Taylor Lynne Trentwood, Ph.D
As an young intern at the VA Hospital in Houston TX, I vividly recall sitting in a military green, linoleum floored room with stacking chairs formed into a circle. A diagnosed PTSD veteran occupied each chair and smoke filled the air so thickly that on most days my eyes would sharply sting. Men (women veterans were rare in those times ) clad in everything from faded pajamas and thin bathrobes to plaid sport shirts and jeans made up a group as varied in appearance as they were in their combat experiences. One unforgettable Christmas we, the staff, hosted a party with music and gourmet treats, bought with our own meager intern-level of pay. We keenly hoped to add some small cheer of the season yet here is what happened.
I can not forget. Most of the men just sat and stared at the buffet and showed little response to the festive “Over the river and to the woods…” music coming through clunky megaphone speakers in the day room. “This is as close to living in Hell as I will ever see “ was my thought at the time, my own joy in the season diminished beyond resurrection by the sight of that “party“. These patients were traumatized to the point of withdrawal from both the pleasures and the pains of life.
The scene was heartbreaking. Formerly strong, vivid, life affirming, even mischievous soldiers, were gathered as huddled grey figures dutifully attending an event in the day room. Enjoyment was impossible for these battle- weary warriors and many had felt no pleasure in anything, whatsoever, for months to years. This is the face of Post Trauma that the public does not see. The patients are unlike any others. No ability to feel joy, no interest in the world or even the person who sits next to you every day for lunch; this is the face of War. No caring about weather, politics, holidays, shopping, great food or good music. Nothing. Life is a burden to these PTSD patients. Suicide is to many a logical solution.
In an attempt to help more ex- warriors with PTSD, the VA recently ran a research project to determine whether the very powerful anti-psychotic drug Risperdal would provide some relief. Here are the findings.
A new research study on veterans with PTSD has made some very surprising reports. Doctors at VA hospitals treating returned combat veterans found that traditional anti-depressants were not helpful to many of the patients. Moving on to the more powerful anti-psychotic medications was hoped to be a useful treatment that would provide greater relief. It turned out to be just another version of the failed Christmas party.
The nightmares, anxiety and tensions that the veterans live with make enjoyment of life and following a usual life- style very difficult. Yet the research, reported by lead author and investigator Dr. J. Krystal reports that the more powerful drugs were also not as effective as hoped. The anti-psychotic Risperdal was the primary focuses of the research but doctors believe that the non- affect will include Abilify, Seroquel and Geodon as well. None of these is now thought to be helpful to PTSD to the degree that was projected. Some patients are helped but the vast numbers do not show a relief of symptoms. In fact, the study showed that the anti-psychotic was no more help to the veterans with PTSD than a sugar pill or placebo.
Talking therapy once again has shown to be one of the more useful treatments. The one on one care of a trained, compassionate therapist is and always has been a treatment modality that is successful. The higher cost of this therapy has moved it to the further regions in hopes that writing a prescription could replace human care. This has proven not to the case and it is reaffirmed in this latest clinical study.
Twenty percent of combat veterans report having post traumatic stress. The good news is the findings that in 24 months time living back in the civilian environment, most patients “reset” and the symptoms fade away. That is excellent news as a life on either anti-depressants or the more powerful anti-psychotics can be filled with the toxic effects of these drugs that include weight gain, fatigue and many other effects that can dampen the enjoyment of life.
People need people. PTSD patients also need the care of a person as much as they need medication according to the emerging picture that comes out of all of these studies. . They need the care and compassion of their support systems and their therapists .T his is the key finding in many recent studies. PTSD is not due to genetic psychosis and so the hope that Risperdal would treat it may have come out of a desperate hope that the medication might relieve symptoms. It did not.
Post WWII the same crisis of treating veterans surfaced. Peer group counseling was found to be one effective answer. In this modality, a group of patients met and supported one another and it was found to be highly effective. This more cost- effective method in which one therapist can lead a group of 8-20 patients worked well. The study on the non-effectiveness of psychotropic drugs may turn us once again to the human support and contact that direct talking therapy provides. A person needing people seems to be the reoccurring theme since the time of the healing temples of the ancient Greek civilization. Perhaps we should stop searching for the treatment that will save the government expense, return to the tried and true, and relegate medication to the second tier level of care. Traumatized patients need compassion, support, good jobs, a sense of security and a listening ear. No pill can provide these essentials.
The economy is a factor that adds to the stress of veterans in that this major life problem of employment is added to an already tense and troubled nervous system. Post WWII the economy was prosperous but today’s soldiers are returning to a life that challenges even the hardiest among us. PTSD, added to this crisis, places a heavy burden on one trying to reestablish a normal life after being in a combat zone. VA doctors, in a valiant attempt to provide relief, have tested anti-psychotic and anti-depressant drugs to treat PTSD. This study by Dr. Krystal as lead author now demonstrates that this line of approach is not effective. A great deal has been learned about PTSD by this study.
We continue to search for answers to disordered minds which have been stretched to handle more demands, pain, stress and chaos than is humanly possible. At this time, however, the passage of time and the loving care of the community appear to be among the most potent weapons of relief.