The War on PTSD

With the recent return of the last American veterans from the Iraq War, the topic of post-traumatic stress disorder has been making headlines.

A recent Rand Corporation survey on PTSD showed an estimated 300,000 veterans of Iraq and Afghanistan suffered some form of the trauma or major depression.

The term PTSD was coined in the mid-1970s, thanks in part to the efforts of anti-Vietnam War activists, Vietnam Veterans Against the War and Chaim F. Shatan, who coined the term post-Vietnam Syndrome.

Reports of battle-associated stress reactions, however, date back to the 6th century BCE by Greek historian Herodotus.

Beyond the cases involving veterans, however, PTSD transcends age, gender, race and economic background and can be associated with any life-shattering traumas.

Philadelphia psychologist Tamar Chansky, founder and director of the Children's and Adult Center for OCD and Anxiety in Plymouth Meeting, has written four books that include discussion about its treatment.

She says that the first step to overcoming PTSD involves therapy that will help patients get a better grasp on why they feel the way they do. "Understanding that PTSD is a medical condition can help reduce the stigma and help offset the isolation many people feel, along with the reality that PTSD is a no-fault condition," asserts Chansky.

"The nature of PTSD is the interplay between the physiological, psychological and neurological. The behavior of a person with PTSD is an adaptation to what is happening to them in the brain, as it is" recalling what was "the best way to cope at the moment of trauma."

"It is about survival rather than viewing the event in a narrative context; at the time of the event, the brain was busy with getting through that moment."

When treating PTSD patients, Chansky sets out to help them understand the mechanism triggering their behaviors and fears, and to translate what they are experiencing into accurate and comforting language. From there, patients realize that what can feel so wrong is actually an expected, normal process of recovering from what they experience as a trauma.

Once a patient reaches that point, suffering is reduced and his or her therapist can work more effectively to find a more permanent resolution to the problem, says Chansky.

"People have different ways of responding naturally to trauma, and for this reason," she says that trauma experts suggest "holding off on treatment for the first 30 days after a trauma so there is the potential for natural recovery from the memories."

However, Chansky adds, "there is a switch point that happens if memories don't fade within that time frame. This is what leads to 'familiar' PTSD behaviors like flashbacks. If things persist, the person needs to get treatment."

Texas-based psychologist Mary Ann Block, who was in Philadelphia recently teaming up with a colleague for an unrelated project, agrees with Chansky that all facets of what trigger and continue the effects of PTSD need to be examined before prescriptions are determined.

"When we look only at" treating what are the "psychological symptoms, there is nothing except for medications," Block laments. Since a number of these medications "have the risk of suicide as a side effect, the end result of taking the drug may be worse than the symptoms themselves.

"My philosophy when approaching any medical condition is to find the cause and fix the problem, not just cover symptoms with drugs."

How to do so? "This approach involves physical exams, lab work and even allergy testing. Giving a psychiatric diagnosis and a psychiatric drug is quick and easy, but to me, the practice of medicine is much more than that."



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