Post-traumatic stress (PTS) can develop after a person has been directly exposed to, witnessed or heard about a traumatic event, involving a threat of severe bodily harm or loss of life to themselves or others. It is the body’s normal reaction to extremely abnormal events.

Military personnel may be more at risk of exposure to traumatic events than the average civilian population due to their frequent deployments to combat zones. In fact, research shows that the repeated deployments of the past ten years have made all Military Service Members, Veterans and Families more vulnerable to developing post-traumatic stress.

Symptoms of post-traumatic stress can occur anytime after returning home, and if the symptoms don’t go away, it’s important to seek help before they get worse. Symptoms may include:

• Nightmares, intrusive memories or flashbacks to the trauma
• Feeling anxious or unsafe, especially when reminded of the trauma
• Difficulty concentrating
• Trouble sleeping
• Constantly feeling on alert and/or easily startled
• Feeling numb
• Feeling irritable or having anger outbursts
• Avoiding people and places

In order to receive a Post-Traumatic Stress Disorder (PTSD) diagnosis, symptoms must persist for at least one month and cause significant distress, interference, or impairment in work, school, or social functioning. Symptoms may last for several months, or become even more chronic. For some, PTSD symptoms emerge six months or more after the traumatic event.

Home Base offers assessment, diagnosis and treatment for Service Members, Veterans and Families experiencing the symptoms of post-traumatic stress. The organization’s seasoned team of clinicians and social workers collaborate with the individual(s) to develop a highly tailored treatment plan, with the goal of helping them ease or overcome the symptoms and enjoy a better quality of life.

For more information about PTS(D), visit:

http://www.massgeneral.org/psychiatry/services/anxiety_ptsd.aspx

http://www.ptsd.va.gov/public/PTSD-overview/basics/index.asp

Sleeping Difficulties Are Extremely Common

For those people deployed to Iraq or Afghanistan or another war theater, they learned to get by on very little sleep, and always remain alert. When returning home, many have trouble falling asleep or have sleep interrupted by nightmares. During the day, some people experience disturbing flash backs of a traumatic event as if it were happening in real time. If these symptoms persist, help is available.

Thoughts and Emotions Can Feel Overwhelming

Many Service Members and Veterans feel as if they are always on alert, jumpy and easily startled. They may have difficulty concentrating at school or at work. Or they might start to avoid crowds, public places, even family gatherings or any situation that makes them feel anxious. At times, they’re anxious, irritable or quick tempered with family or friends. Intense feelings of guilt or fear are common—but so is the opposite extreme, feeling numb. They may find that it’s hard to trust others, or enjoy all the people and life activities that they used to. That’s when it’s time to get care.

A Traumatic Brain Injury (TBI) occurs when a person has had a head injury or a concussion and felt dazed, confused, had “their bell rung”, or been knocked unconscious. The force may cause the brain to jolt backward and forward, hitting the skull and causing damage to the internal lining, tissues and blood vessels of the brain. This damage can result in internal bleeding, bruising or swelling of the brain.

TBI is a complicated injury which can range from mild to severe. It can affect your thinking, memory, personality and emotions. It is an “Invisible Wound of War.”  It is a physical injury to the brain caused by a sudden force. . . TBI can range from mild to severe, depending on the cause of the injury. Most people who experience a mild TBI can recover completely with rest. Others who experience a severe TBI or multiple concussions will need medical treatment.   Any brain injury, whether it’s mild, moderate, or severe, can:

• Cause headache, dizziness, and fatigue
• Temporarily or permanently weaken your physical abilities, including motor function and balance
• Impair your ability to think, concentrate, and reason clearly
• Affect your memory
• Affect your sleep
• Affect your senses, including touch, taste and smell
• Interfere with your emotions and behavior
• Impede language and communication abilities

Treatment Works. There are effective treatments for PTSD and mTBI. Research shows that a number of treatments are effective in helping Veterans overcome Post Traumatic Stress including Cognitive Behavioral Therapy (CBT); Prolonged Exposure Therapy (PE); Cognitive Processing Therapy (CPT), and Pharmacotherapy.

Virtual Reality Exposure (VRE) therapy as a treatment tool for Veterans at the Home Base Program receiving Prolonged Exposure (PE) therapy, a well-established evidence-based cognitive behavioral therapy for PTSD. Home Base is at the cutting edge of integrating VRE therapy directly into clinical care options for veterans diagnosed with PTSD

Effective treatment for Traumatic Brain Injury includes Cognitive Rehabilitation Therapy, Speech and Language Therapy, Occupational Therapy, and Physical Therapy.

Feeling sad or unhappy through life’s ups and downs is a normal reaction. Often people use the word depression to describe day to day sadness, however Clinical Depression is different. Clinical Depression is associated with persistent despair and feeling hopeless, lifeless, or losing interest in enjoyable activities. People with Clinical Depression do not all experience the same symptoms, and the severity and duration of symptoms may vary.

Depression frequently accompanies generalized anxiety disorder, post-traumatic stress disorder, complicated grief, and traumatic brain injury. Home Base clinicians offer Service Members, Veterans and Families evidence-based psychotherapy treatments for depression, and often treat the disorder alongside co-occurring disorders in individual or couple’s therapy. The goal of treatment is to regain the life once lived before depression.

Many people trying to combat concerns like PTS, depression and anxiety cope by using drugs and alcohol to avoid distressing memories, reduce feelings of agitation, or to feel more comfortable in social settings. A recent study of VA Medical Centers shows that almost a quarter of Veterans who have a diagnosis of PTSD also have a co-occurring diagnosis of Substance Use Disorder (SUD).

As with all clinical syndromes, a thorough assessment is needed to evaluate the seriousness of the substance use and how substance use is related to other mental health problems. All clinical staff at Home Base are trained to identify co-occurring substance use and several specialize in the assessment and treatment of substance use.

When a Service Member or Veteran is diagnosed, he/she has two fights on their hands–both substance abuse and emotional difficulties such as PTSD or depression. The best evidence-based approach is an integrated model of treatment. This is imperative because of the complexity of one problem playing off the other. The integrated model of one treatment approach that we use here at Home Base will help our patients win this two-against-one battle, which is also called a co-occurring disorder.

The Department of Veterans Affairs (VA) uses the term “military sexual trauma” (MST) to refer to experiences of sexual assault or repeated, threatening sexual harassment experienced while on federal active duty, active duty for training, or inactive duty training.

MST is underreported in the Military; however data from those that go to the VA to seek treatment reveal that about 1 in 4 women and 1 in 100 men have experienced MST. MST is an experience, not a diagnosis or mental health condition. Common reactions that Service Members and Veterans have in response to MST include strong emotions (depression, anger, and irritability), numbness, trouble sleeping, difficulties with attention and memory, problems with alcohol or drugs, difficulties with relationships and physical health problems. VA medical record data indicates that PTSD, depression and other mood disorders, and substance abuse are all commonly associated with MTS.

Generalized Anxiety Disorder is characterized by long-lasting excessive worry and anxiety about life issues and day to day. People experiencing Generalized Anxiety often find it difficult to relax and have an inability to stop worrying even in the absence of major life stress. Normal anxiety and worry is considered an anxiety disorder when it is severe enough to interfere with normal life functioning such as social interaction or occupational performance. People experiencing an Anxiety Disorder often feel restless or on edge, have difficulty concentrating, are irritable, and experience sleep disturbances. Many of the Service Members, Veterans and Families we treat struggle with Anxiety.

Effective treatments of Anxiety disorders are available at Home Base. Clinicians utilize evidence-based treatments such as cognitive behavior therapy to treat Anxiety disorders alongside other co-occurring disorders. Treating anxiety disorders is an important step in healing the Invisible Wounds.

Worldwide, about 60 million people die every year. Bereavement can shake the foundation of the lives of those left behind. Most people find a way to come to terms with loss; however, for some, grief is complicated and healing stalls. Complicated Grief is an intense and long-lasting form of grief that preoccupies people’s minds and overwhelms their lives. Grief dominates their existence without much respite or hope for relief.

Home Base clinicians offer Complicated Grief Therapy as part of the program’s services for Service Members, Veterans and Family members.  Complicated Grief Therapy remains the best evidence-supported treatment for prolonged or complicated grief, and given the frequency of exposure to loss in these Military populations, Home Base believes this is an important service for the program.

• Feelings of always being on alert, jumpy or easily startled
• Difficulty concentrating at work or school
• Avoidance of crowds, public places or family gatherings
• Anxious, irritable, quick-tempered with friends and family
• Intense feelings of guilt or fear
• Or the opposite extreme: numbness, feeling detached or absent
• Night terrors
• Interrupted sleep patterns or poor sleep hygiene

Veterans may be diagnosed with one or a combination of issues. Each one is debilitating in its own right; co-occurring symptoms can be life-threatening if left to fester, untreated. Through the state-of-the-art treatment programs that Home Base offers, most Service Members, Veterans and Families can overcome the challenges that are associated with the Invisible Wounds of War and achieve a healthier, more resilient life.