Healing Combat Trauma

The Carrot or the Stick: A Specialized "Cocktail" for PTSD?

Carrot of Hope is a nonprofit organization on the Web of individuals with PTSD, who are trying to pool their experiential knowledge base in order to create a better future for those with PTSD.  It's hard to figure out much from their website about what they're about, but perhaps that's just because they're a work in progress. 

However, much of the group's enthusiasm seems to center around a "PTSD cocktail," using various chemicals, that they feel -- from their members' accumulated experience with it -- has some beneficial effect on PTSD.  Apparently they are both trying to raise money to study the effects of this cocktail on PTSD, and also provide resources so that those with PTSD can take the information to their doctors and/or health care providers, and initiate a dialogue about whether this treatment might be beneficial.  Worth checking out -- especially worth sharing with your health care provider, to see if it might have promise in your particular case.

They say that they are "currently taking donations to fund a research project studying the role of the MAO-A enzyme in post-traumatic stress."  According to them, "the Monoamineoxidase-A (MAO-A) removes catecholamines (fight or flight chemicals) from the body," and that "studying MAO-A levels in PTSD patients could be a major key in curing" and possibly even "preventing PTSD in the future.

The article on their website about understanding catecholamines is linked here, and th material about the "PTSD cocktail," which contains three ingredients -- Geodon [Zeldox, Ziprasidone] (20 mg); Propranolol [Inderal] (10-20 mg); and Vistaril (25 mg) -- is linked here.  The main website is linked here.

Study Shows Mind-Body Medicine Works on PTSD

(Just what we've been talking about, and who we've just been talking about as well.  Heh.  Love that.  So confirming...)

Read down and see how therapeutic this would be for people in rural communities, with little or no access to the VA, who are in therapy or not, for DIY types and those who prefer to access healthcare through a practitioner of one kind or another.  Just wonderful... and we knew it all along :-)

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The Washington, DC based Center for Mind-Body Medicine (CMBM) announced today the publication of a landmark study on the use of its comprehensive, non-drug model to treat posttraumatic stress disorder (PTSD) in war traumatized children. The study, “Treatment of Posttraumatic Stress Disorder in Post-War Kosovar Adolescents Using Mind-Body Skills Groups: A Randomized Controlled Trial,” which was published today online in the Journal of Clinical Psychiatry is the first randomized controlled trial (RCT) ever of any intervention with war traumatized children. It is also the first RCT of a successful, comprehensive mind-body approach with any traumatized population.

The study demonstrates that the Center’s groundbreaking model can be used to produce highly significant and lasting changes in levels of stress, flashbacks, nightmares, and symptoms of withdrawal and numbing in highly traumatized children – those who lived in an area of Kosovo where in 1999 90% of the homes were burned and bombed and 20% of the children lost one or both parents.

 The CMBM approach includes self-expression and mind-body techniques and was offered to these children over 12 sessions in an educational, supportive small group setting. Eighty-two high school students in Kosovo participated in the study. The program was conducted by teachers and included meditation, guided imagery, breathing techniques, and biofeedback as well as self-expression through words, drawings, and movement. All the students met the criteria for posttraumatic stress disorder (PTSD) which was measured using the Harvard Trauma Questionnaire. Following the program, the number of students having symptoms indicating PTSD was significantly reduced from 100% to 18%. The reduction in symptoms was maintained at a 3 month follow-up. The improvement in PTSD symptoms was significantly greater compared to a similar group of students who did not participate in the mind-body skills program. This is the same model that CMBM’s founder and director, James S. Gordon, M.D., describes in detail in his new book, Unstuck: Your Guide to the Seven Stage Journey Out of Depression.

“This RCT,” Dr. Gordon, the lead author, says, “is important because it provides scientific evidence for the efficacy of a model that has been taught to almost 3,000 health and mental health professionals and educators worldwide. We’ve used this small group model to give tens of thousands of children and adults practical tools that help them to feel better quickly, and we’ve taught them to use their intuition and imagination to solve problems that had seemed overwhelming. We help traumatized people around the world to draw on strengths they may have forgotten they have, and we offer them a ‘safe place’ in which they can share their pain with others who have suffered as they have.”

“This model is educational, non-stigmatizing, and powerfully effective. It can be easily taught and can be used by people of all ages on their own,” Dr. Gordon explains. “It’s highly acceptable to populations which do not want to be given medication, those with no access to a doctor or therapist, and those who are in psychotherapy.”

This model, which Dr. Gordon presents in a step-by-step self-help format in Unstuck, is currently being used by CMBM with war traumatized populations in Israel and Gaza as well as in post-Katrina southern Louisiana. It is widely used with anxious and depressed people and those with chronic illness in the US, and has already been incorporated as a stress reduction program for students in a dozen US medical schools.

The CMBM model is also of increasing interest to the US Department of Defense and the Veterans Administration. “The military,” Dr. Gordon says, “understands the breadth and depth of the psychological crisis (as many as 300,000 returning veterans are expected to have posttraumatic stress disorder or major depressive disorder, and another 320,000 will have been made vulnerable to these conditions by traumatic brain injury). The military’s leadership is committed to finding evidence-based approaches, like the one taught by The Center for Mind-Body Medicine, that can make a difference for the individual veteran and his/her family, an approach that can be taught to the large numbers of professionals and peer counselors who serve them.” More than 100 health and mental health professionals who work with the military are expected at the next CMBM training in mind-body medicine on October 25-29 in Minneapolis, and many more are expressing interest in learning and using the CMBM model.

For more information about the upcoming training, click here,  or to order Unstuck: Your Guide to the Seven-Stage Journey Out of Depression", please email The Center for Mind-Body Medicine (CMBM) at mindbody@cmbm.org or visit www.cmbm.org.

Refusing to Be a Victim - Rising Above - Giving Back - Changing the World

The Survivor's Pledge:

I will not be a victim.
I will rise above.
I will give back.
I will change the world.

From the new book entitled I Will Not Be Broken: Five Steps to Overcoming a Life Crisis, by Jerry White.

From the product description: "The loss of a loved one, a painful divorce, or a serious physical injury---we must all, at one point, face tragedy---unavoidable moments that divide our lives into “before” and “after.” How do we muscle our way through tough times and emerge stronger, wiser---even grateful for our struggle? In 1984, author Jerry White lost his leg---and almost his life---in a landmine accident. He has endured the pain of loss and the challenge of rebuilding.  As cofounder of Survivors Corps, White has interviewed thousands of victims of tragedy.  With this book, he shares what he has learned."

CJ, over at "A Soldier's Perspective" blog, has been raving about this book: He wants every general in the military to give a copy of this book "as a gift for EVERY Soldier injured in combat and to every family who has lost lost someone in Iraq or Afghanistan."  He writes: 

Having been to Walter Reed many times while I was stationed in the DC area, I can tell you that the way Soldiers deal with their life-changing events varies almost to the Soldier. It's safe to say that you can categorize those Soldiers into one of three groups: those who have accepted their fate and make the best of it, those that are trying to deal with it and may or may not seek help, and finally the victims.

He says:

Today, we have soldiers coming home by the thousands with wounds that are both physical and psychological. Even after the physical wounds have healed, soldiers must learn to deal with the emotional wounds still needing to be patched up. For many soldiers, feelings of embarrassment, inadequacy, and remorse overpower their lives as they attempt to deal with these issues alone.

In other words, it's not such a bad idea to get them thinking quickly about surviving.

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Last year around this time, I was down in the "OC" visiting a longtime friend who I hadn't seen in years. At a bookstore, I bought a copy of a book with a potentially intriguing title, "Deep Survival: Who Lives, Who Dies, And Why."  One of the perils, I guess, of having dated someone who climbed Mt. Everest years ago is thinking I ought to find books with lots of material in them about mountaineering interesting (this one has that).  However, it's sat on my shelf ever since then. 

Quite honestly, Jerry Wright's book sounds much more interesting -- he positions his theme about not just surviving, but not being broken on the anvil of life as tragedy can do: in fact, getting up, succeeding, and giving back.  Wow. If a book like this can motivate veterans to believe their life isn't over because they're suffering intensely from "things they don't understand how to fix" (combat trauma, and resultant PTSD) -- I hope it does get into the hands of veterans, if it can do some good.  And it sounds like it really can, mostly from the motivational pespective.  Great...

How to Follow Legislative Progress on Bills That Concern Veterans, PTSD and Other Issues

"Founding Father" Thomas Jefferson was a firm believer in "open" or "transparent"  government -- and the principle of getting information into the hands of those democratically governed.  As a nod to his considerable contributions, the Library of Congress named their website for following legislation in progress after him -- the "Thomas" site.  It's a veritable "one-stop shopping" Web site for following progress on proposed legislation of concern to veterans and their families -- bills that are currently, or soon to be before the House of Representatives or the Senate.  The Thomas site, linked here, is a free service of the Library of Congress -- in other words, our tax dollars at work.  Go there and punch in any keywords of particular interest to you, such as "veterans" and "PTSD," and it will return a list of the bills that have been introduced to Congress and/or are being voted on, which include those specific terms.  Then you will be able to follow the progress of those bills more closely.

Fortunately, organizations such as the IAVA, VoteVets and others, also are in the habit of letting their members know when something they consider important is getting close to a vote, so that members can take the initiative to call their senators and representatives.  The recent successful passage of the new GI Bill was testament to those organizations' ability to get the word out from their constituents that passage was vitally important.  However, organizations will typically focus only on the bigger proposed bills, or ones with the greatest possible impact to their membership.  It behooves ordinary citizens -- you, me, us -- to become more aware in general of what proposed legislation is in the pipeline, so to speak, before it's voted on.  Then, in case we care to get more involved, or convey our point of view on it to our elected representatives.  Following a bill's progress, from proposal through passage or veto, at a site like the comprehensive Thomas site, is one way to do that.

Another way, that takes advantage of contemporary concepts like RSS feeds, is offered by OpenCongress.org, linked here.  A joint project of the Sunlight Foundation and the Participatory Politics Foundation, OpenCongress is a free, open-source, non-profit, and non-partisan web resource with a mission to help make Congress more transparent and to encourage civic engagement. As they say on their web site:

OpenCongress brings together official government information with news and blog coverage to give you the real story behind what's happening in Congress.

For most people, finding out what's really happening in Congress is a daunting and time-consuming task. The legislative process is frequently arcane and closed-off from the public, resulting in frustration with Congress and apathy about politics.

Small groups of political insiders and lobbyists know what's really going on in Congress, but this important information rarely makes its way into the light. The official website of the library of Congress, Thomas, publishes the full text of bills, but we can do much more to inform ourselves and make our government accessible. Now, with OpenCongress, everyone can be an insider.

What I liked, in particular, about their site is the alphabetical index to issues.  Under "V," you can find those issues with "veteran" in the name -- including veteran's benefits, disability compensation, education, employment, hospitals, loans, medical care, organizations, pensions and rehabilitation.  If you want to search for bills relating to post-traumatic stress disorder, or PTSD, that also has its own category, and is linked here.  You can even subscribe to that category via RSS feed, so you can track that issue, and always kept apprised of what's going on in that area, with a minimum of effort -- because it comes to you, instead of your having to go out and find it (great!).  (For the link to veterans, click here.  For subsets of veteran issues, such as the ones named above, you have to search within "V" because they're listed alphabetically, starting with "veteran" as a prefix.)

If you're as big a fan of Facebook as I am, you'll note that OpenCongress.org has both a group, linked here, and a special application for Facebook users, linked here, to track bills on their profiles. (Yay.)

Editor's note: Thanks to subject matter expert, GuvBoy, for turning me on to the Thomas site.  (And if he ever learns to embrace Facebook, let's hope I returned the favor by turning him on to OpenCongress.org.)

Mind Body Medicine: Healing the Troops

We've talked about James S. Gordon, M.D.'s Center for Mind-Body Medicine and their successes in "Healing the Wounds of War" recently on this blog, and the wait to see if they would revamp this program to address the needs of PTSD and the troops.  Finally, at long last...The Center for Mind-Body Medicine's program for Healing the Troops, informational material linked here.

From their website:

The Center has created a program of training in mind-body medicine and on-going support for physicians and mental health professionals working with veterans returning from Iraq and Afghanistan as a first step to providing veterans with a powerful and healthy approach to dealing with the stress of war and to enhancing their resiliency.

This program will be a significant focus at our Fall 2008 Mind-Body Medicine training, for which we have received funding to bring 20 military healthcare professionals on scholarship. We are seeking additional funding for this important effort.

Also from their website:

The Center for Mind-Body Medicine has developed a trauma relief program utilizing mind-body skills including biofeedback, relaxation, guided imagery, meditation, drawing, and breathing exercises that has been used successfully around the world.

This program, which is presented in small educational groups, has the advantage of enhancing veterans’ capacity to help themselves while mobilizing social support crucial to full recovery. The Center has used this program to assist in population-wide healing efforts in war-torn and traumatized regions around the world, including Bosnia, Kosovo, Macedonia, Israel and Gaza , and in the United States with NYC firefighters post-9/11 and in post-Katrina Louisiana.

Further information about the 2008 conference is linked here. Dr. Gordon's bio is linked here.

"Give an Hour" Helps Fill Veterans Counseling Gap

Give an Hour -- the foundation that matches member psychogists and counselors with veterans and their families in need of counseling at no charge -- to fill the currently unmet gap in mental health services, has been in the news recently.  (You can learn more about Give an Hour's founder, Barbara V. Romberg, Ph.D., in her bio, linked here). It's truly fantastic to see this public-spirited act of service on the part of Give an Hour; at the same time, it's a shame that private industry, so to speak, has to jump in to fill the unmet gap of mental health care -- the need for which care is an entirely predictable "soft cost" of going to war.  Nevertheless, good stuff, and very altruistic and forward-thinking on the part of Dr. Romberg and her organization.

From a press release:

The American Psychiatric Foundation, Lilly Foundation And Give An Hour Join Forces To Provide Mental Health Care To Iraq And Afghanistan Veterans

Heeding the call of a growing public health crisis -- the unmet mental health needs of returning soldiers and their families -- Give an Hour (GAH) and the American Psychiatric Foundation (APF) announced a major expansion of a nationwide effort to help U.S. veterans returning from Iraq and Afghanistan.

GAH and APF, the philanthropic and educational arm of the American Psychiatric Association (APA), will be using a $1 million grant from the Lilly Foundation to recruit and educate volunteer mental health professionals, who will become part of a network aiming to bridge the gap in mental health services for soldiers returning from service, as well as their families. Among troops returning from Iraq and Afghanistan, approximately 40 percent of soldiers, a third of Marines, and half of the National Guard members report psychological problems, but mental health services are in short supply.

"This all-volunteer effort provides badly needed support to help our veterans, many of whom come home with mental health needs," said U.S. Representative Steve Buyer (R-Indiana), Ranking Member, House Committee on Veterans' Affairs. "I applaud the hard work of Give an Hour, the American Psychiatric Foundation, and the Lilly Foundation, which are stepping up to help those who have selflessly served."

Efforts will be made to create a large, national, volunteer network over the next three years to address postwar mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), drug abuse, anxiety and depression.

"This grant will allow us to get out the message that help is available. We want to normalize what our military personnel and their families are experiencing and support the sacrifices that they are making by providing critical mental health support at no cost," said Barbara V. Romberg, Ph.D., founder and president of GAH. "We will be educating the military community and broader public about these mental health needs in hope of helping veterans keep their lives and families intact."

GAH is recruiting mental health professionals to volunteer one hour each week for a minimum of one year to provide direct services in person, by phone or in consultation with schools and community organizations that serve the military community. Services are wide-ranging and include marital and family therapy, substance abuse counseling and treatment for PTSD. APF brings strong ties to the psychiatric community and is actively encouraging psychiatrists to join the network.

"This grant will help us reach our goal of recruiting 10 percent of the 400,000 mental health professionals in the United States by 2015 to assist in this effort," said Dr. Richard K. Harding, M.D., president of the APF. "It is an ambitious goal, but we are confident it can be achieved."

The Department of Defense (DoD) is making an unprecedented attempt to encourage personnel to seek mental health treatment, but a significant increase in demand, in some areas, has forced the rationing of services, created long waiting lists and limited individual counseling sessions. In addition, some members of military families such as parents, siblings and unmarried partners do not qualify for care through the Veterans Administration or DoD but are affected nonetheless by the mental health of the veteran.

"We're privileged to be able to give something back to our troops, but we know there's still much more to be done," said Steven Paul, M.D., executive vice president for science and technology and president of Lilly Research Laboratories. "Lilly is fully committed to assuring that the best possible medicinal treatments are available, but unfortunately, we also know that having access to the best care -- in this case mental health services -- is essential."

About Give an Hour
Give an Hour is a nonprofit 501(c)(3), founded in September 2005 by Dr. Barbara V. Romberg, a psychologist in the Washington, D.C., area. The organization's mission is to develop national networks of volunteers capable of responding to both acute and chronic conditions that arise within our society. Currently, GAH is dedicated to meeting the mental health needs of the troops and families affected by the ongoing conflicts in Iraq and Afghanistan. Give an Hour now has approximately 1,200 providers across the nation and continues to recruit volunteer mental health professionals to its network. For more information or to volunteer to become part of the effort, please visit http://www.giveanhour.org.

About The American Psychiatric Foundation
The American Psychiatric Foundation is the charitable and educational subsidiary of the American Psychiatric Association. The mission of the foundation is to advance understanding that mental illnesses are real and can be effectively treated. For more information, please visit the foundation's web site at http://www.psychfoundation.org.

About Lilly
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers -- through medicines and information -- for some of the world's most urgent medical needs. Additional information about Lilly is available at http://www.lilly.com.

From Give an Hour's website:

Our Mission
Our mission is to develop national networks of volunteers capable of responding to both acute and chronic conditions that arise within our society. Our first target population is the U.S. troops and families who are being affected by the current military conflicts in Afghanistan and Iraq. Give an Hour is asking mental health professionals nationwide to literally give an hour of their time each week to 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.

Our Focus
Our organization is currently focusing on the psychological needs of military personnel and their families because of the significant human cost of the current conflicts. Over 1.6 million troops have been deployed in Afghanistan, Iraq, and the Persian Gulf since September 11, 2001. Nearly 550,000 of these troops have been deployed more than once. According to the U.S. Department of Defense, as of May 15, 2008, nearly 4,600 American troops have died in Iraq and Afghanistan. Roughly 32,875 U.S. troops have been injured during these conflicts.

In addition to the physical injuries sustained, countless servicemen and servicewomen have experienced psychological symptoms directly related to their deployment. According to a RAND report released in April 2008, over 18 percent of troops who have served in Iraq and Afghanistan--nearly 300,000 troops--have symptoms of post-traumatic stress or major depression. At the same time, about 19 percent of service members reported that they experienced a possible traumatic brain injury. And let us not forget: millions of Americans belong to the families of these servicemen and servicewomen. Spouses, children, parents, siblings, and unmarried partners of mili