WHEN STRESS TAKES OVER

After having a particularly stressful day, I got to thinking about PTSD effects our stress levels. I believe that if it’s a stressful day, my baseline increases dramatically due to my PTSD.  My sister will tell you my temper has a hair trigger, and that used to be very true.  I’d like to think it’s not the case so much now, but, it is what it is.  I know that I react to everyday frustrations very quickly, and it’s something I have to keep at the top of my consciousness and work to control every day.

It used to be that I did not realize I was so stressed until I had an emotional melt down. I don’t like myself very much when that happens, so I try to ensure that I’m paying attention enough now to stop it before things get out of hand.  Sometimes that means stepping aside for a voluntary “time out.”  That means I disconnect from whatever is stressing me and focus intently on something enjoyable.  Often I’ll use music to regroup, or maybe I’ll sit down at the computer to play a game or two, or take a ten minute ride in the car.  Basically, it means I’ve had enough stress for the moment and I need to disconnect in order to allow myself a cooling off period.  I really don’t think my family realizes how necessary this is for me, but it is something I feel I have to do for myself to maintain my mental health.

Try monitoring your stress levels throughout the day. If you practice doing this on a daily basis, it will become easier as you go.  Intervening before your stress takes over allows you to stop the cycle of “blowing up” and taking it out on everyone else in the vicinity.  I know I don’t like being known as the person with a temper that explodes on a hair trigger.  Even if others around you don’t understand what you’re doing when you refocus, it’s better for them and you to not let stress push you into the danger zone.

USING TELEMEDICINE IN TREATING PTSD

Telemedicine is the newest trend in treating PTSD. Video teleconferencing (VTC) allows a single person or group of individuals in one location and a clinician in a different location to see and hear each other in real time.

Telemedicine allows veterans living in remote areas to access treatment services they otherwise would have to travel miles to reach. Telemedicine services may include clinical assessment, individual or group psychotherapy, educational interventions, cognitive testing, and general psychiatry. The major benefit is that these services eliminate travel expense that may be disruptive or overly expensive.

Research comparing VTC and real-time methods of PTSD assessment has shown the methods yield comparable results. While providing treatment using telemedicine may need more research, it does provide an alternative for individuals who have difficulty accessing treatment even though they live in remote areas.

Telemedicine appears to offer a more convenient and economical way to provide or supplement PTSD care services. For patients that live remote distances from VA Med Centers, this is one way to make treatment for PTSD accessible.

WHAT’S NORMAL ABOUT PTSD?

The thing about PTSD is that it is a normal reaction to trauma. You can actually think of it as a normal reaction to an abnormal event.  So why do we call it a disorder?  .  Although we may be changed by what we’ve been through, we can and usually do get better over time.  While we may never be the same, for many people the symptoms lessen or disappear altogether.

PTSD treatment works. There are different options you can try to treat PTSD.  The thing is, if you don’t get into treatment, your PTSD may get worse.  It’s never too late to get into treatment; the sooner treatment starts, the sooner you can start to feel better!

There are a variety of treatments available for treating PTSD:

  • Talk Therapy involves discussing what you went through with a therapist.
  • With Prolonged Exposure Therapy, you’ll discuss your experience with a therapist who will ask you to review the situation multiple times. Reliving the experience helps reduce the intensity of the memory.
  • Cognitive Processing Therapy helps you change your thoughts about the event which helps change how you feel too.
  • Eye Movement Desensitization and Reprocessing involves having you think about the event while listening to a sound such as a beeping tone, or being exposed to a blinking light. For some reason, this helps your brain reprocess your feelings about the event.
  • Stress Inoculation Training teaches you the skills you need to handle stress.
  • Medications may be used to increase certain chemicals in your brain that help you manage stress.

PTSD is a normal reaction to an abnormally stressful situation.  It is treatable, and treatment can result in reduction or elimination of symptoms.

COPING WITH ANXIETY

Some tips for helping cope with anxiety:

  • Avoid caffeine – it acts as a stimulant and revs up your nervous system increasing your anxiety.
  • Try relaxation techniques. They may not all work for you, but there are many choices out there and you may just find one that really works. Try meditation, yoga, or deep breathing exercises to help lower your anxiety.
  • Try visualization – like relaxation techniques, visualization can help lower your stress levels. Picture yourself confronting your fears, and handling stressful situations calmly.
  • Ask for help when you need it. Talk to your doctor. There are many different treatments that may reduce your anxiety.
  • Change your attitude. If you can change the way you think about things, they may not seem so bad.

Controlling your anxiety is possible.  Try a variety of coping techniques.  While one may not work for you, another just might do the trick!

HIGH CHOLESTEROL

It seems like we all watch our cholesterol these days, but we may not really understand the importance of doing so. If you have high cholesterol, you are at an increased risk of having a heart attack or stroke.  It’s that simple.

You may be at risk for having high cholesterol if any of the following risk factors fit your profile:

  • Are you a man 45 years old or older or a woman 55 years old or older?
  • Does your family have a history of heart problems? This includes heart attack, coronary heart disease, or atherosclerosis.
  • Do you have high blood pressure? Are you on blood pressure medication?
  • Do you smoke?
  • Do you have diabetes?

If you answer “yes” to one or more of the factors listed, then it may be time for you to make some changes in your lifestyle to lower your cholesterol level.

Some of those changes may include:

  • Eating less fat, salt, and more fiber
  • Comparing labels on the food products you buy and choosing those that are lower in fat, cholesterol, sodium and calories
  • Cooking with less fat
  • Learning correct serving sizes for determining food portions
  • Increase your physical activity to 30 minutes most days to strengthen your heart

High cholesterol can be controlled.  Now is the time to start creating your plan toward a healthier you!

PTSD AND OLDER ADULTS

(Adapted from VA’s “PTSD: The National Center for PTSD”)

There has been little research done that looks at treatment for PTSD in older adults versus younger people. We do know that PTSD, like many other disorders, can affect older individuals differently than it affects younger adults.

When dealing with trauma-focused treatments, older adults may develop increased anxiety and confusion. As it may be more difficult for older adults to benefit from therapies when confusion is present, presenting materials in a variety of formats and focusing on one topic at a time may be helpful. It may also help to include caregivers in the treatment plan as they often play a critical role by reinforcing information presented in therapy sessions.

Medications used to treat older adults may take longer to work, including those drugs prescribed to treat PTSD. Side effects may be more pronounced in older adults too, so dosages may have to be adjusted over time.   And, because older adults are often taking medications for other disorders, physicians should monitor any confusion to determine whether it is related to drug interactions.

PTSD in older adults may need a bit of a different approach for treatment purposes than is required with younger adults. What limited evidence there is at this time does support that PTSD treatments are effective for older adults.

TRIGGER STACKING

As a dog trainer, I sometimes see things that can be applied to people as well as dogs. Last night I worked with a wonderful little beagle who gets so excited she can barely function.  When she’s worked up, she barks constantly and won’t stop.  It’s very frustrating to the owners, as you can imagine.

When the owners drove up, this dog was in the back of the car, and she was very excited over going for a ride. They took her out and she immediately spotted several other dogs and their owners.  That also excited her.  As there were many other dogs that had been on the grounds that day, she was able to scent them, and that further excited her.  And, finally, when we took her to the exercise pen to stretch her legs, she spotted a fat rabbit nibbling the grass on the far side of the fence.  She immediately went into hound behavior, baying at the rabbit and frantically looking for a way to get under the fence to get it.  She was so excited, it was impossible to calm her down.  She was a victim of trigger stacking.

Each one of those events made her excited and nervous. Added together, they created a situation where she became out of control.  Unfortunately, I did not recognize what was happening until after the fact, but at least I was able to identify what was really going on: she wasn’t a bad little dog, just one that observed everything going on around her and was stimulated by it.  Her response was undesirable: barking, non-stop, but she wasn’t “just misbehaving.”

I think trigger stacking happens to humans quite often, and we also may not recognize what’s happening. We’re driving and someone runs a stop sign in front of us.  It scares us and makes our hearts race.  Then we get home and the kids are running around the yard, screaming as they play.  We go inside and the dog bolts out the door and runs away.  Finally we sit down to relax a few minutes and the neighbor comes over banging on the door with a complaint.  That may be the point where we lose it.  They are little things, but they build on one another until you’re feeling frantic.  It’s a perfect time for your PTSD triggers to go off too.

So, how can we respond to trigger stacking to stop the process? Recognizing what’s happening is the first step.  When you start to feel that first racing of your heart, take a time out.  Slow down and let yourself process what’s happening.  Are you in danger now?  No.  Can you afford to pull over for a few minutes at the local park and let yourself calm down?  If you can, it may break the sequence before it goes further.  At each step, recognize that things may be out of control, but there is no actual danger at the moment.

Staying healthy means recognizing when we have multiple issues that are having a negative impact on us. Don’t let your triggers build up until you go over the edge and lose it entirely.  Stop, evaluate the danger you’re really in, and then go on knowing you are in control.