Time for some honest talk about PTSD
Post-traumatic stress disorder, or PTSD, can be caused by a constellation of circumstances — some affecting millions of folks, like the 9/11 terrorist attacks; others intensely personal, such as a sexual assault, bullying or physical trauma from a sports-related injury or car accident. It’s commonly found in victims of gun violence, combat veterans and first responders.
In short, PTSD can happen to anyone.
Researchers at the National Center for PTSD estimate that 7 or 8 of every 100 Americans will have PTSD at some point in their life, and 8 million adults will have PTSD during any given year.
Among veterans, the numbers are much higher: We know that around 11 to 20 percent of those who served in Iraq developed PTSD; in Vietnam the rate hit about 30 percent. Today we have more than 1.3 million active servicemen and servicewomen in the Army, Navy, Air Force and Marines with Special Operations forces deployed in more than 145 countries, according to The Nation and Stars and Stripes. While 31 service members died in actions overseas in the first 11 months of 2017, according to Defense Department data, 20 vets a day commit suicide — often a result of untreated PTSD.
The latest cause of PTSD that we are hearing about is from taking children away from their parents at U.S. border crossings. The reason many of these families are here is because they’re fleeing extreme violence in Central American countries like San Salvador and Honduras. Now there’s a double trauma for each child to process, and there’s a good chance that the resulting PTSD may accompany them for years and result in many behavioral problems, ranging from depression, anxiety and drug abuse to rage and violence. And what about the parents? Ever seen the film “Sophie’s Choice”? Adapted from the William Styron novel, the 1982 film told the story of the Polish holocaust survivor Sophie Zawistowski (Meryl Streep won the Academy Award for Best Actress — maybe best ever!) and what happened after she had to choose which of her two children to leave behind and then deal with her later separation from her son at the Auschwitz concentration camp. She survives the camp, but later when she is living in Brooklyn, she doesn’t survive the PTSD.
No matter the trigger, symptoms of PTSD may include sleep problems; becoming quick to anger and other intense emotional outbreaks; flashbacks; recurring upsetting memories; and thoughts of suicide.
Treatment with a trained therapist will help you open up about your experience and also may include instruction in meditation, progressive muscle relaxation, yoga, tai chi and acupuncture. A good therapist will use some of the newer therapies, including virtual reality exposure and wise use of medications to temporarily treat anxiety and depression. If you cannot get to a therapy session in person, explore telemedicine (the Department of Veterans Affairs is doing a lot of this) and internet-delivered cognitive behavioral treatment for PTSD.
There soon may be a new medical treatment for PTSD that promises to be quite effective.
The results of a Phase II clinical trail are in, and it seems that using MDMA (otherwise known as Molly and ecstasy) with adjunctive psychotherapy in a controlled setting may be somewhat effective and welltolerated in reducing PTSD symptoms in veterans and first responders. A 12-month followup found sustaining benefits.
More information will become available over the coming months. But for now, if you’re suffering the effects of PTSD, see a therapist. If someone you know has PTSD, offer support and understanding.
Let’s not be a country that creates PTSD in children or their parents. The Statue of Liberty harbors the words, “Give me your tired, your poor, your huddled masses yearning to breathe free.” Breathing free — that’s the dream of everyone who has to contend with PTSD.
Q: I know people who have developed Type 2 diabetes who aren’t particularly overweight or sedentary. Does that mean anyone can get it? What can I do to make sure I don’t develop it?
Gracie R., Roanoke, Va. A: That’s a great question — and there’s new research that’s helping to provide answers.
Type 2 diabetes starts either with the inability to use insulin properly or when your body doesn’t produce enough of it to regulate your blood sugar levels — even when it produces more insulin than normal. That can happen because of inflammation, changes in the gut biome and even exposure to antibiotics. Genetics may make you vulnerable, as do lifestyle choices, such as eating high-fat, overprocessed foods; being sedentary; and not getting enough good-quality sleep.
But the latest research shows that air pollution, which triggers bodywide inflammation and reduces insulin production, also is a risk factor, and it contributed to around 3.2 million new diabetes cases globally in 2016. Another recent study found that women who work more than 45 hours a week are 63 percent more likely to develop Type 2 diabetes than women who work 30-40 hours weekly. This probably is related to a chronic stress response that amps up inflammation, disrupts sleep and causes unhealthy eating schedules and choices.
Your best moves to avoid Type 2?
• Get seven to eight hours of quality sleep nightly.
• Maintain a healthy eating schedule, which includes seven to nine servings of produce daily.
• Get at least 30 minutes of physical activity daily and try not to exercise in highly polluted air.
• Install air filters at home.
• If you work long hours and can’t curtail them, find time for daily meditation and physical activity to dispel stress and improve sleep quality.
So, there’s a lot that contributes to developing the disease and a lot you can do to avoid it. Don’t forget Dr. Mike’s tip: “Drinking four cups of coffee over the course of a day will reduce your risk of Type 2 diabetes by 50 percent!”
Q: I need to change several of my doctors because I changed jobs and my old doctors don’t take my new health insurance. What am I supposed to do?
William C., Wooster, Ohio A: It’s a problem with today’s U.S. health care system, and no one seems to have an answer. A new, major British study that reviewed outcomes in 22 countries with different health care systems has found that staying with the same doctor(s) for a long period of time leads to better health and longevity and is better for the docs, too. But don’t worry, even though that was the conclusion, if you become your own best patient advocate, you will emerge from this change in doctors as a healthier you. Here’s how to do it:
• Specialization is increasing, so your GP’s job is offering important baseline health monitoring (annual physicals, vaccinations) and giving you referrals to specialists like cardiologists and orthopedic surgeons. The key is to have your medical records available to your new GP, and all your GP’s records available to any specialists, so they will know if you have health issues that affect their care of you.
Your task: Have every doc give you both a digital and printed copy of your records; review them and correct any mistakes. And make sure the doctors are communicating your records to one another digitally; it’s the best way to protect yourself from medical oversights when you change docs.
• The British research study mentioned that patients who stay with their docs for long periods of time had what they termed a “greater adherence to medical advice.” In other words, folks who move around from doc to doc are less likely to follow their doc’s advice. So act like a member of the care team from the start: Be an engaged patient, ask questions, be polite to the staff, show you care about quality care and you’ll get it.
Contact Drs. Oz and Roizen via sharecare.com.