- Last year the U.S. Food and Drug Administration (FDA) urged the makers of antidepressants to expand a 2004 "black box" warning that the drugs may increase the risk of suicide in children and adolescents. The agency asked for – and got – an expanded warning that included young adults ages 18 to 24, the age group at the heart of the Army. The question now is whether there is a link between the increased use of the drugs in the Iraqi and Afghan theaters and the rising suicide rate in those places.
Military praises 'fantastic' new post-traumatic stress therapy
Simple technique 'going viral,' bringing 'rapid improvement' to soldiers, families
9:00 pm Eastern By David Kupelian
© 2011 WND For the American soldier, it's become the sneakiest of all sneak attacks to watch out for – the enemy's final chance to wreak havoc by secretly following the soldier home and attacking him and his loved ones there.
Post-traumatic stress disorder, or PTSD – frequently characterized as "bringing the enemy home with you" – has become an epidemic in the U.S. military. But because of a dramatic breakthrough from the grassroots, there is new hope.
The problem is dire. Exacerbated by back-to-back tours of duty in a war environment where enemy combatants are often indistinguishable from civilians and every passing vehicle a potential car bomb, up to 20 percent of Iraq and Afghanistan war vets are currently struggling with PTSD, according to the federal Department of Veterans Affairs.
And the Department of Defense Task Force on Mental Health, calling combat "a life-changing experience, imposing long-lasting emotional challenges for combatants," reports a staggering "20 to 50 percent of active duty service members and Reservists reported psychosocial problems, relationship problems, depression, and symptoms of stress reactions, but most report that they have not yet sought help for these problems."
Symptoms of PTSD commonly include a high level of anxiety and emotionality, anger and rage, mentally re-experiencing traumatic events through flashbacks or nightmares, avoidance of things associated with the trauma, depression, difficulty sleeping and other debilitating symptoms – including, as a recent study shows, increased risk of heart disease.
Of course, it's not just warriors who battle PTSD: Any human being experiencing the sudden death of a loved one, a devastating natural disaster or a violent crime like rape or assault; being victimized by childhood molestation, abuse or neglect; witnessing a serious accident or terrorist attack – in short, suffering any intensely traumatic or shocking experience that overwhelms one's ability to cope – can face post-traumatic stress disorder, says the National Institute of Mental Health.
But help is on the horizon. To begin with, PTSD and other stress-caused problems are getting lots of publicity. Medal of Honor recipients do public service announcements urging soldiers to seek help and not be deterred by the stigma that often accompanies the "warrior ethos" – namely, if you have any kind of mental or emotional problem, just "suck it up" and go back to work.
Indeed, the vast majority of soldiers suffering from PTSD do not seek help, whether because of warrior ethos or fear of being disqualified from further deployments or advancements on "psychiatric" grounds, or just being prohibited from owning a firearm. And even for those relatively few who do seek professional help, the system is scandalously overloaded.
The 9th U.S. Circuit Court of Appeals recently excoriated the Department of Veterans Affairs for its "unchecked incompetence" in dealing with a flood of PTSD, depression and similar conditions, taking an average of four years to provide veterans their mental health benefits, and often taking weeks to get a suicidal vet his first appointment.
Even if an appointment is obtained, what help is available? Until recently, the choices have been primarily the psychiatrist's couch and medications. Traditional "talk therapy" can be helpful, but depends on the skill of the practitioner and the willingness of the soldier to participate, perhaps over an extended period – something most warriors avoid.
On the other hand, psychiatric drugs, and particularly antidepressants, are very controversial. Although the Department of Veterans Affairs assures soldiers "a type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD," many consider antidepressants part of the problem, not the solution.
Indeed, in a shocking 2008 cover story "America's Medicated Army," Time magazine revealed:
- For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan. … About 12 percent of combat troops in Iraq and 17 percent of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope.
- Last year the U.S. Food and Drug Administration (FDA) urged the makers of antidepressants to expand a 2004 "black box" warning that the drugs may increase the risk of suicide in children and adolescents. The agency asked for – and got – an expanded warning that included young adults ages 18 to 24,
the age group at the heart of the Army. The question now is whether there is a link between the increased use of the drugs in the Iraqi and Afghan theaters and the rising suicide rate in those places.
"The high percentage of U.S. soldiers attempting suicide after taking SSRIs should raise serious concerns," Harvard Medical School's Dr. Joseph Glenmullen told Time.
New coping strategies
Fortunately, a new technique for coping with PTSD and other stress-related syndromes – involving neither drugs nor, in many cases, even the psychiatrist's couch – is now spreading rapidly throughout the various service branches. Although it has proliferated almost entirely by word of mouth – given to soldiers and family members by psychologists, nurses, military chaplains, fellow soldiers and senior officers – its simplicity, privacy and remarkable track record are being noticed at the highest levels.
"In my own experience as a commander who mobilized and returned thousands of wartime veterans, I have seen soldiers make rapid improvement through use of these CDs," said Maj. Gen. George R. Harris.
"CDs"? Help for a serious condition like post-traumatic stress disorder, just from listening to a compact disc? Really?
Harris – a recently retired West Point general assigned to the Office of the Secretary of the Army – is indeed talking about a single compact disc, playable on any CD player or computer, titled "Coping Strategies," distributed to the military by a 501 (c)3 nonprofit called Patriot Outreach. The CD, which helps users overcome the negative effects of stress, is sent free upon request to military service personnel, veterans and their families, and also made available to the general public at a nominal cost, which in turn helps pay for the manufacturing and free distribution to military families.
"I can tell you exactly where I'm coming from on this CD," Harris told WND. "We send thousands of soldiers overseas, and then we bring them back. We try to assimilate them back into life and their families, and there are lots of bumps in the road."
"As a commander," he explained, "where I would see those bumps firsthand would be, most often, when a wife would approach one of my chaplains and say, 'My husband, who you sent to Iraq, didn’t return home the same person. But no matter how much I beg him to seek help, he refuses to see a professional counselor.'
"So in that environment, it was fantastic to have this CD to give to chaplains, who can then work through that wife, and get the soldier to try this. In every case I heard of that he went through the process, it was helpful to the soldiers and their wives."
In fact, said Harris, it is often "the wives, the spouses, the kids – they're the ones who will take advantage of this CD and use it themselves, and then encourage their soldiers to do it."
"Getting soldiers to seek professional help is still the goal," added Harris. "This is a fallback plan, something the wives and chaplains can fall back on."
So intrigued was this Army commander by the improvement he witnessed in his super-stressed soldiers using "Coping Strategies" that he tried it out on himself.
"Now, I don't think I have PTSD," he cautioned WND, "but, just for the heck of it, I locked myself in my bedroom and tried the CD – it's about a 30-minute exercise." Afterward, he said, "I felt completely invigorated, ready to tackle anything." (Note: Maj. Gen. Harris even recommended this writer try out the exercise, saying it's beneficial for everyone, not just warriors with PTSD.)
The "Coping Strategies" CD includes two parts: 1) an audio program called "Be Still and Know" – a state-of-the-art mindfulness exercise, which, as the Department of Veterans Affairs states, is recognized as a "benefit to trauma survivors" since it can "increase your ability to cope with difficult emotions, such as anxiety and depression," thus significantly enhancing the ability to handle stress. And 2) additional audio programs on overcoming stress, fear and pain, as well as field manuals, guidelines, DoD reports, articles and resources that are available on the computer data section of the CD.
While the entire "Coping Strategies" multimedia CD, including "Be Still and Know," is available free to military, veterans and their families, it is also available to civilians for a small charge. The "Be Still and Know" exercise is also available as a download, free for the military, and at a nominal charge for the general public.
What's more, "Be Still and Know" can be listened to online by anyone at any time – at no charge.
"I reached the conclusion," said Harris, "that I didn't give a damn if I could prove it worked medically, because I know it works. Besides, it's so much better than what most of the soldiers are now getting – which is nothing."
And that point leads directly to Patriot Outreach and its founder and president, Col. Antonio Monaco, U.S. Army (Ret.).
Having served the Army in a variety of senior leadership positions including brigade-level commands and deployments in support of Operation Iraqi Freedom/Operation Enduring Freedom as well as in Bosnia (IFOR), Monaco explained his organization's mission with the following motto: "Coping Strategies provides simple, effective, non-intrusive support, and was designed to bridge the gap between those who seek help and the silent majority who avoid the stigma."
And just how big is that stigma-avoiding "silent majority"? Believe it or not, said Monaco, of all the tens of thousands of active-duty warriors and veterans dealing with PTSD and other serious combat-related stress conditions, "only about 2 to 3 percent, according the office of the surgeon general, seek out professional help."
"Coping Strategies," Monaco said simply, "is for the other 97 percent."
After all, he said, "We are private and non-governmental. When you come to us, no one knows – so there is no stigma."
Monaco, recently designated by the Pentagon as Army Reserve ambassador for Kansas, a two-star appointment, notes that over 65,000 CDs and 34,000 downloads have already been provided, rattling off some of the more notable requests he's received for "Coping Strategies":
"The 82nd Airborne Division ordered 5,000 CDs; Fort Hood, after the terror shooting event, ordered 3,500; the 91st Division ordered 3,000 CDs for their troops; the Joint Task Force Headquar
ters, 1,500; USO, 1,000; VFW, 8,000 …"
When it comes to dealing with overwhelming stress, one person who really understands the value of "Coping Strategies" is Army Lt. Col. Phillip L. Pringle, a Southern Baptist chaplain who has lived and counseled soldiers in one of the most stressful environments on earth.
Pringle served in Iraq with the 110th Engineer Battalion – the "IED Hunters" – tasked with the crucial but numbingly dangerous job of making Iraqi roads safe for military convoys and civilians by clearing them of IEDs, one of the most hazardous aspects of that war.
Yet he's witnessed so much success in helping soldiers and their families with the "Coping Strategies" CD that he wrote a letter detailing his experiences to Monaco, which is posted on the Patriot Outreach website.
Pringle describes a typical scenario: "What I notice in passing out the 'Coping Strategies' is, soldiers don't often like to talk about their depression or their anxiety. But if I talk about, 'Hey, how much stress are you going through?' they say, 'Oh, Chaplain, I've got a lot of stress.' And so I will give them this 'Coping Strategies' and say, 'Hey, try this out. It will help you with your management of stress' – and that seems to work."
Like Harris, Chaplain Pringle also adds a note about his own personal experience with the CD, saying: "The 'Be Still and Know' exercise works for me. It calms my soul, enhances my thinking, and improves my emotional regulation. I am thankful to be a more resilient chaplain."
The "Be Still and Know" exercise is the result of six decades of work and development by renowned stress expert Roy Masters, who at 83 still hosts the longest-running counseling program in talk radio's history, on the air continuously since 1961.
Regarding "Be Still and Know," Masters says the exercise is so effective simply because "it enables you to become objective, a little bit separate and disentangled from all your troublesome thoughts, emotions, heartaches, fears and traumatic memories – and that, all by itself, is extremely helpful, and actually healing."
Among the professional counselors who have long made use of the exercise is George M. Hayter, M.D., a Navy psychiatrist and lieutenant commander during the Vietnam War, and currently chief of psychiatry at St. Joseph's Hospital in Orange, Calif. He concludes: "I must say, on the basis of 20 years experience, that the application of this technique has made a significant contribution to the treatment of the great majority of those people who have learned it." Hayter, a diplomate of the American Board of Psychiatry and Neurology, later became an original member of the board of directors for Patriot Outreach.
So how exactly did Patriot Outreach come into being?
In 2006, while visiting an Army clinic to pick up a pair of glasses, Monaco recalls, "I ran into one of my soldiers. He was undergoing endless tests to diagnose stomach problems, but no one could figure out the cause." However, says Monaco, the soldier "leaned over and quietly and privately confessed to me of having this recurring image, over and over in his mind, of a dead soldier with a bullet hole in his head, whom he had zipped into a body bag."
Later that week, continued Monaco, "I read a U.S. News & World Report article dealing with post-traumatic stress disorder, which featured a friend of mine, Col. Kathy Platoni, a combat-stress team psychologist." Zeroing in on one particular phrase in that PTSD article – "reimagining the trauma again and again" – and knowing that stomach, back and similar symptoms can be caused by undiagnosed stress, Monaco had an epiphany. "It dawned on me," he said, that the "Be Still and Know" exercise that had "helped me immensely in overcoming extreme adversities" years before could be a useful tool for soldiers with PTSD. Platoni agrees.
Wanting to help soldiers like the one with the stomach symptoms and tens of thousands of others like him, Monaco arranged with Masters to incorporate the exercise as a tool in a multimedia CD for warriors called "Coping Strategies."
Regarding the future of "Coping Strategies," Lt. Col. Pringle, the Southern Baptist Army chaplain, has absolutely no doubts: "It is going viral."
"It will grow in the military," he explained, "because it fits in very well with the hot issue of learning to be resilient – to embrace and overcome adversity." And like Gen. Harris, Pringle recommends the exercise for everyone, military and civilian, as prevention as well as treatment. "Being still helps a person be their own best therapist, to reflect on their life, to calm them, to think critically about their problems to overcome them," he said.
How high up the chain of command has the "Coping Strategies" CD gone? The U.S. Army's Chief of Chaplains, Maj. Gen. Douglas L. Carter, calls "Coping Strategies" a "great resource for our Soldiers." And Col. John Bradley, M.D., the chief of psychiatry at Walter Reed Army Medical Center, the U.S. Army's flagship medical center in Washington, D.C., is also sold. In fact, so convinced is Bradley that the "Coping Strategies" CD is a valuable tool for the hundreds of thousands of soldiers and family members struggling with the psychological scars of war, he has taken it to the top, affirming simply: "I have rendered a positive opinion to The Surgeon General."
Meanwhile, back "in the trenches," so to speak, Pringle's "going viral" comment wasn't just a reference to the Internet. On May 30 – Memorial Day – Iowa Gov. Terry Branstad, before thousands of attendees at the state's Gold Star Military Museum in Camp Dodge, signed an executive proclamation declaring Memorial Day in Iowa also to be "Patriot Outreach Day." (Listen to audio below.)
His action followed unanimous resolutions in the Iowa House and Senate commending Patriot Outreach, "founded here in our beloved city of Davenport, Iowa, on September 7, 2006," for providing "simple, effective, non-intrusive support" for America's warriors and their families. They acknowledged the tens of thousands of CDs and downloads delivered free "to all armed forces, veterans, first responders, government civilians, battlefield contractors and their families" and paid tribute to the program's proven "effectiveness in combating anger, stress, pain, combat stress, and even PTSD."
"Wow!" quipped Monaco. "Who said Democrats and Republicans can't unanimously agree on a great cause?"
Since Patriot Outreach receives no government funding, it relies entirely on tax-deductible donations to keep it alive and growing and providing free services for the troops. After all, asks Monaco, "What was the invisible hand that got all these soldiers the CDs that have helped them so much?"
Answering his own question – it was, of course, those who have already contributed to Patriot Outreac
h – he adds, unapologetically, "Please donate so we can get more CDs in the hands of our warriors who need them. It's notable that there are 65,000 CDs out there, but wouldn't it be great if that was over half a million?"
To potential benefactors of Patriot Outreach, Monaco asks that they "please contact me directly."
Indeed, demand for "Coping Strategies" threatens to overwhelm available resources, as soldiers and family members visit the Patriot Outreach website, where they can check out the materials for themselves, privately, and at no cost to them. (Again, the CD is also for sale to civilians, the funds from which serve to underwrite the free grants to soldiers.) Typical comments left by service personnel making online CD requests include these:
- "When I returned from Afghanistan last year to a divorce, your CD is what helped me through it. There are soldiers in my unit that need to learn better coping skills." (Staff sergeant, infantry)
- "I heard about this CD from my psychologist who has been treating me for PTSD." (Airman second class)
- "I am a combat trauma therapist. I have given your disc to many veterans who find great benefit. … I will take as many discs as you can send – they will be used!!! Thank You!"
- "I am a Navy nurse who is in regular contact with military active duty suffering from PTSD. This is the cardinal injury of this war. I am a moderate sedation provider, and to see the disinhibition of these soldiers as they undergo sedation and 'relive' the trauma, it is incredibly sad and moving. I would like to request 50 copies of the CD for disbursement to those I feel could be helped by your program."
- (From the USO): "I am requesting 1,000 copies to be given out during missions going to Iraq, Afghanistan and Africa."
- And just last week: "I am requesting 500 copies to be distributed to Soldiers throughout my division. I am the division chaplain and I have found this audio and data CD to be a tremendous help to my Soldiers." (Army colonel)
"Every day," intones the narrator over heart-pounding war video, "American soldiers are fighting to defend our freedoms around the world. … But the fight, for the soldiers, continues even after they have left the battlegrounds. PTSD has taken hold of our beloved soldiers and is now destroying them from the inside. Thousands of soldiers return from active service, to find they have nowhere to turn when their own thoughts begin to overpower them."
However, assures the speaker, reinforcements are on the way: "There is hope. Patriot Outreach is an organization that provides the useful tools for our troubled soldiers and arms them with a renewed inner strength – a strength never to be shaken or stirred by angry thoughts or uncontrolled emotion. …”
"The soldier is now free to come home."