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Posts Tagged ‘PTSD’

PTSD: Signs, symptoms and support

Monday, October 31, 2016 @ 02:10 PM
posted by Tara McNeil

Submitted By Manuela Joannou M.D. CCFP (EM)

When we think of post-traumatic stress disorder (PTSD), we tend to think of soldiers returning from deployments where they were actively engaged in warfare, or first responders involved in one too many critical incidents. The truth is that PTSD results from a normal reaction to abnormal events, so any of us can be vulnerable.

The events that typically lead to PTSD are those that challenge our view of the world as being a generally safe place. We may become traumatized by witnessing extreme suffering and death, and realize it could happen to us. Moral injury occurs when we feel we or someone with us did something we shouldn’t have or didn’t do something we should have, or we witnessed something that is just plain wrong and did not stop it. Often this occurs in professionals who are just following protocols and carrying out orders.

PTSD symptoms may begin soon after being involved in difficult incidents, or months or even years later. It can be the result of a single incident, or slowly develop from cumulative exposure to repeated traumas.

PTSD may be formally diagnosed by a mental health care practitioner when a person has been subjected to actual or threatened death, serious injury or sexual violation.

The symptoms of PTSD that give the diagnosis are as follows:

1) Hypervigilance and arousal, being always on guard, constantly feeling the threat of being once again in danger. This results in irritability, impulsivity, angry outbursts and insomnia.;

2) Re-experiencing and flashbacks, where images, smells and sounds or other memories of the traumatic events intrude into thought and mind, causing distressing emotions and sensations and giving rise to nightmares.;

3) Avoidance, where a person is reluctant to go places or to see people where their memories of the event could be triggered or they may have to think or talk about what happened.; and

4) The symptoms cause significant mental distress and impair the ability of the person to function at work, in social situations or other usual activities.

We know that the sooner a diagnosis is made and treatment is started, the less an individual suffers and the better the chance of full recovery. One of the biggest barriers to receiving treatment is the reluctance to come forth admitting the need for help, because of stigma regarding mental illness.

First responders suffering from PTSD almost always develop a sense of shame, feeling somehow weak and inadequate. They believe that everyone else can plainly see their weakness. This stigma can be lessened by understanding that PTSD happens to normal healthy people who happened to be involved in abnormally traumatic experiences. In other words, it’s not a problem within you, it’s what happened to you.

There is a move to dropping the ‘D’ in PTSD because it is a condition but not a disorder. The term “Operational Stress Injury” has been coined to replace PTSD in soldiers and first responders who develop the condition in the line of duty.

So what is the treatment for PTSD?

Medication is often necessary to help with sleep, especially immediately after the incident. Maintaining normal sleep patterns is crucial for healthy mental processing of traumatic events. Medication may also be necessary to treat anxiety or if prolonged symptoms lead to depression.

Therapy is usually necessary for help with processing beliefs, attitudes and thoughts surrounding the traumatic incidents.

What to do if your suffering

If you think you may be affected by PTSD, please reach out to your family doctor or local mental health agency. You may seek out the help of a psychologist or other counsellor. If you are deeply troubled by symptoms, especially if you are having suicidal thoughts, please get yourself to the nearest emergency department. Remember, all the doctors and nurses are sympathetic to the effects of trauma and will be compassionate and understanding.

Our team at Project Trauma Support (PTS) believes that true recovery from PTSD happens in a group atmosphere. Our five half-day program for military and first responders allows immersion into a cohort where everyone has had similar experiences and symptoms and there is true peer support. We use group exercises that explore and challenge paradigms, values and belief systems. In this way, emotional reactions to difficult elements in one’s life story are reprocessed and gradually there is a return to understanding that ultimately the world is a benevolent place after all. Furthermore, together with our comrades we can follow a purpose filled life to ensure that it remains so, for ourselves and others.

For more information about Project Trauma Support, please see our website,
www.projecttraumasupport.com

Medical Director
Project Trauma Support.

Local doctor brings internationally recognized PTSD program to Perth

Saturday, February 27, 2016 @ 02:02 PM
posted by admin

By Dianne Pinder-Moss

Randy Hillier has seen firsthand how therapeutic it can be for military veterans to share with one another about their experiences.

In early 2015, the Member of Provincial Parliament for Lanark-Frontenac-Lennox & Addington was on a train ride from Toronto with his son Dillon, a Canadian Forces veteran of Afghanistan who had recently returned from fighting the Islamic State group alongside Kurdish Peshmerga forces in Iraq.

By coincidence, the man sitting directly across from them on the train was a Canadian who had served in the Iraq war with the U.S. Marines. Another Canadian who had also served with the U.S. Marines in the Gulf War in the early 1990s was seated across the aisle.

“We ended up just having a tremendous conversation,” Hiller said in calling the train ride “the most therapeutic three-and-a-half-hours.”

Having been “enlightened” by that train trip and having other members of his extended family who have seen military service, as well as his work with constituents who have family members suffering from post-traumatic stress disorder (PTSD), the MPP has become one of a local doctor’s biggest supporters in her efforts to bring the internationally recognized Spiritual Process and Resiliency [SPARTA] program to Canada to help military veterans and first responders dealing with PTSD.

“I just felt these people had it right,” Hillier said of the program, spearheaded by Dr. Manuela Joannou to start the first Canadian cohort.

Dr. Joannou is very much aware of PTSD, both personally and professionally.

“I would be lying if I didn’t have cases that profoundly affected me,” she says, adding this is true of any profession “bearing witness to pain and suffering and critical incidents.”

On a professional basis, the Perth area family/emergency physician is familiar with PTSD, both through the counselling she does and her interaction with her colleagues in the emergency department, in addition to first responders like police, firefighters and paramedics.

Dr. Joannou thinks of PTSD as “an operational stress injury for professionals.”

“I don’t like the idea that it is a disorder or a disease,” she said. “I think it is an injury and it needs to be looked at in a different category.”

She says those who care the most are more vulnerable to developing this type of injury.

“They really feel each other’s pain and are empathetic,” she remarked. “If we can intervene and help these people and get them back to their service, they are just such a huge asset.”

Frustrated with the treatments that were being offered, Dr. Joannou started doing research on possible alternatives.

“I felt what was missing was addressing the moral injury, the deep impact to a person’s heart and soul,” she said.

When the physician came across an interview with one of the American founders of SPARTA, “it just blew me away.”

“I realized they were doing it with great success but not a whole lot of recognition,” she said.

Having started off under the name “Save A Warrior,” it’s a very intensive five-and-a-half-day program using holistic and alternative methods.

“It is very experiential,” says Dr. Joannou who spent a week with the main program providers in Malibu in November. “They’re introduced to a lot of different concepts that really ground them and get them to connect to something greater than themselves.”

Along with group therapy discussions, SPARTA participants also engage in meditation, horse-assisted counselling and adventure programs like high ropes.

“Spending time in nature can really be a spiritual experience for anyone,” the physician commented. “With high ropes, we allow people to feel their fear in a very controlled safe environment.”

Likewise, one of the things that interests Dr. Joannou about the horse-assisted counselling component is that it incorporates the Equine Assisted Growth And Learning Association (EAGALA) model, training for which she completed 12 years ago.

“I am really excited that it is starting to get some validation and recognition,” she said.

Dr. Joannou is also excited that the first Canadian cohort of SPARTA could take place as early as this spring as she has received a commitment from the providers to come here. Currently, they are in Australia doing the first cohort there. Given the invitation for them to go to that country came from the Australian government is, she says, “just a testimonial to the fact it is being regarded as a worthwhile program.”

All the logistics have been planned out for the first cohort in Canada, which Tay River Reflections hopes to host using its new aqua facility, which is secluded from the rest of the spa and has its own parking area.

“It’s like its own microcosm,” she said. There are approximately five kilometres of walking trails just outside the door of the aqua facility.

She says her dream is to train people to have other facilities across the country.

“My vision is that the program could be adapted to any country in the world,” she said.

Dr. Joannou would also like to be able to oversee the research as to outcomes analysis.

“We would like to have the metrics to show it is a very effective treatment,” she said.

She says she’d like to work with the providers in the U.S. “to see if there are some things we need to tweak to give it a Canadian context” and ensure the curriculum meets the needs of Canadian organizations. As an example of how the program could be Canadianized, because the weather is different here than in Malibu, some winter outdoor activities could be added, she suggested.

Likewise, while SPARTA operates on a complementary and alternative medicine model in the U.S., Dr. Joannou is a strong proponent for utilizing a medical model here in Canada. That way, she says, if a person requires medication or even medical attention, that care would be available.

She says she was very encouraged by the large turnout for a full-day workshop on PTSD at Tay River Reflections on Jan. 13.

“It was just testimonial to how important people feel this topic is right now,” she stated.

For Perth town councillor Jim Graff who, along with Hillier, were among the attendees that day, the event really “opened my eyes” about PTSD.

“First of all, I don’t think society, including myself, is aware of the residual effect for first responders in working in an environment that primarily deals with tragic events,” he said in an email. “For policemen and soldiers in the course of their duty, having to take a life or be witness to indescribable horror is cavalier in the movies but not in real life.”

Having worked in the U.S. towards the end of the Vietnam War, Graff some of the returning veterans. He remembers how little of any help was available from the Department of Veterans Affairs there “and readjusting to civilian life for them was impossible.”

 

“Personally, I think we have a moral obligation to help these folks regain the quality of life that they lost in the performance of their duty,” he said “The SPARTA program I think will do that from Dr. Joannou’s presentation and a film we saw.”

 

With the progress being made in the understanding of mental health issues, Graff believes it’s “a no brainer that we should get behind physicians like Dr. Joannou and encourage government support for this SPARTA program.”

 

The estimated cost to run a cohort, taking into account the providers, lodging, food and the horse component, would be $3,000 per person.

“If we had $36,000, we could have it happen,” she said.

Ideally, Dr. Joannou would like to start off with two cohorts, one for men and one for women. Of course, everything hinges, she says, “on us being able to raise funds.” She’s currently looking at community fundraisers and corporate sponsorships to help fund the program.

The physician is appreciative of the support she’s receiving for SPARTA, particularly from Hillier. Calling the MPP “a champion” of the program, she says he has had “great ideas” and “connected us with political people to make it happen.”

“This is personal for him,” she stated. “He really cares. I just love that about him.”

For his part, Hillier says he has no doubt the SPARTA program will happen and will help out “wherever I can.”

“I think it is powerfully needed,” he said in a phone interview. He says for many with PTSD, it is not just a chemical imbalance they are suffering from that can be treated with medication.

“That’s what the SPARTA program recognizes,” Hillier said. “For many people, it is a moral injury.”

Based on his own experiences with people, the MPP believes there is a need to do something different in treating PTSD from what is currently being done.

“I have felt that what we have been doing in the past has been less than effective,” he stated. “The stats bear it out.”

In 2015, alone, 39 first responders and 12 members of the military died from suicide in Canada. Already, in the first month of this year, three more first responders have been added to those numbers.

A solemn Dr. Joannou doesn’t mince words when she talks about the sense of urgency she feels about the situation.

“I just wish we had this system in place where we could reach out to them a real solution for their suffering,” she said. “It is not a quick fix but it is a support channel to connect into a source that will lead them on the road to healing.”

To date, more than 300 people have completed the SPARTA program since it launched in 2012.

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Posts Tagged ‘PTSD’

PTSD: Signs, symptoms and support

Monday, October 31, 2016 @ 02:10 PM
posted by Tara McNeil

Submitted By Manuela Joannou M.D. CCFP (EM)

When we think of post-traumatic stress disorder (PTSD), we tend to think of soldiers returning from deployments where they were actively engaged in warfare, or first responders involved in one too many critical incidents. The truth is that PTSD results from a normal reaction to abnormal events, so any of us can be vulnerable.

The events that typically lead to PTSD are those that challenge our view of the world as being a generally safe place. We may become traumatized by witnessing extreme suffering and death, and realize it could happen to us. Moral injury occurs when we feel we or someone with us did something we shouldn’t have or didn’t do something we should have, or we witnessed something that is just plain wrong and did not stop it. Often this occurs in professionals who are just following protocols and carrying out orders.

PTSD symptoms may begin soon after being involved in difficult incidents, or months or even years later. It can be the result of a single incident, or slowly develop from cumulative exposure to repeated traumas.

PTSD may be formally diagnosed by a mental health care practitioner when a person has been subjected to actual or threatened death, serious injury or sexual violation.

The symptoms of PTSD that give the diagnosis are as follows:

1) Hypervigilance and arousal, being always on guard, constantly feeling the threat of being once again in danger. This results in irritability, impulsivity, angry outbursts and insomnia.;

2) Re-experiencing and flashbacks, where images, smells and sounds or other memories of the traumatic events intrude into thought and mind, causing distressing emotions and sensations and giving rise to nightmares.;

3) Avoidance, where a person is reluctant to go places or to see people where their memories of the event could be triggered or they may have to think or talk about what happened.; and

4) The symptoms cause significant mental distress and impair the ability of the person to function at work, in social situations or other usual activities.

We know that the sooner a diagnosis is made and treatment is started, the less an individual suffers and the better the chance of full recovery. One of the biggest barriers to receiving treatment is the reluctance to come forth admitting the need for help, because of stigma regarding mental illness.

First responders suffering from PTSD almost always develop a sense of shame, feeling somehow weak and inadequate. They believe that everyone else can plainly see their weakness. This stigma can be lessened by understanding that PTSD happens to normal healthy people who happened to be involved in abnormally traumatic experiences. In other words, it’s not a problem within you, it’s what happened to you.

There is a move to dropping the ‘D’ in PTSD because it is a condition but not a disorder. The term “Operational Stress Injury” has been coined to replace PTSD in soldiers and first responders who develop the condition in the line of duty.

So what is the treatment for PTSD?

Medication is often necessary to help with sleep, especially immediately after the incident. Maintaining normal sleep patterns is crucial for healthy mental processing of traumatic events. Medication may also be necessary to treat anxiety or if prolonged symptoms lead to depression.

Therapy is usually necessary for help with processing beliefs, attitudes and thoughts surrounding the traumatic incidents.

What to do if your suffering

If you think you may be affected by PTSD, please reach out to your family doctor or local mental health agency. You may seek out the help of a psychologist or other counsellor. If you are deeply troubled by symptoms, especially if you are having suicidal thoughts, please get yourself to the nearest emergency department. Remember, all the doctors and nurses are sympathetic to the effects of trauma and will be compassionate and understanding.

Our team at Project Trauma Support (PTS) believes that true recovery from PTSD happens in a group atmosphere. Our five half-day program for military and first responders allows immersion into a cohort where everyone has had similar experiences and symptoms and there is true peer support. We use group exercises that explore and challenge paradigms, values and belief systems. In this way, emotional reactions to difficult elements in one’s life story are reprocessed and gradually there is a return to understanding that ultimately the world is a benevolent place after all. Furthermore, together with our comrades we can follow a purpose filled life to ensure that it remains so, for ourselves and others.

For more information about Project Trauma Support, please see our website,
www.projecttraumasupport.com

Medical Director
Project Trauma Support.

Local doctor brings internationally recognized PTSD program to Perth

Saturday, February 27, 2016 @ 02:02 PM
posted by admin

By Dianne Pinder-Moss

Randy Hillier has seen firsthand how therapeutic it can be for military veterans to share with one another about their experiences.

In early 2015, the Member of Provincial Parliament for Lanark-Frontenac-Lennox & Addington was on a train ride from Toronto with his son Dillon, a Canadian Forces veteran of Afghanistan who had recently returned from fighting the Islamic State group alongside Kurdish Peshmerga forces in Iraq.

By coincidence, the man sitting directly across from them on the train was a Canadian who had served in the Iraq war with the U.S. Marines. Another Canadian who had also served with the U.S. Marines in the Gulf War in the early 1990s was seated across the aisle.

“We ended up just having a tremendous conversation,” Hiller said in calling the train ride “the most therapeutic three-and-a-half-hours.”

Having been “enlightened” by that train trip and having other members of his extended family who have seen military service, as well as his work with constituents who have family members suffering from post-traumatic stress disorder (PTSD), the MPP has become one of a local doctor’s biggest supporters in her efforts to bring the internationally recognized Spiritual Process and Resiliency [SPARTA] program to Canada to help military veterans and first responders dealing with PTSD.

“I just felt these people had it right,” Hillier said of the program, spearheaded by Dr. Manuela Joannou to start the first Canadian cohort.

Dr. Joannou is very much aware of PTSD, both personally and professionally.

“I would be lying if I didn’t have cases that profoundly affected me,” she says, adding this is true of any profession “bearing witness to pain and suffering and critical incidents.”

On a professional basis, the Perth area family/emergency physician is familiar with PTSD, both through the counselling she does and her interaction with her colleagues in the emergency department, in addition to first responders like police, firefighters and paramedics.

Dr. Joannou thinks of PTSD as “an operational stress injury for professionals.”

“I don’t like the idea that it is a disorder or a disease,” she said. “I think it is an injury and it needs to be looked at in a different category.”

She says those who care the most are more vulnerable to developing this type of injury.

“They really feel each other’s pain and are empathetic,” she remarked. “If we can intervene and help these people and get them back to their service, they are just such a huge asset.”

Frustrated with the treatments that were being offered, Dr. Joannou started doing research on possible alternatives.

“I felt what was missing was addressing the moral injury, the deep impact to a person’s heart and soul,” she said.

When the physician came across an interview with one of the American founders of SPARTA, “it just blew me away.”

“I realized they were doing it with great success but not a whole lot of recognition,” she said.

Having started off under the name “Save A Warrior,” it’s a very intensive five-and-a-half-day program using holistic and alternative methods.

“It is very experiential,” says Dr. Joannou who spent a week with the main program providers in Malibu in November. “They’re introduced to a lot of different concepts that really ground them and get them to connect to something greater than themselves.”

Along with group therapy discussions, SPARTA participants also engage in meditation, horse-assisted counselling and adventure programs like high ropes.

“Spending time in nature can really be a spiritual experience for anyone,” the physician commented. “With high ropes, we allow people to feel their fear in a very controlled safe environment.”

Likewise, one of the things that interests Dr. Joannou about the horse-assisted counselling component is that it incorporates the Equine Assisted Growth And Learning Association (EAGALA) model, training for which she completed 12 years ago.

“I am really excited that it is starting to get some validation and recognition,” she said.

Dr. Joannou is also excited that the first Canadian cohort of SPARTA could take place as early as this spring as she has received a commitment from the providers to come here. Currently, they are in Australia doing the first cohort there. Given the invitation for them to go to that country came from the Australian government is, she says, “just a testimonial to the fact it is being regarded as a worthwhile program.”

All the logistics have been planned out for the first cohort in Canada, which Tay River Reflections hopes to host using its new aqua facility, which is secluded from the rest of the spa and has its own parking area.

“It’s like its own microcosm,” she said. There are approximately five kilometres of walking trails just outside the door of the aqua facility.

She says her dream is to train people to have other facilities across the country.

“My vision is that the program could be adapted to any country in the world,” she said.

Dr. Joannou would also like to be able to oversee the research as to outcomes analysis.

“We would like to have the metrics to show it is a very effective treatment,” she said.

She says she’d like to work with the providers in the U.S. “to see if there are some things we need to tweak to give it a Canadian context” and ensure the curriculum meets the needs of Canadian organizations. As an example of how the program could be Canadianized, because the weather is different here than in Malibu, some winter outdoor activities could be added, she suggested.

Likewise, while SPARTA operates on a complementary and alternative medicine model in the U.S., Dr. Joannou is a strong proponent for utilizing a medical model here in Canada. That way, she says, if a person requires medication or even medical attention, that care would be available.

She says she was very encouraged by the large turnout for a full-day workshop on PTSD at Tay River Reflections on Jan. 13.

“It was just testimonial to how important people feel this topic is right now,” she stated.

For Perth town councillor Jim Graff who, along with Hillier, were among the attendees that day, the event really “opened my eyes” about PTSD.

“First of all, I don’t think society, including myself, is aware of the residual effect for first responders in working in an environment that primarily deals with tragic events,” he said in an email. “For policemen and soldiers in the course of their duty, having to take a life or be witness to indescribable horror is cavalier in the movies but not in real life.”

Having worked in the U.S. towards the end of the Vietnam War, Graff some of the returning veterans. He remembers how little of any help was available from the Department of Veterans Affairs there “and readjusting to civilian life for them was impossible.”

 

“Personally, I think we have a moral obligation to help these folks regain the quality of life that they lost in the performance of their duty,” he said “The SPARTA program I think will do that from Dr. Joannou’s presentation and a film we saw.”

 

With the progress being made in the understanding of mental health issues, Graff believes it’s “a no brainer that we should get behind physicians like Dr. Joannou and encourage government support for this SPARTA program.”

 

The estimated cost to run a cohort, taking into account the providers, lodging, food and the horse component, would be $3,000 per person.

“If we had $36,000, we could have it happen,” she said.

Ideally, Dr. Joannou would like to start off with two cohorts, one for men and one for women. Of course, everything hinges, she says, “on us being able to raise funds.” She’s currently looking at community fundraisers and corporate sponsorships to help fund the program.

The physician is appreciative of the support she’s receiving for SPARTA, particularly from Hillier. Calling the MPP “a champion” of the program, she says he has had “great ideas” and “connected us with political people to make it happen.”

“This is personal for him,” she stated. “He really cares. I just love that about him.”

For his part, Hillier says he has no doubt the SPARTA program will happen and will help out “wherever I can.”

“I think it is powerfully needed,” he said in a phone interview. He says for many with PTSD, it is not just a chemical imbalance they are suffering from that can be treated with medication.

“That’s what the SPARTA program recognizes,” Hillier said. “For many people, it is a moral injury.”

Based on his own experiences with people, the MPP believes there is a need to do something different in treating PTSD from what is currently being done.

“I have felt that what we have been doing in the past has been less than effective,” he stated. “The stats bear it out.”

In 2015, alone, 39 first responders and 12 members of the military died from suicide in Canada. Already, in the first month of this year, three more first responders have been added to those numbers.

A solemn Dr. Joannou doesn’t mince words when she talks about the sense of urgency she feels about the situation.

“I just wish we had this system in place where we could reach out to them a real solution for their suffering,” she said. “It is not a quick fix but it is a support channel to connect into a source that will lead them on the road to healing.”

To date, more than 300 people have completed the SPARTA program since it launched in 2012.

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