Traverse City Record-Eagle

April 6, 2013

Ex-Army nurse researches PTSD treatment

Traverse City Record-Eagle

---- — TRAVERSE CITY — Retired Lt. Col. Linda Fletcher, a 22-year veteran of the Army Nurse Corps, thinks it’s time to ask different questions about post-traumatic stress disorder that afflicts many returning veterans of Iraq and Afghanistan wars.

What if the medical diagnostic definition of PTSD is not comprehensive enough?

What if, as a result, current treatments that have been used since World War II have limited success?

Fletcher,a 22-year veteran of the Army Nurse Corps, now lives in Long Lake Township. She has spent the last six years researching PTSD and treatments on her own.

She will teach a two-session Northwestern Michigan College extended education class later this month.

PTSD is a mental health condition triggered by a terrifying and/or tragic event — war, combat, catastrophe and abuse of all kinds. Symptoms include flashbacks, nightmares and severe anxiety and uncontrollable thoughts about the event. Timely diagnosis and effective treatment have become a major national concern. Statistics tell why.

A U.S. military veteran commits suicide every 65 minutes, on average, according to the most recent Department of Veterans Affairs study. About 22 veterans committed suicide each day in 2010.

Nearly 30 percent of the veterans who served in Iraq and Afghanistan have PTSD and 50 percent of those with PTSD do not seek treatment.

Female veterans are particularly likely to suffer from mental health issues. According to the VA, about one in five female veterans have post-traumatic stress related to "military sexual trauma," a catch-all category that includes everything from sexual harassment to rape.

Fletcher said she is concerned about the long-term effect PTSD will have on the vets, their families and American society.

“What we are doing doesn’t work,” she said. “ We’re still treating people from World War II and Vietnam. It’s incredibly expensive and there is a lot of collateral damage — drug and alcohol abuse, inability to hold a job, homelessness, suicide, fractured homes. All of this drains on the resources of society. It’s a huge problem and it’s just getting bigger.”

She thinks the current medical definition of PTSD fails to cover the full range of dissociative symptoms veterans suffer. It also does not address psychological/spiritual symptoms such as deep shame, guilt and rage that can come out of combat experiences.

PTSD is defined as an “anxiety disorder” in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association and used by Veterans Administration doctors to diagnose returning soldiers.

“There is increasing reference in national and international reference to broadening the PTSD definition to encompass the dissociative aspects of post-traumatic stress,” Fletcher said.

Disassociation reaction is considered an often involuntary defense mechanism that can include disruptions or breakdowns of memory, awareness, identity or perception. It is thought to be caused primarily by psychological trauma, according to various medical definitions.

Anxiety disorders and disassociation reaction both are treated with similar therapeutic methods — cognitive behavioral, creative art, hypnotherapy, psychotherapy and drugs.

“The use of psychotropic agents, which include anxiety medications and anti-depressants, is also coming under question because of concerns about long-term consequences of their use,” she said. “As a result, their use in treating PTSD may be worth re-evaluating.”

Fletcher grew up in a military family. She was born in Seoul, where her father Charles, a career Army officer who retired as a lieutenant colonel, was stationed after World War II.

She said she realized over the last six years that her father, who won a Silver Medal for gallantry during World War II in Italy, was profoundly impacted by PTSD and his battle experiences.

“He lived a tortured life and my mom did, too,” she said. “He had horrible nightmares and often would go to the den and fall asleep, only to jettison out of his chair because of the nightmares. He never said one word about his experience in the war to me or my brothers.”

Fletcher earned her bachelor’s of science in nursing in 1972 from the University of Texas and completed her graduate work in trauma nursing at Texas Woman’s University on an Army scholarship in 1978. She spent most of her career in infection control and hospital epidemiology, teaching and supervising emergency and critical care in medical centers. She received her certificate as a master hypnotherapist in 2008.

Her class, “PTSD: The Facts and the Future,” will offer an up-to-date look at PTSD and the ways it plays out in individual lives as well as discuss how combat-related trauma has been managed over time and the changing approach to PTSD treatment. It is designed for those in helping professions, families, and those with PTSD. Fletcher said the purpose of the class is not to help people navigate through the existing system.

The class will meet on April 23 and 30 from 6:30 to 8:30 at the University Center. Cost of the class is $35. For registration or more information, call NMC at 995-1700.