Young vets see suicide as their biggest challenge

ptsd

By Debbie Gregory.

Suicide is becoming an epidemic among veterans of Iraq and Afghanistan.  Last year, more active-duty soldiers killed themselves than died in combat. And after a decade of deployments to war zones, the Pentagon is bracing for things to get much worse.

Even as the war in Afghanistan winds down,  the greatest source of frustration and heartache within the United States military is the continuing rise in the suicide rate among the troops.

Our military leaders are well aware of the human cost of this campaign. Indeed, they are attempting to address the psychological needs of the troops through a variety of programs within the military culture.

Give an Hour™ is asking mental health professionals nationwide to literally donate an hour of their time each week, and provide free mental health services to military personnel and their families. Research will guide the development of additional services needed by the military community, and appropriate networks will be created to respond to those needs. Individuals who receive services will be given the opportunity to give an hour back in their own community.

The Soldiers Project is a group of licensed mental health professionals who offer free psychological treatment to military service members (active duty, National Guard, Reserves and veterans) and their loved ones who have served or who expect to serve in the conflicts in Iraq or Afghanistan. The Soldiers Project is a private, non-profit, independent group of volunteer licensed mental health professionals including psychiatrists, psychologists, social workers, registered nurses and marriage and family therapists.

Post Traumatic Stress Disorder (PTSD) is a mental health problem that can occur after someone goes through a traumatic event like war, assault, or disaster.

There is growing awareness among healthcare providers that traumatic experiences are widespread, and that it is common for people who have been traumatized to develop medical and psychological symptoms associated with the experience.

The preferred treatments for PTSD are psychotherapy (“talk” therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health care provider who is experienced with PTSD. Those with PTSD need to try different treatments to find what works for them.

Tragedy Assistance Program for Survivors (TAPS) is the 24/7 tragedy assistance resource for ANYONE who has suffered the loss of a military loved one, regardless of the relationship to the deceased or the circumstance of the death.

Founded out of tragedy in 1994, TAPS has established itself as the front line resource to the families and loved ones of our military men and women.  TAPS provides comfort and care through comprehensive services and programs, including peer based emotional support, casework assistance, connections to community-based care, and grief and trauma resources.

VA professionals at the Veterans Crisis Line (1-800-273-8255 and Press 1) offer confidential resources that connect Veterans in crisis and their families and friends with qualified, caring VA responders. The specially trained and experienced professionals help Veterans of all ages and circumstances—from Veterans coping with mental health issues that were never addressed, to recent Veterans struggling with relationships, or the transition back to civilian life.

The Aftermath of War

Greg Rivers

By Debbie Gregory.

For many veterans the aftermath of war means dealing with Post Traumatic Stress Syndrome (PTSD). PTSD is a type of anxiety disorder. It can occur after an extreme emotional trauma that involves the threat of injury or death.

PTSD is a real and potentially debilitating anxiety disorder triggered by exposure to a traumatic experience such as an interpersonal event like physical exposure to a disaster, accident or combat, or witnessing a traumatic event.

Post-Traumatic Stress Disorder and Traumatic Brain Injury (TBI) have left their mark on many returning service members.  Moses Maddox is just one veteran who has returned from deployment in Iraq, suffering from PTSD, and trying to rebuild his life.

Mike Liguori returned home after two tours in Iraq with the Marines, and then slipped into a depression that, at its depths, left him contemplating suicide. But the San Carlos native emerged from the darkness of post-traumatic stress disorder, and today feels his life is in a great place. He still has one big problem: he needs a job.

A key fear is how a PTSD diagnosis could be contributing to higher joblessness among the generation who enlisted after the 9/11 attacks. Because employers are barred, by law, from asking job applicants about mental health conditions, many assume that any veteran can be afflicted with PTSD, even though the vast majority of them returned from war without emotional problems, researchers and veterans advocates say.

Why do veteran jobs play such an important role in the recovery of returning service members with PTSD? Employment enables many people with disabilities and combat-related conditions, including those with PTSD, to fully participate in society. In fact, according to the National Council on Disability, people who regain employment following the onset of a disability report higher life satisfaction and better adjustment than those who are unemployed. At the most fundamental level, employment generates income, which is vital to individual and family economic well-being. Given how closely our identities are tied to our occupation, employment plays a critical role in maintaining our self-esteem. Furthermore, employment affords opportunities to experience success which is a critical element towards psychological health. It facilitates social interaction and connections that can reduce the isolation that is commonly experienced through depression and PTSD. For these reasons, gainful employment can be an important component in the recovery and rehabilitation of people with PTSD.

Corporate America and the White House are becoming acutely aware that something must be done to help returning veterans find jobs.

MilitaryConnection.com’s Veteran Job Search begins with the Virtual Job Fair and continues to the Job Board. The employment resources focus on transitioning military, Guard/Reserve, Veterans, Military Spouses, or anyone who is searching for a job. Your job search will enable you to look for jobs in occupational areas across the board, nationwide and worldwide. MilitaryConnection.com has partnered with a number of employment resources such as Indeed, NCOA and the Department of Defense to aid your job search by providing thousands of job listings.

The Obama administration has teamed with the private sector on an initiative called “Joining Forces,” which seeks to find at least 15,000 jobs for veterans in coming years.  MilitaryConnection.com is a proud supporter of Joining Forces and a Top 100 Employment web site.  According to CEO Debbie Gregory, “Companies hiring Veterans end up with employees with an extraordinary work ethic that are disciplined and will reach their goals/mission.”  Gregory also provides employers detailed information on the tax incentives in the VOW To Hire Heroes Act.

Fighting An Uphill Battle

fighting uphill battle

By Debbie Gregory.

Studies have found that almost one in five veterans returning from Iraq and Afghanistan suffer from PTSD. But as the Army continues to wage war on the battlefield, commanders are having difficulty fulfilling the needs of its soldiers as they wage their own battle against PTSD. It has resulted, in many cases, in soldiers, many decorated for their service, running into trouble and being discharged.

For Capt. Anthony Martinez, PTSD was the beginning of the end of his 16-year military career.

Martinez, 34, immigrated to the United States at age 13 from the Philippines. He didn’t speak English. His stepmother abused and starved him and his younger brother. The Army offered an escape. And Martinez excelled at what he saw as a new chance at life. At his first duty station officers encouraged him to apply to the United States Military Academy at West Point. He was accepted in graduated in 2004 with high marks.

On his first deployment to Iraq in 2006 a good friend was killed, rattling Martinez. Once home, he began showing signs of PTSD. He punched holes in his walls and drank heavily. In 2009, he deployed again as a small, 11-man team assigned to a base with thousands of Iraq soldier who they were helping to train. Martinez and his men felt unsafe and slept with loaded rifles. They grew more and more suspicious over the deployment as several incidents unfolded: Martinez was fired on while training local soldiers, a mortar was launched at their building and interpreters proved to be untrustworthy.

After the deployment, Martinez was shipped to an intensive three-course military class. There he was aggressive in class and failed the material. Doctors diagnosed him with adjustment disorder, anxiety and depression.

Next he volunteered to teach soldiers at a training center. There, his PTSD symptoms worsened. He says he couldn’t sleep or function. By the time he returned home, he was sleeping only two to three hours a night. He suffered anxiety attacks in crowds. He was drinking heavily. The psychologist changed his diagnosis to PTSD. At the same time, his unit chose him to command Headquarters company. When Martinez asked to be removed from the position because of his diagnosis and continuing health problems, he was told no.

After he took command, his unit had six months to prepare for deployment. Martinez began to crack under the pressure. Senior NCOs recognized his difficulties handling the job and recovering from PTSD and asked that he be relieved of his duties. Their requests were ignored.

With each red flag and warning signal that Martinez was suffering more, commanders ignored both his pleas for help and of those around him.

Six weeks before shipping off, Martinez threatened suicide. Then he wrote a formal memo detailing who should take over the company if he had a mental breakdown while in Afghanistan.

Martinez’s commanders still sent him to war. When he arrived in Afghanistan, Martinez quickly cracked. He isolated himself, had angry, irrational outbursts and threatened two soldiers.

He told one to get out of his office “or I’ll shoot you in the face.” Then, during an argument with his supply sergeant, he ordered a private in the room to load his weapon — an unheard of escalation on a fellow soldier.

Now the Army wants to act. Martinez is facing a general discharge. Despite the repeated pleas for help and signs of Martinez’s deteriorating mental health, his battalion commander, Lt. Col. Calvin Downey wrote that Martinez “made a series of decisions that led to unfortunate circumstances.

Martinez’s lawyer, Douglas Cody, said there were many points along the way where the Army could have prevented this outcome and gotten Martinez the help he needed.

“That’s the tragedy of the situation,” he said. “They set him up for failure and now are abandoning him.”

Martinez’s fate will soon be in the hands of the secretary of the Army. He will decide whether the captain should be medically discharged or kicked out for misconduct.

PTSD: Myths and Reality

ptsd

By Debbie Gregory.

Post-Traumatic Stress Disorder is not strictly a battlefield injury. Victims of accidents, serious injury or even severe mental stress can suffer very serious effects from the disorder. However, the general public continues to believe a number of myths about the disorder as people both in and out of uniform work to recover. And recovery can be a long and difficult process. Brig. Gen. (Dr.) John M. Cho, deputy chief of staff for operations with Army Medical Command, has said “The invisible wounds — post-traumatic stress disorder and traumatic brain injury — are just as damaging as the visible ones. They impact the families as well as the soldiers.”

Often those who suffer, or their families, must first overcome the misperceptions they have before they take the first important step of seeking help.

The most common myths:

  1. Seeking help will kill my career: Actually, the opposite is true- going without help/treatment can negatively impact your career. PTSD can lead to worsened health conditions and cause individuals to have angry outbursts, fight or have difficulty at work and in their personal relationships. That, in turn, could lead to actions that will destroy careers. Instead, service members who suffer from PTSD can seek help, work to get their health under control and, under a new regulation, they do not have to release information about their treatment for deployment-related psychological health conditions.
  1. Everyone will know: Untrue. Treatment for psychological health is generally confidential. Service members who still are not comfortable seeking help at the base health facility can talk to their chaplain about receiving off-base resources.
  1. Treatment doesn’t work: Scientists have logged decades of research in treatment for PTSD, and have found several forms of counseling and medications that have proven to help PTSD symptoms. Non-traditional treatments, such as sports, have also shown promising results. Both science and the DOD continue to develop and research treatments and have developed mobile apps to help those who suffer from symptoms.

PTSD is a very real and difficult disorder. Finding help and treatment for every service member who suffers from PTSD is so important to the current administration that President Obama recently hosted a symposium about Traumatic Brain Injury at the White House. The VA has also exponentially increased its spending and manpower dedicated to helping service members find treatment and deal with PTSD symptoms.

The bottom line is simple… it is crucial to seek treatment and begin the journey to healing from PTSD. The programs are in place and help is available. The key taking the first step and asking for help.

Get the facts on PTSD

ptsd

By Debbie Gregory.

Post-Traumatic Stress Disorder can be experienced by anyone after witnessing or enduring a traumatic event. While PTSD has recently become intertwined with the post-war experience of many Iraq and Afghanistan veterans, anyone can suffer from it. In fact, nearly 8 percent of the U.S. population will experience some level of the disorder in their lifetime. Still, the general public continues to believe myths and misconceptions about the disorder as people both in and out of the military struggle to recover.

The most common misconceptions:

  1. PTSD is in your head, it’s something you make up. As previously stated, PTSD may occur after someone is involved or witnesses a traumatic experience. Symptoms may not surface for hours or years afterwards. Often, classic PTSD symptoms such as nightmares, hyper-vigilance, short-temper, social disconnect or the feeling of always being on-edge may be triggered by later events. The trigger could be the anniversary of the trauma, loud noises, or stressful situations. Those who suffer from PTSD view the world differently, because in order to process the pain, their brains function differently following the trauma.
  2. Weak people suffer from PTSD. There is no one type of personality prone to suffering from PTSD. Many recent military leaders and Medal of Honor recipients have publicly documented their struggles with PTSD to encourage others to seek help.
  3. Only wounded soldiers suffer from PTSD. Anyone who has suffered a traumatic or highly stressful event can suffer from PTSD. In the aftermath of the Sept. 11, 2001 attacks, many of the civilian rescue crews who picked through the rubble to locate victim’s bodies suffered PTSD. They were never harmed, and may not have been present on the day of the attack, but the process of cleaning up was stressful and damaging enough to prompt the onset of PTSD.
  4. Why doesn’t everyone who has suffered a trauma experience PTSD? It takes more than a horrible event to cause an individual to suffer PTSD. Researchers have found that many things play a role in determining who will develop PTSD, including genetics, past history of other traumas and the degree or duration of their exposure to traumatic events. Not everyone will develop PTSD after a traumatic event. However, for those that do, the disorder is a very real and difficult struggle.

If you or someone you know is or might be suffering from PTSD, take action and ask for help. Every branch of the military has developed programs to help servicemembers work toward recovery.

Check for resources at the National Directory (NRD),the Defense Centers of Excellence (DCoE), the Department of Veterans Affairs (VA) as well as the Services’ wounded warrior programs: Navy Safe Harbor, Army Wounded Warrior (AW2), Air Force Wounded Warrior (AFW2), the Marine Corps Wounded Warrior Regiment (USMCWWR) and the USSOCOM Care Coalition.

White House directs resources to target military and veteran mental health issues

Enduring Freedom

By Debbie Gregory.

Thousands of mental health providers, millions of dollars, and hundreds of mental health summits across the nation – the White House is arming the VA to tackle mental health issues and get help for every veteran who needs it.

As he opened the National Conference on Mental Health, President Barack Obama said, “Today, we lose 22 veterans a day to suicide — 22. We’ve got to do a better job … of preventing these all-too-often silent tragedies. That’s why we’ve poured an enormous amount of resources into high-quality care and better treatment for our troops.”

The White House is hosting the conference as the first of a series of steps to assist the nation in combating diagnoses such as PTSD and TBI. One in five adults suffers from mental illness, and still the diseases routinely are untreated. President Obama hopes to end the stigma that often comes with a diagnosis.  Obama singled out service members and veterans who struggle with mental health issues, but are afraid to get help.

“We see it in veterans who come home from the battlefield with the invisible wounds of war but who feel, somehow, that seeking treatment is a sign of weakness when, in fact, it’s a sign of strength,” the president said.

In conjunction with the conference, the VA announced that it met the president’s goal to hire 1,600 new mental health professionals to give better access to mental health services for veterans, service members and military family members. Obama set the goal in an executive order in August, 2013.

Secretary of Veterans Affairs Eric K. Shinseki said, “Meeting this goal is an important achievement, but we recognize that we must continue to increase access to the quality mental health care Veterans have earned and deserve.”

The VA has also hired 318 new peer specialists and expects to meet the goal of hiring 800 peer specialists by Dec. 31, 2013 as outlined in the Executive Order.  The department also has enhanced the capacity of its crisis line by 50 percent and established 24 pilot projects in nine states where VA is partnering with community mental-health providers to help veterans more quickly access mental health services.

In addition to hiring more mental health professionals, VA is expanding the use of innovative technology to serve Veterans in rural or underserved areas. VA expects to increase the number of Veterans receiving care from tele-mental health services in fiscal year 2013, and has increased the number of Vet Centers, which provide readjustment counseling and referral services from 233 in 2008 to 300 in 2012.

This summer, the VA is directing 151 of its health care centers nationwide to conduct mental health summits with community partners, which include local government officials, community-based organizations and veteran service organizations. The summits will identify and link community-based resources to support the mental health needs of veterans and their families and increase awareness of VA programs and services.

The president also announced an online effort to combat mental illness. The White House launched http://mentalhealth.gov, a consumer-friendly website with tools that help users with the basics of mental health and the signs of mental illness, and show them how to talk about mental health and how to get help. The site also features interviews with celebrities and other Americans who have been affected by mental illness.

The VA previously launched an award-winning, national public awareness campaign called Make the Connection, aimed at reducing the stigma associated with seeking mental health care. It also informed Veterans, their families, friends, and members of their communities about VA resources. To view the site, visit, www.maketheconnection.net.

Yoga program focuses on wounded warriors

yoga

By Debbie Gregory.

Post Traumatic Stress Disorder (PTSD) is a severe anxiety disorder, usually occurring after an extremely stressful event, such as the threat of violent death or serious injury.

Working in the psychiatric ward at Landstuhl Regional Medical Center, Lt. Col. Shaye Molendyke has seen PTSD and the effects of war, up close and personal. A number of years ago, after a severe injury, Molendyke began yoga training.  Many years later, she decided to take her love of yoga to the next level, combining her counseling skills honed at Landstuhl with her knowledge of yoga, developing a new program called “YogaFit for Warriors”.

YogaFit for Warriors has been specifically developed to help wounded warriors, emergency responders, and those who suffer from PTSD, stress, anxiety and other mental and physical traumas.

The stigma of PTSD prevents members of the military from coming forward and seeking help. A new study in the Journal of Alternative and Complementary Medicine indicates that active-duty troops are using some alternative therapies such as massage therapy, meditation and guided imagery therapy for stress reduction at rates up to seven times higher than civilians.

When most people think about the military, a calm yoga room is probably the last thing that comes to mind. But with veteran unemployment, substance abuse, and suicide rates due to post-traumatic stress disorder (PTSD) on the rise, the U.S. Armed Forces are using yoga to do what conventional drugs and therapy cannot. Trauma-sensitive yoga helps people suffering from traumatic stress, with the added benefit of increased strength, flexibility, agility and relaxation

Over the next six months, Molendyke plans to visit Army bases that include Fort Campbell, Ky.; Fort Bliss, Texas; Joint base San Antonio and Fort Belvoir, VA., to train yoga instructors in trauma-sensitive yoga. It’s always great to see new progress when it comes to helping those with PTSD.

While yoga is not a cure for PTSD, it has already become an important tool used to treat PTSD effectively and efficiently.

Iraq Vet Loses Struggle With PTSD

By Debbie Gregory.

Army psychologist Capt. Peter Linnerooth helped many soldiers deal with the demons of PTSD, depression and anger.  Unfortunately, after returning home to Minnesota, he wrestled with the same  PTSD demons as those he counseled, and lost. The wonderful man and officer who helped so many others, was not able to save himself.  Peter Linnerooth  died by his own hand in January, 2013. A fight with his wife, alcohol and a loaded gun proved a tragic combination.

Linnerooth had the magic touch. He was genuinely empathetic. He listened to the soldiers’ stories and comforted them. He was their counselor and their friend. He knew how to sooth soldiers returning from the battlefield, after losing their buddies who were killed by bombs. He comforted medics reliving the horrors of death all around them.

Linnerooth helped soldiers who suffered from nightmares, reliving the horrors they had witnessed. He soothed the heavy hearts of soldiers with insomnia.   He was there for soldiers suffering from PTSD and depression.  When the Iraq war was at it bloodiest, Linnerooth easily put in 60 to 70 hours a week. He carried the pain of those around him on his shoulders. He had the right stuff to help others.

After leaving the military, Linnerooth became a college professor in Minnesota. He continued to counsel veterans in California and Nevada. He always felt that he could have done more to help the troops. At the same time, he struggled with his own demons. He struggled with PTSD, depression and anger.

Linnerooth was always there for others, but in the end, he gave up on himself.  Peter Linnerooth was a devoted father and an admired Army captain. He was 42, but in reality, he was much older.  Working to help others, no matter how much he accomplished , he never felt it was enough. But to the many soldiers who are alive today because of his counsel, it was.  Our sincere condolences to the loved ones of Captain Peter Linnerooth who made a huge difference for so many.  Rest In Peace.

Gender Related PTSD

By Debbie Gregory.

Researchers at the Department of Veterans Affairs are initiating studies into the complexities of post-traumatic stress disorder and how it differentiates between genders.

According to Dr. Sonja Batten, the V.A.’s Deputy Chief Consultant for Specialty Mental Health, women are twice as likely as men to develop post-traumatic stress disorder. But, she says, “Among recent returnees seeking care at the Veterans Administration,  PTSD rates among Veteran men and Veteran women  are the same.” Dr. Batten further explains, “Statistics such as these suggest the need to better understand the role of gender in PTSD, particularly as it may impact our Veterans seeking care.”

A recent Veteran Administration study examined how men and women learn to fear. Dr. Sabra Inslicht, who is involved in the study, is a staff psychologist at the San Francisco Medical Center, and also Assistant Professor of Psychiatry at the University of California, San Francisco. Her work on the subject was published in the Journal of Psychiatric Research.

In her study, Dr. Inslicht and her team of researchers enlisted 18 males and 13 females, all diagnosed with PTSD. Electrodes were attached to the palms of each participant’s hands. The research staff was then able to detect and measure criteria in each subject’s physiological response to visual stimuli of computer-generated images. Following specific generated images, the test subject was issued a minor electrical shock. Eventually, the test subject associated the particular images with a gradual, unpleasant discomfort. “They learned to anticipate the impending shock,” Dr. Inslicht remarked. “They learned the danger cues. We call this ‘fear conditioning.”’

“We discovered that women responded more strongly to the visual cues than men, when they saw a particular image that they knew was going to be followed by an electric shock,” said Dr. Inslicht. “This suggests that women conditioned more robustly than men. In our future work, we’d like to get a better understanding as to why these differences may occur.”

According to Dr. Inslicht, this fight or flight response can sometimes persist, even in non-threatening circumstances. “When you’re unable to turn it off in safe situations, the stress becomes prolonged. This can cause wear and tear on both the mind and the body,” she said. “When this heightened reactivity starts to negatively impact your daily life, we worry about post-traumatic stress.”

Dr. Insicht went on to say, “Fear extinction occurs when you are gradually exposed to the previous learned danger cues, such as crowds, and you gradually learn to realize that the cue will not be followed by a potentially stressful, traumatic event. Since fear-extinction learning is significant for recovery from PTSD, a deeper understanding of this process could alter our strategy for how we treat PTSD in Veteran men and Veteran women.”

Researchers are cognizant that this is a new field of study with much to learn concerning fear and extinction mechanisms and their relationship to PTSD, especially for Veterans.

Veteran Healthcare on the Streets

By Debbie Gregory.

Homeless veterans are now receiving healthcare assistance by VA doctors. The Veterans Administration has a new program. VA doctors are taking it to the streets.

Many homeless veterans are suffering from post-traumatic stress disorder (PTSD) and other ailments. Veterans are 50% more likely to become homeless than the average American. Homeless veterans account for nearly 20% of the homeless population living on the streets and in shelters in Los Angeles.  The Veterans Administration states that they are making slow but measurable progress toward eliminating homelessness among veterans by 2014.

A new VA program is sending teams of healthcare providers to the streets to provide homeless veterans with the same healthcare they would receive at a VA medical center. The idea is to help veterans overcome barriers to obtaining good healthcare services.

Homeless Patient Aligned Care Team (HPACT), which focuses on the primary healthcare needs of homeless Veterans in coordination with housing programs.  This program is up and running in over thirty sites with another eight sites in the stages of development  and  planning.  The HPACT is built at the intersection between two successful healthcare models, the Healthcare for the Homeless Primary Care Clinics and the Patient-Centered Medical Home.

Often both the physical and mental illnesses of Veterans are not being treated. Sometimes a Veteran might  need help to register for supplemental programs such as food stamps.  The long-term goal is to create a VA healthcare team with one primary care provider and one mental health provider to provide services for Veterans who are homeless.

The VA’s new Homeless Patient Aligned Care Teams (HPACT) are modeled after both of these successful interventions, and tailored to the needs of homeless Veterans.  This is accomplished by creating a hub in order for homeless Veterans to access housing and stabilization services that have recently been developed and expanded across the VA system.  In addition, the HPACT program has a robust evaluation component so that the intervention can be assessed for quality and cost-effectiveness. It is expected that the evaluation will show that participating Veterans will have a marked decrease in utilization of expensive healthcare crisis services such as emergency department visits and inpatient admissions that are avoidable.

Dr. Thomas O’Toole is the Medical Director of the Providence clinic as well as the Medical Director of the national HPACT program. Dr.  O’Toole believes that the intersection of chronic pain and addiction can often be an underlying issue that can lead to failure of permanent supportive housing for Veterans.

This new program has doctors out in the streets to evaluate and provide healthcare for homeless veterans. The healthcare delivery system is taking another innovative step forward to be Veteran-centric in its service model. Over the next two years, this sensible, cost-effective system of care (HPACT) promises to significantly contributing toward achieving the goal of ending homelessness among Veterans by 2015.

Military Connection is excited about this program because it will provide much needed healthcare for Veterans who are not able to come to the VA.   Physicians, nurses, allied health professionals and social workers will be in the trenches to bring healthcare services to our homeless Veterans.