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A couple of folks complained that all I seemed to cover was combat-related PTSD.  That's because almost all the PTSD-related news stories that Google serves up are about that population.  So, to try and catch any other stories, I broadened my search terms to include "traumatic stress".  One thing this exercise shows me is how under-reported and discussed other populations of survivors are, especially since soldiers make up the minority of those with PTSD.  So let's see what Google offered us yesterday and today...

The Trauma Diet

Dr. Kathleen Kendall-Tackett is giving webinars in "How Trauma Makes You Fat." She makes the same links between obesity and trauma that have lately been described in the research, but makes a claim that is, so far as I can find, unsupported in the literature, at least in human studies: "The good news is that when traumatic stress is addressed, inflammation and insulin resistance can be reversed." She's hyping a book that she will self-publish later this year. The info is taken verbatimfrom this press release (there is very little real science journalism any more). While I easily foundmore than one 2013 study that suggests that weight loss has a beneficial effect on PTSD symptoms (as it does on depression, and also for reasons that are as yet unclear), I found no studies that suggested the opposite: that PTSD treatments resulted in weight loss for obese patients.  I'll be curious to see her references when the book comes out, but my guess is at this point they're confined to conclusions drawn from animal studies.

Fund Raising Efforts

The Republican American featured a story on a motorcycle ride to raise money for PTSD, organized by Arthur Melcher of American Legion Post 43 in Minnesota.  They raised about $3000, which will will go into the Post's "Post-Traumatic Stress Disorder account."  The ride was in memory of Matthew Marc Melanson, who committed suicide after returning from military service in Afghanistan.

Also in the fund-raising department, The Northwestern.com has published a story about Tom Voss and Anthony Anderson, the Iraq war vets from Wisconsin who plan a 2700 mile journey to raise money for Dryhootch. They've so far raised about $15,000 of the $100,000 that they're looking for. The bulk of that comes from a $10,000 donation by the U.S. Concealed Carry Association, a commercial organization that carrying concealed weapons is a "social obligation," and that strongly promotes gun ownership in houses where there are children.

Send 'em back into the field!

The military's failure to either "prevent" or to "cure" PTSD has spawned a new philosophy:  Redeploy soldiers with PTSD, again and again.

But a diagnosis of post-traumatic stress disorder is not a barrier to being redeployed. Not when the Army needs its most experienced soldiers to wrap up the war. Instead, the Army is trying to answer a new question: Who is resilient enough to return to Afghanistan, in spite of the demons they are still fighting?

As the Army has knowingly redeployed soldiers with symptoms of PTSD - and learned of the remarkable coping skills of some - it is now regularly embedding psychologists with units in the field. They are treating men and women recovering from 12 years of relentless combat, even as the soldiers continue to fight.

It seems the military has discovered that some soldiers with PTSD can continue functioning in a wartime environment, and it's willing to redeploy them until they crack for good.  Although many studies suggest that each successive retraumatization does more damage to the individual psyche, the military is apparently unconcerned with a soldier's capacity to function in the civilian world, post-combat.  The argument that some people seemed to survive years in a concentration camp, and to come out intact, would never be used to justify concentration camps since we know that many of those who were high-functioning in the world of the camps, and who survived many years there, failed to adjust to normal life after they were released, had breakdowns, or committed suicide.  There's no reason to think war is any different: some soldiers with PTSD will continue to be high-functioning combat soldiers, but we have no idea how the 7-tour combat veterans that the article describes will adjust to civilian life postwar. The role of the therapist, in such a combat mill, becomes deeply troubling.

The article describes embedded mental health professionals who travel with the troops, and who are charged with keeping them going between combat engagements. Capt. Stacey Krause is "one of dozens of behavioral health experts deployed across Afghanistan."  She doubles as marriage counselor and financial advisor, and is "often the only person on Arian who knows how the soldiers of 10th Mountain are holding up."  She says,  that soldiers "can meet the criteria for PTSD but still be able and willing to serve this kind of mission... After multiple deployments, soldiers are able to build robust coping mechanisms."  As any properly trained psychotherapist will tell you, "coping mechanisms" are not the same thing as "mental health".  The former might allow you to endure the combat environment, but it's the latter that allows you to reintegrate into civilian society.  But given the increasing number of combat tours that veterans are accruing, perhaps the army wants troops that can find a "safe harbor" only under combat conditions, who can "cope" only by redeploying over and over again. Says one of the soldiers quoted in the article, "It just seems inevitable that we'll be sent somewhere again... That's the one thing we've learned from experience."

This attitude is summed up beautifully by U.S. Army Brig. Gen. Walter E. Piatt, who wants to turn meditation and mindfulness into tools of war. (The irony just never stops, does it?):

“We fight now in a cognitive struggle with an enemy that can’t be defeated through technology. They’ve taken our strengths, big weapons and technology, and changed the game,” Piatt says. “They attack on their terms. They don’t care about civilian casualties. Our best weapons in that fight is the soldiers’ minds.

“You’re not letting your mind wander, you’re focusing straight on. This is what her technique teaches you to do, focus on the task.’’

The rhetoric of "hearts and minds" that was once cynically applied to applied to winning over the Vietnamese people to the American cause has now shifted into a battle for the hearts and minds of our own soldiers. Piatt doesn't just admit that U.S. soldiers suffer from PTSD, he positively revels in it. The answer? Crazy shit, like the Mind Fitness Training Institute founded by Georgetown University professor Elizabeth Stanley, Ph.D. MMFT® allegedly "blends mindfulness skills training, stress resilience skills training, and concrete applications for the operational setting."  This as-yet-unproven "stress innoculation training", administered under a registered trademark, has already reaped the benefits of military largess towards those who promise to keep their troops in the field longer. I'm pretty sure meditation and mindfulness have positive effects, but it's exceedingly doubtful that those modest good effects will overcome neurological stress reactions in the long term.  What's most interesting is the way that meditation techniques have been hijacked from cultures from which they emerged.  Meditation and mindfulness are traditionally activities engaged in by those who seek peace, not those who prepare men and women for war. And it's about as true to the tradition as claiming that the central tenet of Buddhism is "every man for himself."  This kind of training resonates more with magical thinking movements like The Secret (no I won't link to that garbage), and "failure to meditate properly" will doubtless be listed as the reason that troops are succumbing to PTSD in the field....

Social Media

The Facebook page Military with PTSD was apparently shut down for 12 hours by FB admins, over a post (which I can't find anywhere) "about God and religion."  The page has 22,000 "fans", and was started by Shawn Gourley,  the wife of a military vet who suffers from PTSD.  FB is notorious for banning and unbanning sites at will, so it'sdisturbing to read Gourley's comments: "On our page, I am a certified suicide gatekeeper... And we do have suicidal vets on the page that come to us for help. We cannot contact them or message them... Someone posted on my personal page that they felt like the walls were closing in on them and they don't know how much longer they can hang on and I can't respond to her."  It's even more disturbing to read the words of another page administrator, veteran Marcus Spaulding, who claims, "Facebook put a lot of lives in danger... We have many veterans who come to that page to talk to counselors, to talk to Shawn, to talk to me... They don't know where else to turn to... We could be burying another vet."  These statements arein direct contradiction to the description of the Facebook page:

We are not doctors or in any sort of health care field. We are just veterans and spouses coming together for support. We are not responsible for suicidal/homicidal content or actions. If you are in crisis, please call 911, go to your nearest Emergency Room, or call 1-800-273-TALK (1-800-273-8255)(Spanish/Español 1-888-628-9454). Veterans, press "1" after you call -- or go to Veterans Suicide Prevention Hotline to chat live with a crisis counselor at any time of day or night.
No veteran should be dependent on a Facebook page as a lifeline, and if the site administrators see themselves as providing such a service, then they're acting in a deeply irresponsible fashion.  While online communities and fora can be very helpful for people with medical and psychological conditions, they are no substitute for local support networks, qualified therapists, and treatment centers.  Online communities attract all kinds of people, and there is no way to certify who is who:  real vets mix with fakes, and qualified therapists mix with well-meaning amateurs who are simply not equipped to deal with the problems they are attempted to help solve, and with quacks who "prescribe" fake cures. A responsible administrator would nip in the bud any relationship with a veteran who seems to be growing dependent upon the page, and suggest they redirect their focus to a local source of help. Instead, the two administrators who were quoted above seem to revel in the alleged dependence of the vets with whom they interact.

More media "diagnoses" of PTSD

Fox News is reporting that actress Amanda Bynes, who has been hsopitalized for schizophrenia, has PTSD, and that story is being echoedfox  around the web. The PTSD "diagnosis" apparently comes from "a source close to" Bynes. The anonymous source claims, "“There are no drug problems involved, it’s all mental. She has deep anger and PTSD, which tripped a psychotic episode… She is very ill, but manageable. Amanda genuinely wants to get better and has wanted to get better for some time.” The source also claimed her PTSD "stems in part from the pressures of her Hollywood career, in which she shot to Nickelodeon stardom as a child..." and from "very deep-seated conflict issues with her parents."  It's news to me that child stardom and the pressures of Hollywood are causes of PTSD, and "deep-seated conflict" is a far cry from traumatic abuse.  I don't know Byne's specific history, but the point is that neither does Fox, which is lobbing out a faux diagnosis based on alleged symptoms.

And now from Big Pharma...

Tonix Pharmaceuticals is promoting cyclobenzaprine, the active component of TNX-102, a new sublingual tablet, at the International Pain Society's 9th World Congress on Myofascial Pain. In December of 2012 Tonix raised $2.3 million to further develop TNX-102 (CNS Drug News, 6 December), which is a proprietary formulation of cyclobenzaprine (CBP). Tonix pitches the drug as a treatment both for fibromyalgia and PTSD since both seem related to poor sleep. Tonix claims that "the unique qualities of TNX-102 SL provide for rapid absorption into the bloodstream and rapid excretion from the system. This is ideal for a bedtime medicine to reduce next day somnolence. In addition, since TNX-102 SL avoids first-pass metabolism by the liver, a psychoactive metabolite of cyclobenzaprine, norcyclobenzaprine, is not generated. TONIX believes that this metabolite contributes to reduced long term efficacy with the off-label chronic use of generic cyclobenzaprine." Since the military is cutting down on the number of benzodiazepines it prescribes, this would leave the billion-dollar military pharmaceutical market wide open for Tonix. The results they're reporting are from non-clinical studies; clinical studies won't start until later this year.  I'll follow this drug as it moves through testing and towards the market.

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