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Monday, August 27, 2012

Forgetting Bad War Memories – Possible Today?

Jack Kemp In “Jarhead,” the classic book about Gulf War I, a group of Marine veterans travel to Michigan to attend the funeral of one of their former war buddies named Troy who died in a civilian automobile accident. With the Marines drinking constantly, only slowing down hours before they had to lift Troy’s casket at the cemetery, they decide a day after the funeral to visit the favorite bar of their late buddy. The story then tells how one of the Marines then voiced is anguish to a female bartender, saying “that if she could get him so f***ed up that he forgot Troy was dead, he’d give her $100.” The problem is that even if the bartender had some drink strong enough to make the Marine forget his buddy’s death, its effects wouldn’t last into the next day. But that young Marine’s wish, of wanting to quickly (or instantly) overcome his grief, is shared by every sober doctor and psychologist who works to relieve Post Traumatic Stress, be it military and/or civilian in origin. Researchers studying the chemical composition of memory processing, especially repeatedly occurring bad memories that cause frequent nightmares, have yielded some results, small victories. A January 2012 article at NPR’s website explains: BEGIN QUOTE Scientists wanted to find out the reason why people with PTSD can't sleep and dream normally. One theory comes from Matthew Walker, a psychology researcher at the University of California, Berkeley. His particular interest lies in rapid eye movement, or REM. It's the time during sleep when a lot of dreaming occurs. It's also a time when the chemistry of the brain actually changes. Levels of norepinephrine — a kind of adrenaline — drop out completely. REM sleep is the only time of day when this happens. That struck Walker as a mystery. "Why would rapid eye movement sleep suppress this neurochemical?" he asks. "Is there any function to that?" Walker found that in healthy people, REM sleep is kind of like therapy. It's an adrenaline-free environment where the brain can process its memories while sort of stripping off their sharp, emotional edges. "You come back the next day, and it doesn't trigger that same visceral reaction that you had at the time of learning." SECTION OMITTED Walker's theory suggests that in people with PTSD, REM sleep is broken. The adrenaline doesn't go away like it's supposed to. The brain can't process tough memories, so it just cycles through them, again and again. END QUOTE A “diversion” here from the article’s discussion will explain a relationship not often mentioned in pieces for a general readership, but significant as background information. Ironically, this same adrenaline is what the Mahdi militia used to raise their bodies and psyches to superhuman levels by way of ingesting large amounts of American epinephrine pills at the battles of Fallujah and some other clashes with U.S. Forces in Iraq. These pills kept the Mahdi insurgents hearts pumping and fighting even after their arms could no longer hold the weapons shot away from them. Of course that meant American soldiers and Marines, whether facing the Mahdi militia or other fighters, had to develop their own heightened level of adrenaline-induced awareness to overcome them, whether the insurgents were taking these pills or not. Returning to the topic of the NPR article’s discussion of the brain’s processing of hyper-vigilant traumas, it further notes what doctors have recently found to regulate a brain’s nighttime adrenaline-induced hyper state: BEGIN QUOTE So, what if you could make the adrenaline just go away? Enter prazosin. Pfizer Inc. introduced the drug under the brand name Minipress in the 1970s to treat high blood pressure. Dr. Murray Raskind, a VA psychiatrist in Seattle, says the drug, now generic, can cost anywhere between 5 and 15 cents. And, actually, it's not terribly effective as a blood pressure medication, he says. But what prazosin does do is make people less sensitive to adrenaline. About a decade ago, Raskind starting giving prazosin to some of his PTSD patients, including one Vietnam War veteran. "He had this recurrent nightmare of being trapped by the Vietcong forces in a landing zone and having his best friend killed in front of his eyes by a mortar round," Raskind says. After a few weeks of treatment with prazosin, the veteran came in for a follow-up appointment. Raskind says the veteran told him that he wasn't sure the medication was working. He was still having the same dream over and over — just about something else. He told Raskind that in the new dream he was in his fifth grade classroom and there was a test. If he didn't pass the test, he wasn't going to be promoted to the next grade. But he never even got the assignment. "I said, 'That's my nightmare!' " Raskind says. Indeed, the veteran's new dream was the stress dream of a healthy brain trying to work things out, Raskind says. This year, the VA is expected to finish up its trial for prazosin. It's already prescribing the drug to about 15 percent of its PTSD patients. Raskind, of course, would like to see that number rise. END QUOTE As positive and promising as prazosin is, notice that the article still says the Veterans’ Affairs/Administration doctors thought it was only appropriate for one in seven cases of PTSD under their care. Without saying it directly, we are being told that despite our modern high tech computer and drug era research, we are still only in the early days of understanding human memory processing. The situation is somewhat analogous to just after Pasteur developed the germ theory – but before others had developed the quinine cure for malaria and the streptomycin cure for tuberculosis. But prazosin is one of the first effective ways of managing – and possibly curing – PTSD. Before finishing, another well known old “home remedy” for lowering blood pressure and stress is definitely worth mentioning. It is one that WebMD states has nearly twenty-five years of research showing its effectiveness in lessening anxiety and high blood pressure. Technically called “pet therapy,” it is simply owning a dog. American soldiers at distant battlefields have adopted stray dogs for generations. A recent book, “From Baghdad with Love” and its sequel, “From Baghdad to America,” tell of how a stray pup kept one Marine officer in touch normal life and “his humanity” - even in the chaos of fighting house to house in Fallujah. Further evidence of how effective this “home remedy” can be was recently brought to my attention when YouTube presented me with a video recommendation based on my past searches. In it, a former U.S. Airman stationed in the Middle East credits a shelter dog with saving his life after his Stateside PTSD developed. If you watch it at and listen closely, you will hear the significance of what he is saying. The dog doesn’t judge him. The serviceman feels he can obviously tell his concerns to the dog without worrying that the animal will repeat his stories and embarrass him in front of military and civilian friends, and his family. The serviceman appears to have initially judged himself as not capable of companionship with others after returning Stateside, yet his new dog broke through that self-fulfilling (and self-defeating) thought pattern, unconditionally accepting him and leading him to believe that whatever happened during his deployment overseas, he is still able to be a companion to this dog. And that new reality lead to his believing he could once again be a companion to his friends and family. The term “home remedy” has gained a double meaning here. The dog has made the Airman’s residence a home once again – and that is a significant initial step towards a remedy. There are other, more sophisticated accounts of dealing with Post Traumatic Stress way beyond the scope of this small article - and of this writer. What is presented here just touches the surface of this issue and yet will hopefully be of benefit to some readers. I should have more to say next month concerning two books on PTSD, one published and one about to be published, both written by professionals who also served in combat zones and later worked assisting other veterans for many decades.

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