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PTSD Frequently Asked Questions


 

FACT:
One out of every two people will be exposed to a traumatic experience at least once in thier lifetime.
 

How does PTSD develop?

Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.
The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such asreunions or media broadcasts of the anniversaries of war events).


PTSD Update 12/31/2016 ► How VA Handles Post-Traumatic Stress Disorder Claims

Post-traumatic stress disorder, or PTSD, is a condition that’s both underestimated and misunderstood, especially when it comes to the Veterans Association. PTSD is actually a common condition. T he Mayo Clinic estimates that more than 3 million Americans are diagnosed with PTSD every year — and that doesn’t take into account those individuals who never receive a diagnosis. PTSD develops when an individual has witnessed or experienced a traumatic or terrifying event. Unsurprisingly, it’s a condition that’s particularly prevalent among veterans. Although the VA estimates that 10-15% of veterans will develop PTSD at some point following their military service, it’s entirely possible these numbers might actually be much higher in reality.

PTSD is classified as a trauma and stressor-related disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, the condition is characterized as a repetitive re-experiencing of an extremely traumatic event (or stressor), usually accompanied by increased arousal, nightmares, and flashbacks. Those who have PTSD often have trouble concentrating, remembering, and sleeping. But a PTSD diagnosis is not always easy to come by. The manifestation of the condition i s not always straight-forward and doesn’t appear in the same way from person to person. It may take months or even years to develop, and symptoms may shift or appear over time. To diagnose a case of PTSD, physicians will look at specific criteria for symptoms. There are four distinct groups of criteria, all with different symptoms. These groups are:

  • Intrusion Symptoms—Nightmares, intrusive memories or thoughts, or psychological and physical reactions to memories of the event.
  • Avoidance Symptoms—Avoiding situations, thoughts, or feelings that you associate with the traumatic event.
  • Negative Changes in Cognitions and Mood—Memory issues, negative thoughts about themselves or others, severe emotions like shame or sadness, lack of interest in activities they once enjoyed, or feelings of detachment, isolation, or disconnection.
  • Changes in Arousal and Reactivity—An easy startle response, or feeling constantly jittery or alert.

It’s easy to see how these symptoms could easily disrupt a person’s life and take a significant toll on their mental health, as well as their personal and professional life. If you or someone you love may be suffering from PTSD, it’s important to seek out help. Because PTSD presents itself differently in every patient, treatment must be sought and tailor-made for each individual. Although there is no cure for PTSD, treatment has proven to be very effective for the majority of patients. Typically, this treatment includes psychotherapy — including cognitive and exposure therapy, as well as regular appointments with a psychiatrist — and in some cases, medication.

If you are a veteran who has been diagnosed with PTSD, you may be entitled to receive benefits and compensation from the VA. There are many things that you need to know to get the benefits that you deserve, and the veterans advocates at Hill & Ponton have published a PTSD guide covering everything regarding a PTSD claim at https://www.hillandponton.com/introduction-ptsd-guide. In years past, veterans were required to provide evidence of the traumatic event that led to the development of their condition. Below are some of the important points in the guide on how to establish service connection and get the proper rating.

The first thing is to establish a service connection for your PTSD in order to be eligible for benefits.

The three things the VA requires are:

  • Current Diagnosis: you must have a current PTSD diagnosis that was given by professionals who the VA has deemed “qualified to perform PTSD Compensation and Pension examinations.” These professionals have doctoral-level training in diagnostic methods, clinical interview methods, and psychopathology. They also need to have a working knowledge of the DSM-V and have extensive clinical experience with both the diagnosis and treatment in veterans with PTSD. Typically, these are board-certified psychiatrists and licensed psychologists, but may also include psychiatric residents and psychology interns as long as they’re under close supervision of an attending professional in the field. Essentially, if you’ve received a current PTSD diagnosis from a licensed professional, that analysis satisfies this requirement. Please note: most VA hospitals and clinics employ licensed mental health social workers to treat veterans. Their diagnosis of PTSD alone is not enough to meet this requirement.
  • In-Service Stressor: This might be the most difficult requirement to satisfy. Sometimes, trauma is easy to determine, but other times, proving its occurrence can be challenging. There are a lot of different regulations regarding the type of trauma you experienced. For example, the rules for determining fear of terrorist activity are different from veterans who engaged in combat or sexual trauma. It’s recommended that you consult with your psychiatrist or psychologist, as well as a qualified lawyer, to address this requirement.
  • Nexus: Basically, this is the link between the first two requirements. It’s what connects the traumatic event you experienced with your current diagnosis of PTSD. A medical expert is required in order to explain how your symptoms are a direct result of your in-service stressor — which is especially important if you have multiple stressors. It’s vital you establish that the traumatic event is the definitive link to your diagnosis and cannot be explained by any other events that took place outside of your military service.

Once these requirements have been satisfied, you can then file a claim through the VA. If you file a claim, you’ll need to undergo a Compensation and Pension Examination (sometimes called a C&P Exam) to verify your diagnoses, assess symptom severity, and definitively determine whether your PTSD is directly related to your military service. The VA treats the C&P exam with a lot of weight and it will determine the amount of compensation you receive. When you go to your exam, remember to be as honest and as forthcoming as possible. You should bring written statements from family or friends that say how your PTSD has impacted your life. You should also bring a list of symptoms you’ve experienced to help you when being questioned during the exam. After the exam, you will be assigned a disability percentage rate. This percentage reflects how severe your condition is and how much the symptoms affect your ability to work and maintain social relationships. Depending on the severity of your PTSD, you could potentially receive a disability rate of 0%, 10%, 30%, 70%, or 100%.

Overall, the compensation you receive will be related to your estimated impairment of working ability. Above all, it’s important to demonstrate evidence of occupational impairment due to PTSD. Even if your symptoms don’t constitute a 100% disability rating, you may still be able to receive one through a TDIU, which stands for total disability based on individual unemployability. A TDIU may be assigned if an individual fails to meet the criteria for 100% disability but is still completely unable to obtain and maintain employment. Because the way the VA determines disability percentages can be highly confusing and complex, working with a lawyer who specializes in VA claims may be to your benefit. The various rules and regulations for determining physical disability can be hard to navigate, but mental conditions like PTSD can be even more difficult to prove. That’s why having an expert on your side can be vital.

If you or someone you love may be suffering from PTSD as a result of military service, seek out assistance from an attorney who specializes in veterans’ issues. Alternatively, if you are dissatisfied with a disability rating you have received and aren’t receiving the benefits you need, there may be other options at your disposal. [Source: Independent National News for Veterans (VNN) | Matt Hill | November 8, 2016 ++]


How common is PTSD?

An estimated 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.

About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high as 8 percent.


Who is most likely to develop PTSD?

1. Those who experience greater stressor magnitude and intensity, unpredictability, uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and betrayal

2. Those with prior vulnerability factors such as genetics, early age of onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events

3. Those who report greater perceived threat or danger, suffering, upset, terror, and horror or fear

4. Those with a social environment that produces shame, guilt, stigmatization, or self-hatred


What are the consequences associated with PTSD?

PTSD is associated with a number of distinctive neurobiological and physiological changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The amygdala has also been found to be involved in coordinating the body's fear response.

Psychophysiological alterations associated with PTSD include hyper-arousal of the sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities.

People with PTSD tend to have abnormal levels of key hormones involved in the body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in individuals who have both PTSD and depression.

PTSD is associated with the increased likelihood of co-occurring psychiatric disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence (27.9 percent).

PTSD also significantly impacts psychosocial functioning, independent of comorbid conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system.

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD.


How is PTSD treated?

PTSD is treated by a variety of forms of psychotherapy (talk therapy) and drug therapy. There is no definitive treatment, but some treatments appear to be quite promising, especially cognitive-behavioral therapy, group therapy, and exposure therapy. Exposure therapy involves having the patient repeatedly relive the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Prozac and Zoloft. At present, cognitive-behavioral therapy appears to be somewhat more effective than drug therapy. However, it would be premature to conclude that drug therapy is less effective overall since drug trials for PTSD are at a very early stage. Drug therapy appears to be highly effective for some individuals and is helpful for many more. In addition, the recent findings on the biological changes associated with PTSD have spurred new research into drugs that target these biological changes, which may lead to much increased efficacy.


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