Any intervention method chosen should seek to address the nature of disorders accompanying PTSD and chronic pain.Related to the PTSD is the chronic pain due to injury to the soft tissues, bone fractures, burns, neuropathic pains and pain from embedded metals in the body among others. There are pharmacological intervention strategies that may target the treatment of pain. These involve use of drugs like Non-steroidal Anti-inflammatory Drugs (NSAD’s), anti convulsants, tricyclic antidepressants among others. These drugs are aimed at managing the pains accompanying the PTSD.
Conclusion
In conclusion, post-traumatic stress disorder has emerged as an anxiety disorder that is caused by exposure to traumatic events or experiences. Posttraumatic stress disorder can be caused by exposure to stress resulting from various life experiences such as involvement in war. A huge number of combat soldiers involved in war suffer different symptoms related to posttraumatic disorder. The genesis of the use of the term posttraumatic stress disorder is the symptoms suffered by soldiers following the Vietnam War. Due to the stressful experiences of the soldiers from the war, they suffered a lot of stress that resulted in posttraumatic stress disorder. The issue has also been identified in the increasing cases of soldier receiving treatment for posttraumatic stress disorder. The effects of the disorder to the individuals suffering from the disorder, his family and the society in general have been studied. Emotional and physical health problems associated with the disorder are obvious.
More research is needed to develop measures to address the problem of posttraumatic stress disorder. Research is required to help inform more effective prevention policies and refining the current treatment options for the combat soldiers. It is also very important for policy makers in the area to develop policies aimed at addressing the problem and providing effective treatment for the soldiers with posttraumatic stress disorder. Development in prevention strategies is one of the ways of achieving a considerable solution towards this end. This is possible by researching on risk factors related to the disorder. This is also possible by developing programs to counsel the soldiers before and after deployment. Additionally, treatment and rehabilitation for returning soldiers will go a long way in addressing the issue. Researchers should continue developing models that help policy makers in the military in making informed decisions in the implementation of effective interventions. There are various difficult situations that combat soldier experience.  Although there are various options available for treatment of PTSD, there is no single method that can treat the situation. Therefore there is need for an integrated therapy that will help in dealing with the many situations faced by the soldiers.
Reference
Bradley, R., Greene, J., Russ, E., Dutra, L., Westen, D., et. al., (2005). A multidimensional Meta-            analysis of psychotherapy for ptsd. The American Journal of Psychiatry, 162(2), 214-27.            http://search.proquest.com.ezproxy2.apus.edu/docview/220485782?accountid=8289.
Kim, N. S., Paulus, D. J., Gonzalez, J. S., &Khalife, D. (2012). Proportionate responses to life      events influence clinicians' judgments of psychological abnormality. Psychological    Assessment, 24(3), 581-591. doi: 10.1037/a0026416
Novaco, R. W., Swanson, R., D., Gonzalez O. I., Gahm G. A., Regar M., D., et. al., (2012).         Anger and post combat mental health: Validation of a brief anger measure with u.s. soldiers post deployed from iraq and afghanistan. Psychological Assessment, 24(3), 661-  675, doi: http://dx.doi.org.ezproxy2.apus.edu/10.1037/a0026636
Rauch, S. A. M., Eftekhari, A., Ruzek, J. I., (2012). Review of exposure therapy: A gold standard for PTSD treatment. Journal of Rhabilitation Research and Development, 49(5),         679-687, http://search.proquest.com.ezproxy2.apus.edu/docview/1034972018?
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Reger, G. M., Durham, T. L., Tarantino, K. A., Luxton, D. D., Holloway, K. M., & Lee, J. A.       (2012). Deployed soldiers' reactions to exposure and medication treatments for PTSD.           Psychological Trauma: Theory, Research, Practice, and Policy, doi: 10.1037/a0028409
Sloan, D. M., PhD.,Bovin, M. J., PhD., &Schnurr, P. P., PhD. (2012). Review of group     treatment for PTSD. Journal of Rehabilitation Research and Development, 49(5), 689-    701. Retrieved from http://search.proquest.com/docview/1034972016?accountid=8289