Fear and anxiety are two of the worst PTSD symptoms. A pair of new drugs may now help alleviate these symptoms in contractors who developed Post Traumatic Stress Disorder in Iraq and elsewhere.
Inside the brain, fatty acid amide hydrolase (FAAH) enzymes are associated with fear and anxiety. Swedish researchers recently discovered that some patients experienced signs of fear extinction after they received FAAH inhibitors. The sample size was very small, so the results are only preliminary. Nevertheless, the Mayo Clinic said the findings were “very exciting” and the FAAH inhibitor “may offer a new way to treat PTSD and also other stress-related psychiatric conditions.”
FAAH enzymes are cannabinoid particles. A Canadian company has been working on the same problem from a different angle. Allied Corporation recently filed a U.S. patent for a hemp-based product which could relieve anxiety. David Weinkauf, Allied’s Vice President of Pharma Development, said the company was “excited to begin taking the strategic steps to developing and protecting our IP&PD strategy in the United States and around the world.”
Some eight million people struggle with Post Traumatic Stress Disorder. Nearly all of these individuals are combat veterans or first responders.
PTSD and Military Action
Some accident victims and a few other people experience Post Traumatic Stress Disorder-type symptoms. But for the most part, combat stress causes PTSD. That is the way it has been for centuries.
400 years ago, William Shakespeare wrote Henry IV, Part I. At one point, Lady Percy speaks to her husband, Hotspur, who has just returned from a war. She is distressed over his behavioral changes:
“O my good lord, why are you thus alone?
For what offense have I this fortnight been
A banished woman from my Harry’s bed?
Tell me, sweet lord, what is ‘t that takes from thee
Thy stomach, pleasure, and thy golden sleep?
Why dost thou bend thine eyes upon the earth,
And start so often when thou sit’st alone?
The symptoms she notices, such as solitude (why are you thus alone), unjustified anger at family members (a banished woman from my Harry’s bed), depression (why dost thou bend thine eyes upon the earth), and heightened awareness (starting often when thou sit’st alone), are all classic PTSD symptoms. So, Shakespeare was either an incredibly good guesser, or he had seen these symptoms firsthand.
Many years later, World War I brought PTSD out of the closet and into the open. Doctors believed that shell shock, battle fatigue, and other maladies were essentially processing disorders. If victims had some time off, they normally recovered.
That attitude has only recently changed. In the early 2000s, almost a hundred years after World War I, the Canadian Armed Forces replaced the PTSD label with OSI, or Operational Stress Injury. OSI victims are eligible for the Sacrifice Medal, which is Canada’s equivalent of a Purple Heart.
PTSD Causes: The Latest Research
That change came about after researchers discovered that PTSD is not a processing disorder at all. Instead, exposure to combat stress causes a chemical imbalance in the brain. That chemical imbalance causes PTSD symptoms.
First, it is important to understand the relationship between the cerebral cortex and the amygdala. The cerebral cortex controls logical responses, and the amygdala controls emotional responses. Some researchers say the bond is like a horse and rider. If the rider (cerebral cortex) cannot control the horse (amygdala), the horse runs amok.
Researchers are not sure why exposure to combat stress erodes the cerebral cortex, but there is definitely a relationship. As the cerebral cortex shrinks, the amygdala expands. That change explains most PTSD symptoms. Heightened awareness is a good example. PTSD victims cannot react logically to potentially threatening situations, even if the threat is extremely minimal. Instead, they react emotionally. Furthermore, many PTSD victims cannot understand why other people do not have the same reaction (i.e. “don’t you know how dangerous the world is?”). As a result, other PTSD symptoms, like depression and isolation, get worse. The downward spiral begins.
The bottom line here is that PTSD is a physical injury. That is important for Defense Base Act purposes, as outlined below.
Treatments for PTSD and Brain Injuries
Brain injuries like PTSD are quite difficult to treat, mostly because the injuries are permanent. Once brain cells die, they never regenerate. So, PTSD victims will never be “cured.”
However, mostly through physical therapy, it is possible to reduce the symptoms. Many times, the symptoms become almost unnoticeable. Unfortunately, physical therapy only goes so far.
PE (prolonged exposure therapy) is a good example. To help PTSD victims deal with fear, therapists sometimes have victims relive traumatic memories over and over. Eventually, the person becomes desensitized and the fear is no longer as acute.
At least that is the way it is supposed to work. And, PE is usually effective for most people. But a significant number of victims do not respond to PE at all. Furthermore, for other victims, the relief is only temporary. Once the therapy stops, the fear returns.
Doctors hope that the aforementioned FAAH inhibitor might make PE more effective for everyone. Alternatively, physical therapists could try another approach altogether. Regarding physical therapy, there is no one-size-fits-all strategy.
Physical therapy is not just hit and miss. Progress often comes in fits and starts. Victims may show little or no progress for weeks or months, and then suddenly experience a breakthrough.
In both these situations, stingy insurance companies are quick to say “therapy is not working” and pull the financial plug. If that happens, temporary disability benefits end. However, if the victims have not reached MMI (maximum medical improvement), permanent disability benefits may be unavailable. An assertive lawyer can keep victims out of this twilight zone.
Overseas contractors may experience combat stress at any time, and not just during work hours. In places like Iraq, Syria, and Afghanistan, the entire country is a war zone. Militant abushes, drone strikes, or terrorist attacks are just as likely to occur in crowded markets as they are at military bases.
To establish Defense Base Act benefits claims, victims must only establish a nexus between the illness or injury and their overseas deployment. Victims do not have to be “on the clock” when the injury or illness occurred. Simply being in-country is probably sufficient.
Moreover, as mentioned, DBA benefits only apply to physical injuries. However, as PTSD clearly shows, injuries can be invisible and still be physical. That is certainly the case with regard to Mild Traumatic Brain Injuries (mTBI), which is the most common combat-related brain injury. But do not let the “mild” fool you. These injuries have life-altering consequences which, in many cases, may also be life-threatening.
Finally, both combat and non-combat contractors are eligible for compensation. Job duties are irrelevant. Type of employment is the only thing that matters.
Reach out to Barnett, Lerner, Karsen, Frankel & Castro, P.A. to learn more about DBA benefits.