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Post-traumatic stress disorder (PTSD) is a neglected but much a critical and often chronic psychiatric disorder that develops in a significant minority of trauma survivors. The disorder is identified by repeated intrusion into the consciousness of painful traumatic memories, accompanied by constant increased arousal. Typically the numbing of emotional response and active avoidance of reminders are core features, particularly in more chronic forms of the disorder. PTSD is associated with significant distress, as well as social and occupational impairment. (M.Bison, 2005)
My uncle joined the Pakistani armed forces in the late 90’s. He was inducted into the SSG unit of the military. During this time period tensions between the Pakistani and Indian forces reached a boiling point over Kashmir and specifically over Siachin; a 70 km glacier, 21,000 ft. above the sea, with staggering temperatures going below -50 C. Shortly, after he made the team, the conflict came close of a full-fledged war. His team was one of the first ordered by the central command to go first. He was part of the reconnaissance team to get Indian positions on the Bilafonda pass, where they were camping. He came back after a month as a result of a temporary ceasefire. His coming back home was surreal; he wore warm clothes even on hot days and was always was on guard constantly with a type of bayonet concealed in his pants. He used to be an auspicious guy before he went, but had turned rather solemn since his return. My mom told me that she remembers him being awake all night; constantly pacing around checking out the window. When he’d go to the mosque or a family function, he’s begin to smell for rats and be suspicious of people, even those he had spent his entire life knowing. He’d feel more comfortable being by himself. Couple of months passed like this and then the conflict again broke out over Siachin and he was called for duty and this time he had to go for 6 months. As he returned back many noticed a further exacerbation in his mental condition, including my mom, who tells me that “You’re Uncle is a brave soldier, but war got the best of him”. He began having dreams in which he would be under attack by grinning Indian soldiers, where the dream would culminate by him waking up screaming “Allah o Akbar” or “All Praise be to God”. In other scenarios he would find himself reliving the deaths of his unit members, where he would be in their body. These dreams at first would happen once a week but as time elapsed they became more and more frequent to the point that whenever that the doctor had to give him different types of sedatives in order to reduce his anxiety. He spent his better days reliving the past over and over again in more horrendous ways, until he was admitted by the family into a mental rehabilitation center 10 years ago.
There are few treatments for PTSD for war veterans, some of them include: Psychoeducation-is the education of a person in subject areas that serve the goals of treatment and rehabilitation. Psychoeducation involves teaching people about their problem, how to treat it, and how to recognize signs of relapse so that they can get necessary treatment before their difficulty worsens or occurs again. Family psych education includes teaching coping strategies and problem-solving skills to families, friends, and/or careproviders to help them deal more effectively with the individual. Stabilization and Engagement-Good clinical practice would dictate that the therapist’s first concern should be stabilization prior to the commencement of interventions directed specifically at PTSD. If the veteran, for example, is actively suicidal or homicidal, is in the midst of a major psychosocial crisis, or requires practical assistance with concerns such as personal safety or accommodation, those issues should be addressed as a matter of priority before embarking on treatment. (Winkler, 2008). Stress-inoculation training (SIT) – This is often a useful first step in treatment. Strategies would often target each domain of the presenting symptom profile, including physiological components (e.g., relaxation, controlled breathing, aerobic exercise), cognitive components (e.g., self-statements, distraction, thought stopping), and behavioral components (e.g., daily-activity scheduling, social reintegration).
Prolonged Exposure-the traumatic memories is often considered essential for long-term recovery from trauma. Widely used in the management of anxiety disorders for many years, P.E. constitutes a central component of successful treatments for PTSD, and a large body of empirical research supports the efficacy of this approach in both civilian and veteran populations. Working through the trauma or coming to terms with the experiences refer to a similar process. The basic process involves assisting the person to confront the feared stimuli and to remain engaged until the anxiety reduces. It would be common to develop a hierarchy of feared objects or situations and to work through them progressively in order of difficulty. In other anxiety disorders, of course, the feared stimuli are often external (e.g., a spider in spider phobia or contamination in obsessive compulsive disorder) and the exposure is carried out in vivo (i.e. within the living).
In PTSD, while there may be external cues (places, people, activities) to be included as part of the exposure hierarchy, the main feared stimulus is the painful memories. It is these that become the focus of imaginable exposure. The veteran is helped to repeatedly talk through the traumatic incident one at a time until the anxiety has reduced, Eye Movement Desensitization and Reprocessing EMDR-it is a specialized form of psychotherapy that is used almost exclusively for treating PTSD and its associated conditions, including depression. EMDR most often integrated into a conventional psychotherapy procedure and is not used alone to treat PTSD. The theory behind EMDR is that stimulated rapid eye movement may help in the psychological processing of trauma. It is thought that the day’s events and our reactions to them are processed during sleep. In a controlled EMDR session, moving light is used to induce rapid eye movement. Because it is a new method of treatment, only a relatively small number of patients have been treated with EMDR for PTSD. However, the EMDR Institute reports that there are more controlled studies of EMDR and its effects than of any other trauma treatment. The EMDR Institute states that an estimated 1,000,000 people had been treated by 1995, with varying degrees of improvement. Some, but not all, studies document improvement after relatively few interventions. (Fsu.edu)
Abstract: Since 1980 when PSTD gained a formal status in the shelf of mental illnesses efforts, made to prevent the illness have met with relatively limited success, however theoretically driven preventive promising approaches with regards to efficacy can be seen emerging. The above research critically investigates PTSD’s in soldiers and enumerates the treatment programs to those who have been exposed to a traumatic event. It highlights the under discussed battlefield shell shocks that can be treated, however are usually neglected or the resolve is decided to be a mental facility. The research first gives a brief thorough definition of PTSD’s and explains what it is. Secondly discusses the factors that put people in general on risk of PTSD’s and finally discusses the treatment programs that the war veterans have access to.
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