IN PROGRESS
Last updated Friday, 30-Apr-2010 12:24:05 MST

This grant submission was crafted after numerous surveys of individuals diagnosed with PTSD. These individuals were all members of the PTSD Support Group on www.DailyStrength.org.

It is striking that so many people with PTSD have very similar personalities. Every day we are learning more about the fight-or-flight chemicals (catecholamines) and how they affect our bodies. After watching a recent program on PBS, it made sense that those of us with PTSD are so much alike. Because we have elevated levels of adrenaline (epinephrine), noradrenaline (norepinephrine) and dopamine, we actually experience very similar feelings. Elevated levels of dopamine help us feel optimistic even when we are in terrible situations. Did you ever wonder why you were still thinking about the positives while everything was falling apart? Elevated levels of adrenaline and norepinephrine keep us feeling energetic, focused and able to accomplish many things at one time. How often have you willed yourself to complete tasks quickly and stayed focused for long periods to the envy of others? These are all good signs that you have excess catecholamines.

Here is how the main part of the grant turned out. What do you find that reminds you of yourself?

Project Narrative

Innovation

This program would focus on the identification of behavioral traits shared by patients both prior to and subsequent to acquiring PTSD in order to create new measures in screening, detection and diagnosis. This includes identifying neurobiology/genetic factors, which may indicate predicators of susceptibility (such as IQ), previous exposure to traumatic events and responses to traditional and alternative treatment strategies. Additional data would be gathered regarding individual attempts to deter affects of PTSD pre- and post-diagnosis. This includes evaluating the individual's thought process before he/she realized that he/she had acquired an SMI, allowing for a more thorough epidemiological study of how PTSD evolves over time. With data already gathered, this program believes it can provide improved treatment and intervention plans for both military and nonmilitary personnel by changing the standard practice for treating patients.

Hypothesis/Rationale/Purpose

Currently, the standard practice for treating victims of PTSD is medicating with SSRIs. However, information garnered from individuals finds that treatment with SSRIs often fails to give patients sufficient relief to function in social situations, let alone within controlled environments, including their own homes. More disconcerting is the aptitude for SSRIs, tricyclics, MAOIs and other mood disorder medications to lead to more volatile behavioral states, which may provoke patients to become DTO or DTS.

Information gathered from PTSD support groups suggests that victims share strikingly similar behavioral traits. In addition, while PTSD is considered an anxiety disorder, the same traits do not appear to be associated with anxiety patients without PTSD. This suggests that treatment for these two groups should be conspicuously different. Traits shared by PTSD victims include but are not limited to:

  Above average IQs / high achiever

  Logical

  Focus on effective/high productivity

  Highly successful and respected in their careers

  Charismatic

  Sought out by others for guidance

  Others often confide highly personal, confidential and explosive information

  Exposure to previous trauma

  Respond to trauma by trying to normalize the event and emotions

  Choose to repress harmful emotions and/or release them through self-harm

PTSD sufferers may also have very strong emotions, which they focus on repressing around other people. The preference of PTSD sufferers is to release stress verbally and unemotionally. However the inability to trust others created by the illness and/or the fear of becoming volatile causes PTSD victims to seek out other methods, such as self-harm.

The high aptitude of PTSD victims make them the best resource for identifying who gets PTSD, when one gets PTSD, what causes a person to get PTSD and details of how PTSD progresses and affects one's life.

The type of traumatic event appears to be entirely irrelevant in PTSD cases. Whether obtained during wartime, in a business environment, as a crime victim or in one’s home environment, PTSD victims describe notably similar attempts to recover from the trauma, use similar skills to cope and follow nearly identical patterns in the progression of the disease. Identifying these patterns would allow for intervention before patients become completely disabled from the illness. The final phase of this illness appears to result in agoraphobia and a comprehensive withdrawal from society, including friends and family. However, in any moment that a PTSD victim feels stability, this person immediately attempts to counteract this downslide through interaction with safe people, going to safe places and/or increasing his/her productivity by attempting to complete a project, whether it be household chores or something larger. Finding ways to help PTSD patients sustain this natural drive may be the ultimate key to permanent recovery.

Surveyed PTSD victims describe themselves as feeling overwhelmed and frustrated. They fear symptoms of their illness and note that new triggers are easily created. Struggling to cope with day-to-day concerns, victims eventually find themselves stuck in survival mode, going from one crisis to another. Those without a strongly supportive family are left to struggle to find healthcare, mental care and financial support structures. Frustrated PTSD victims, despite their intelligence, extensive coping skills and problem-solving abilities, find themselves overwhelmed by the mounting problems. They watch as their lives tumble from success to a period of immobility. Unless someone becomes a caretaker, victims trying to get a grip on their illness watch as their homes fill with trash, dirty dishes and complete disorder. They withdraw from society in an attempt to regain control over their volatile emotions. Given enough time without conflict, these victims do rebound to some extent. However, as they attempt to regain control over their physical surroundings and financial stability, they are once again overwhelmed and confronted with conflict, which causes symptoms to reoccur. This leads to continuous cycles of progression and setbacks.

This program hypothesizes that early intervention, before a patient reaches the period of immobility, can halt the cyclical nature of PTSD. The suggested intervention is a combination of medications that suppress chemicals released as part of the fight-or-flight response (such as low doses of propranolol), alternative treatments.

Due to the duration, unresponsiveness to medication and debilitating nature of PTSD, this program hypothesizes an aggressive treatment that temporarily removes patients from their current environment is critical to permanent recovery. The program believes that PTSD victims need treatment akin to in-patient treatment given to other cyclical illnesses such as drug addictions and eating disorders.

Objectives

The objectives of this program would be to gather statistical data regarding intellectual aptitude and personality traits of PTSD victims. The program would include taking a detailed life history of PTSD patients and the coping skills they used before becoming disabled by PTSD. It would also review the efficacy of a patient's current and prior treatments as well as elicit types of treatments and environmental changes the patient believes would expedite his/her recovery, if access to such options were enabled. Finally, it would coordinate with patient's medical providers to review efficacy of changing volunteer's treatment from SSRIs, tricyclics, MAOIs and other mood disorder medications to the sole use of medication which blocks adrenaline, increases cortisol and/or decreases catecholamines, which are associated with PTSD and the fight-or-flight response.

Methods
 

  Online support groups where data can be gathered from a large and varied pool of victims. Data would include personal history of trauma prior to the PTSD event, history of all coping skills used before and after illness became disabling and efficacy of current and previous treatment methods.

  Working with local universities to gather personality profiles.

  Intelligence and temperament testing.

  Use of service animals in early intervention and with victims who have already isolated.

  Use of in-patient treatment, which allows victim to focus on healing while receiving support in a compassionate and nurturing environment.

  Use of drugs specifically known to block adrenaline or affect fight-or-flight hormones.