For many generations, misconceptions about Post Traumatic Stress Disorder effectively prevented victims from getting treatment. For example, in the American Civil War, doctors concluded that soldiers with depression and other PTSD symptoms had nostalgia, which was essentially advanced homesickness. The cure, according to doctors, was a vigorous offensive campaign that would take their minds off their homesickness. Ironically, of course, vigorous offensive action probably caused this brain injury in the first place.
That’s right. We said that PTSD is a brain injury. Combat stress and other extreme stress alter brain chemistry. The cerebral cortex, which controls logical responses, shrinks. As a result, the amygdala (emotional responses) enlarges. It is like a cowboy and a horse. If the cowboy (cerebral cortex) controls the horse (amygdala), everything is okay. If the cowboy loses control, the horse runs amok.
Despite clear science to the contrary, the aforementioned misconceptions about PTSD persist. As a result, many doctors misdiagnose it or simply do not address it properly. The victim’s PTSD then escalates from a relatively mild form to an extreme form. More on that below.
A Defense Base Act lawyer cannot change a doctor’s erroneous beliefs about PTSD. But an attorney can connect these victims with doctors who thoughtfully diagnose and aggressively treat PTSD. Most injured overseas contractors qualify for these benefits. They must suffer a deployment-related injury in an overseas war zone. The law defines all these requirements in broad, victim-friendly ways. For example, although the Iraq War is over, Iraq is still a war zone since the United States has an official military presence in that nation.
Normal Stress Response
During combat operations, private military contractors must always be on their toes. For example, they must assume that every person with a cellphone is preparing to trigger an IED. Shift after shift of such stress creates an unreasonable amount of tension and causes NSR.
If doctors get ahead of the problem, NSR does not develop into full-blown PTSD. In fact, these victims often do not need medication, therapy, or other professional medical products or services. They just need someone to talk to.
As mentioned, however, doctors often do not get ahead of the problem. So, they do not encourage NSR victims to vent and may even downplay their mental illness. At that point, PTSD is just around the corner.
Acute Stress Disorder
Indirect combat participants often develop ASD. For example, Sally may be in the last humvee in a long column when militants attack the lead humvee. More than likely, she was never in mortal danger. But to her brain, that does not matter. It was like she was in the lead humvee.
These victims often need a little more than TLC. Short-term medication and a handful of therapy sessions are usually appropriate, so these victims can get over the hump. Unfortunately, doctors who do not recognize the signs of pre-PTSD certainly won’t prescribe medication to prevent it.
Incidentally, PTSD, like other brain injuries, is permanent. So, the symptoms are permanent as well. But in ASD situations, the symptoms are mild enough that, after the initial intervention, victims usually do not need ongoing professional care.
This form of Post Traumatic Stress Disorder is usually the most common form of this brain injury among overseas private military contractors. A life-threatening traumatic event triggers classic PTSD symptoms, including:
- Nightmares, and
- Daytime flashbacks.
PTSD medications do not reverse the brain injury. But they do minimize the effects of this injury, giving therapy a better chance to work.
PTSD therapy usually includes individual and group therapy. One-on-one therapy helps these victims identify PTSD triggers, such as violent movies, and avoid them. Group therapy gives these victims a safe place to vent and reminds them that they are not alone.
Contractors who serve multiple tours of duty are at risk for complex PTSD. This form of this brain injury is like uncomplicated PTSD on steroids. Multiple life-threatening events cause it. As a result, it is deeply entrenched and difficult to treat.
Not everyone can tolerate aggressive PTSD treatments. The drugs are very powerful, and they have powerful side effects. In many cases, the cure is worse than the disease, and that is pretty bad.
Individuals with complex PTSD can be diagnosed with a borderline or antisocial personality disorder or dissociative disorders. They exhibit behavioral issues, such as impulsivity, aggression, substance abuse, or sexual impulsivity. They can also exhibit extreme emotional issues, such as intense rage, depression, or panic.
Many private military contractors are former servicemembers. These individuals are very independent. When they encounter problems like PTSD, they try to overcome them on their own. As a result, the temptation to self-medicate with alcohol or drugs is very strong.
At first, this self-medication usually works. Alcohol and drugs are depressants that dull emotions, both good and bad ones. Additionally, published stories state that some drugs, like marijuana and MDMA (ecstasy), could effectively treat PTSD.
But this strategy is not sustainable over time. Additionally, although drugs like marijuana and MDMA might help, only a doctor should administer these powerful drugs.
Eventually, self-medication often leads to other destructive behaviors. Using drugs or alcohol as a way to numb the pain will only make things worse and prolong treatment.
For more information about covered DBA injuries, contact Barnett, Lerner, Karsen, Frankel & Castro, P.A.