A New Development in PTSD Treatment

A New Development in PTSD Treatment

A newly-discovered treatment may enable injured brains to heal themselves after incidents in Afghanistan or elsewhere.

High-resolution Relational Resonance-based Electroencephalic Mirroring (HIRREM) is essentially an acoustic mirror that gives the brain a chance to examine itself, according to Wake Forest Medical School’s Dr. Charles H. Tegeler. Dr. Tegeler and his team studied 18 symptomatic veterans who each received about a dozen HIRREM treatments over about four months. “We observed reductions in post-traumatic symptoms, including insomnia, depressive mood and anxiety that were durable through six months after the use of HIRREM, but additional research is needed to confirm these initial findings,” he stated.

Dr. Tegeler added that the results were very preliminary; he also pointed out that the study had an extremely small sample size. Nonetheless, “This study is also the first to report improvement in heart rate variability and baroreflex sensitivity – physiological responses to stress – after the use of an intervention for service members or veterans with ongoing symptoms of post-traumatic stress,” he concluded.

Old Thoughts Regarding PTSD

As the violence in warfare escalated, so did the recorded PTSD incidents. Therefore, it is not surprising that many doctors equated PTSD-like symptoms with a processing disorder based on the horrors of combat.

These symptoms were documented among soldiers almost as soon as they took up arms against one another. Doctors usually diagnosed the condition as “nostalgia,” under the erroneous yet understandable belief that these soldiers were simply very homesick. After all, enlistments usually lasted several years, soldiers had nothing but slow-moving and unreliable letters to connect with their loved ones, a soldier’s relatively inactive life is fertile ground for frequent trips down memory lane, and most of these kids had never ventured more than a few miles from their front doors.

The late 19th century introduced the concept of total war and attacks on non-military support targets. In the American Civil War, doctors usually diagnosed soldiers suffering from fear, anxiety, flashbacks, and other PTSD symptoms with “camp disease,” listing its causes as moral turpitude, feeble will, and/or camp inactivity. The prescription usually included a transfer to a more intense area of war, a prescription which probably just made the condition worse.

By World War I, combat was more intense than ever, largely because the world’s armies used TNT instead of the much weaker picric acid in their bombs, along with some never-seen-before weapons, such as huge artillery pieces, machine guns, hand grenades, and flamethrowers. Some of the more heartbreaking cases are recorded in this video, which features a former British soldier who is completely unresponsive unless someone shouts a trigger word, like “bomb” or “grenade,” and he then scurries under a bed. There is also a former French soldier who is terrified of an officer’s red hat, apparently because he cannot bear the thought of returning to combat.

Many of these soldiers recovered from “shell shock” after extended physical therapy, or even experimental shock therapy treatments. The vast majority either never got better at all or never improved very much.

The understanding of PTSD expanded significantly during ensuing decades, but attitudes remained much the same. In World War II, General George Patton ordered his subordinates to stop sending battle fatigue patients to hospitals, because “Such men… bring discredit on the army and disgrace to their comrades.” In his personal diary, Patton used even harsher language, referring to such individuals as weaklings.

Later, following the Vietnam War, the media often did the opposite. Many movies and television shows implied that almost all veterans suffered from serious brain injuries that rendered them incapable of functioning normally. As a result, to avoid being stigmatized, many veterans did not get the treatment they needed.

New Thoughts Regarding PTSD

While these attitudes still linger, even among some medical professionals, the latest research clearly indicates that PTSD is a physical injury and not merely a processing disorder.

Many soldiers suffer not from PTSD, but from blast-associated traumatic brain injury (bTBI). The concussive blast of a roadside bomb or other such explosion disrupts brain functions, even if the victim is not physically knocked down or shows no other physical injury symptoms, such as a trauma wound. According to some researchers, when blast shock waves strike bones, they create a field of electrical energy. Such piezoelectricity is common in loudspeakers and other machines, but has only been recently connected to the human brain. In some cases, the electric fields could be 10 times more hazardous than dangerous electrical wiring.

Other emerging research points to the relationship between the amygdala and the prefontal cortex. The former controls logical responses in the brain; the latter governs emotional impulses, such as fear and depression. For reasons that are still not clear, exposure to combat stress erodes the amygdala, which is why PTSD victims experience symptoms like heightened awareness, nightmares, flashbacks, and depression. Researchers are not sure whether a one-time event, like a particularly intense firefight, or long-term exposure to lower levels of combat stress triggers such erosion.

Based on this new research, the Canadian military made the controversial decision to eliminate the “PTSD” moniker and replace it with Operational Stress Injury. OSI victims are eligible for the Médaille du sacrifice (Sacrifice Medallion), which is that country’s equivalent of a Purple Heart.

Compensation Available to PTSD Victims

Brain injuries, like PTSD, are incurable. Extensive, long-term physical therapy is the only treatment. During such therapy, uninjured areas of the brain often learn to assume the lost functions, which is why, as mentioned earlier, such approaches were often successful in the Great War. Recovery also involves life adjustments, perhaps a new job, a new place to live, or in-home nursing care. All these treatments are very expensive, and they can be as much as $3 million over a lifetime, according to some estimates.

Fortunately, the Defense Base Act allows injured contractors access to the financial resources they need to recover from PTSD and other associated brain injuries. The insurance company usually pays medically necessary costs directly, and victims are not responsible for any unpaid charges.

The phrase “medically necessary” is often the center of controversy in DBA cases. Many doctors either do not recognize PTSD as a physical illness because of the developing nature of the science, or quickly declare that victims have reached their maximum medical improvement and further physical therapy would not produce results. Often, the best approach is switching doctors to a physician that focuses in this area. Many DBA attorneys have such partnerships, so victims can get the treatment they need.

Other DBA benefits are available as well. Contact Barnett, Lerner, Karsen & Frankel, P.A., to learn more.