Thursday, October 23, 2014

PTSD: So Many Have An Untold Story

Lyndon B. Johnson taking the oath of office on...
Lyndon B. Johnson taking the oath of office on Air Force One following the assassination of John F. Kennedy, Dallas, Texas, November 22, 1963 (Photo credit: Wikipedia)
"Boomers all had a bit of PTSD. If you had not experienced the assassination, your life would have been different. You wouldn't have felt that vulnerability at such a young age." Sarah Feuerbacher*

Post Traumatic Stress Disorder

Trauma occurs when a life event, usually one that threatens or causes great physical or emotional harm, overwhelms the brain's inbuilt chemical and physiological defenses to stress. Post traumatic Stress Disorder (PTSD) is an anxiety disorder that sometimes develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.

Post Traumatic Stress Disorder (PTSD) is a topic we often discuss. It comes up repeatedly in the news as we watch events unfold live (like yesterday's apparently lone gunman's attack on a Canadian soldier seeking to reach Canada's parliament), or as we receive updates on historical events that have taken their toll on us as a community.

Two stories separated by more than 40 years...

This week we happened upon two stories that deal with PTSD. Actually there are many news stories that deal with PTSD every day of the week, but it is unusual that one story ties back to the generation that witnessed their president being assassinated in 1963, while the other story is tied to an event that, as a nation, we shared together as a result of our war in Afghanistan...the 2004 death of Pat Tillman. 

Jacqueline Bouvier Kennedy Onassis ~ THE UNTOLD STORY 

On October 28, 2014, Barbara Leaming's latest book will be available in hardcover. It is a biography of Jacqueline Bouvier  Kennedy Onassis' 31 year struggle with PTSD.  NBC's TODAY Show featured Leaming's work on October 22, 2014.

If you are having trouble viewing the video, you can see it here.

Pat Tillman died April 22, 2004, fellow soldier Steven Elliot is haunted by PTSD

While Pat Tillman died in April 2004 it was not until April 2014 that Steven Elliot accepted responsibility for the friendly fire that killed Pat.  Since Pat's death Steven has suffered from PTSD and now works with other veterans. On October 18, 2014, NBC Nightly News profiled Mr. Elliott's story.

If you are having trouble viewing the video, you can see it here. 

We all have an untold story...

*Sarah Feuerbacher is the clinic director at the Center for Family Counseling at Southern Methodist University, in Plano, Texas. Last year, on the occasion of the 50th Anniversary of President Kennedy's assassination,  she was interviewed by HealthDay's Barbara Bronson Gray. Part of healing is sharing one's story...providing a teachable moment and stopping the isolation.

Start the conversation....

Wednesday, October 22, 2014

New Study: Examines Heart Attacks Followed By Depression And Anxiety

An overview of heart disease in the United States

In case you didn't realize it, according to the Centers for Disease Control (CDC) heart disease is the leading cause of death in the United States. Here are the general facts, as the CDC outlines them:

  • About 600,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths.
  • Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men.
  • Coronary heart disease is the most common type of heart disease, killing nearly 380,000 people annually.
  • Every year about 720,000 Americans have a heart attack. Of these, 515,000 are a first heart attack and 205,000 happen in people who have already had a heart attack.
  • Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity.

Regarding women and heart disease, the CDC drills down a bit further:

  • Heart disease is the leading cause of death for women in the United States, killing 292,188 women in 2009—that’s 1 in every 4 female deaths. 
  • Although heart disease is sometimes thought of as a "man's disease," around the same number of women and men die each year of heart disease in the United States. Despite increases in awareness over the past decade, only 54% of women recognize that heart disease is their number 1 killer.
  • Heart disease is the leading cause of death for African American and white women in the United States. Among Hispanic women, heart disease and cancer cause roughly the same number of deaths each year. For American Indian or Alaska Native and Asian or Pacific Islander women, heart disease is second only to cancer. 
  • About 5.8% of all white women, 7.6% of black women, and 5.6% of Mexican American women have coronary heart disease. 
  • Almost two-thirds (64%) of women who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease. 

New study examines connection of depression and anxiety following a heart attack 

If you inquired of any person who experienced a heart attack, mostly likely they would share that their heart attack (myocardial infarction - MI) was a life altering event. The heart attack patient's family members would be quick to agree with that observation. 

This week was the third annual congress of the Acute Cardiovascular Care Association of the European Society of Cardiology.  This event took place in Geneva, Switzerland. 

Professor Pranas Serpytis of Lithuania presented the results of a current study that examined the impact of gender regarding risk factors associated with developing depression and anxiety following an MI.  

Study's parameters...

  • The study reviewed 160 patients who were admitted for an MI to the Vilnius University Hospital Santariskiu Clinics in Vilnius, Lithuania.
  • These patients were interviewed at least one month after the MI
  • Researchers determined gender, age, education and marital status
  • Researchers also gathered information about other health issues like diabetes mellitus, previous treatment for hypertension and previous heart attacks 
  • Occurrence of depression and anxiety were both assessed 

Study's findings...

  • 25% of the patients were depressed following the heart attack
  • 28.2% of the depressed patients received treatment with antidepressants
  • Current smokers were more likely to experience anxiety following the heart attack than those who had never smoked or had quit two years previous
  • They found no association between smoking and depression following a heart attack
  • Patients who were physically inactive tended to be depressed, with 64% of patients with depression admitted they were not physically active
  • Women were more likely to develop anxiety and depression following a heart attack 

Looking forward...

Like most research more questions are generated following a review of the results. Dr. Serpytis offered that more research will need to be conducted as to why women are more likely to develop anxiety and depression post MI. Additionally, he shared with the congress:
“The World Health Organization predicts that by 2020 depression will be the second leading cause of disability and mortality in the world, surpassed only by ischaemic heart disease. Major depression follows MI in approximately 18% of cases and is an important predictor of disability and poor quality of life in the year post-MI.

Patients with depression are nearly 6 times more likely to die within 6 months after an MI than those without depression. The increased risk of death in patients with depression persists up to 18 months after the MI. But despite the fact that post-MI depression is common and burdensome, the condition remains under-recognised and undertreated.”  

Friday, October 17, 2014

Looking Through Google Glass™ ~ Internet Addiction Disorder

Checking-in for addiction treatment...

Checking-in for addiction treatment and/or co-occurring disorders is often a shock to one's system.
The day for check-in frequently occurs after coming to terms with oneself, family members and/or employer that now is the time to get sober and deal with any other mental health issues that may yet to be discovered.

The patient always has questions about "what can I expect when I check-in," like:
  • Will I have roommates?
  • How long will detox/withdrawal take?
  • Is smoking allowed?
  • Can I bring my laptop or tablet?
  • Can I have visitors?
  • Can I make phone calls?
  • Can I check my email?
  • Can I bring my cellphone or smartphone?
Of course, as our world of hardware and software technology advances most treatment centers' admissions teams continually reevaluate the list of what a patient can and cannot bring with them and what restrictions will be placed on access to devices which allow using the internet while in treatment. 

U.S. Navy's Substance Abuse and Recovery Program (SARP) has requirements, too

The U.S. Navy's SARP unit requires that all patients admitting for treatment must abstain from alcohol, drugs, and cigarettes; additionally, all electronic devices are surrendered for the length of the 35 day program. And so it was, in September 2013 when a 31 year old serviceman checked-in for alcoholism treatment.

Soon the doctors treating this young man realized that he was exhibiting withdrawal symptoms that were worse than his withdrawal from alcohol. reports that one of the electronic devices surrendered by the patient was his Google Glass. He explained to the doctors that he had been wearing the glasses for 18 per day for the two months prior to his admittance. The following are the withdrawal symptoms noted in this case:
  • frustration and irritability 
  • involuntary movements to the temple area; involuntary tapping of temple with forefinger, especially when asked questions
  • short-term memory problems 
  • trouble focusing; unclear thought processes
  • viewing dreams as if through the device's gray window

U.S. Navy team identifies first known case of "internet addiction disorder" (IAD)

Dr. Andrew Doan of the Naval Medical Center San Diego's Department of Mental Health and Department of Ophthalmology co-authored a study of this case. The research results were published on-line September 26, 2014, and will appear in the February 2015 issue of Addictive Behaviors: Internet addiction disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program.

The treatment team concluded:
Over the course of his 35-day residential treatment, the patient noted a reduction in irritability, reduction in motor movements to his temple to turn on the device, and improvements in his short-term memory and clarity of thought processes. He continued to intermittently experience dreams as if looking through the device. To our knowledge, this is the first reported case of IAD involving problematic use of Google Glass™.

Going forward...

This is an interesting paper that sheds real time light on understanding internet addiction disorder. Newsweek contributes the following observations:
Internet addiction is commonly linked with cellphones, laptops and personal computers. This is the first reported case involving Google Glass. Though it is a growing problem, Internet addiction does not appear in the Diagnostic and Statistical Manual of Mental Disorders, a book of standard criteria for the classification of mental disorders. Instead, it is included in the appendix as a disorder that requires further study. While some psychiatrists believe it can be a primary problem, others maintain that it is merely a symptom of other psychological issues.
IAD: A disorder that requires further study...

Wednesday, October 15, 2014

Study: Examines Stress, Rumination and Depression

How often do you reminisce about your adolescent years? 

The word "reminisce" infers a pleasant experience. Don't you think? Consider meeting with childhood friends, paging through scrapbooks, attending a family reunion...or just daydreaming about days gone by. We might recall great teachers, school plays, dances, sporting events, and graduations. But for as many wonderful memories one might have about their adolescent years, there can be and often are just as many stressful memories.

For women remembering the adolescent years they may recall being bullied, suffering from acne, struggling with grades, experiencing problems with their menstrual cycle, fretting about socializing with the opposite sex, determining their sexual orientation...the list goes on.

Men, too, may recall stressful memories regarding their adolescent years dealing with bullying, team sports, physical issues like weight, facial hair, voice change or acne, dating relationships, sexual orientation...again, the list goes on.

So does stress experienced in adolescence have long term affects?

Researchers at Temple University in Philadelphia, PA, asked this question.  Their research was published online this month in the Clinical Psychological Science Journal: Stress and the Development of Cognitive Vulnerabilities to Depression Explain Sex Differences in Depressive Symptoms During Adolescence.  The lead author was Jessica Hamilton of Temple University. They conducted what is referred to as a multi-wave study with the following parameters:
  • 382 boys and girls participated
  • the adolescents completed initial evaluations of their cognitive vulnerabilities and their depressive symptoms
  • Each received a three follow-up assessments with each were spaced seven months apart

Study's findings...

As reported by PsychCentral:

  • As expected, teens who reported higher levels of interpersonal dependent stress showed higher levels of negative cognitive style and rumination at later assessments. 
  • This finding was confirmed even after the researchers took initial levels of cognitive vulnerabilities, depressive symptoms, and sex into account. 
  • Girls tended to show more depressive symptoms at follow-up assessments than did boys — while boys’ symptoms seemed to decline from the initial assessment to follow-up, girls’ symptoms did not. 
  • Researchers also discovered that girls were exposed to a greater number of interpersonal dependent stressors over time. 
  • Investigators believe this observation shows that it is this exposure to stressors that maintained girls’ higher levels of rumination and, thus, their risk for depression over time. The researchers emphasize that the link is not driven by reactivity to stress; girls were not any more reactive to the stressors that they experienced than were boys. 

Some closing thoughts...

For sure growing up in today's world brings many challenges, even when children are being raised in a stable and healthy family unit. Family life can be complicated by health issues, divorce, and parent's jobs or lack of same. Stress is part of life, both interpersonal dependent stress as well as non-dependent interpersonal stress.

This study goes a long way in starting a conversation so that young people can learn how to deal with stress and ruminate less. This is particularly important for teen-age girls.  Additionally Jessica Hamilton explained to PsychCentral: “Parents, educators, and clinicians should understand that girls’ greater exposure to interpersonal stressors places them at risk for vulnerability to depression and ultimately, depression itself."

Friday, October 10, 2014

#14Days On The Wagon...You In?

Logo of CBS News
Logo of CBS News (Photo credit: Wikipedia)

Are you participating in #14Days on the Wagon

CBS News' #14Days project actually started on Monday, October 6, 2014. So today is #day5. Have you heard about this project? We came across it last evening and it started us thinking about #14days and what it can mean to the average person.

For the record, #14days is equal to two weeks, 336 hours and 20,160 minutes. Seems like a long time, right? But really only if you are trying to NOT do something for #14days or trying to WAIT in anticipation of something happening in #14days: Like giving birth, hearing about your SATs or your BAR exam, waiting for the school year to end, anticipating going off to college, starting a new job, leaving an old job, coming home from war, voting for the first time, starting a vacation.

The truth is life is a waiting maybe #14days isn't really so long!

CBS News announced #14Days on the wagon on October 1, 2014

Throughout the #14Days CBS is publishing advice and inspiration from leading experts on addition, recovery, health and wellness.  Here is part of their announcement...
CBS News invites you to join the movement by "going on the wagon," meaning ditching alcohol and any non-medically necessary drugs for two weeks. In cutting these substances out of our lives for 14 days, we are supporting our own health and wellbeing as well as showing solidarity with friends and loved ones in recovery.

It's our hope that becoming more conscious of our own habits will allow us to develop more compassion for those struggling with the disease of addiction -- a disease that contributes to the deaths of more than 90,000 Americans each year.

If you are having trouble viewing the video, you can see it here.

Some thoughts about Cottonwood's family program

Have you ever attended a family program when your loved one has gone through treatment for addiction?  If so, you might remember wondering quietly or even asking the question out loud: "Since my loved one needs to abstain, does this mean the whole family should abstain from drinking alcohol?"

The goal of Family Program is to help families relearn behavioral interaction so that healthy behaviors become logical. Interpersonal change that can be sustained after treatment requires a movement from following direction (first order change) to internalizing new ways of interacting (second order change). Families shift from obsessive worry and controlling behaviors to acknowledging that which is outside of their control and learn to focus on their own personal needs and boundaries. They learn to detach from the pain, and not from the person.

Family program counselors will suggest that family members avoid having alcohol in the home and from partaking of alcohol when their recovering family member is present. This change starts slowly, but before you know it #14days goes by, then a month or two, and before you know it you have changed your own behaviors and everyone in the family is feeling healthier. 

Share your own stories...

It is easy to share your story...use the hashtag #14days in your Twitter messages, your Istagram photos, and even find it on FACEBOOK.  Be part of the conversation...