#1

Shortly after the conclusion of this course, I will be moving to California with my family (boy and girl under 5, wife, three dogs and cat). This will be our first time (and mine as well) in an area prone to earthquakes as well as the potential aftermath of it (including tsunami’s and other secondary events). For me, being able to help my children in this type of event is my biggest priority and so it will be my focus for this week.

Knowing that we are at risk immediately by entering the state, the preparation phase would be a large portion of my concentration. Explaining to kids what to expect in a manner that they can understand is a key factor. Letting them know that the house might start dancing, or wiggling and knocking things all around, would be my approach (rather than telling them that the earth itself is shaking violently). Additionally letting them know where to go if it happens, and what might happen after, such as damage to the house, and if the house is damaged one of the dogs could get out so we might have to look for them.

This as well as utilizing many of the instructions from the PFA, on how to discuss how children are feeling, without necessarily describing feeling, and ensuring they know that other people will be upset and it is in no way their fault. This message is also something that I can share with any other parent I know (my son will be starting school then so even contacting the school to make sure they have a plan might be good).

The goal of all of this is to try and help my family be prepared, and to understand that if it does happen, even being prepared won’t stop the emotions that come with a disaster and that their reaction to the disaster is ok and normal. With kids specifically, making sure that you discuss if beforehand helps ensure that you can talk to them in a way they comprehend, and at a time when the stress of the disaster itself has not already happened and you can give them your full attention. The last thing I would want to consider is any kind of pharmacological approach, as many of the medicines carry long term downsides, especially for developing minds.

#2

This may be oversharing, but I’ve been accused of worse.  I find this topic very interesting and very personal, as most of you probably do as well. As mentioned earlier in the course, I am currently being “treated” in the military’s Behavioral Health system. I had never considered PTSD as a diagnosis before, but as my treatment endures I have seen no real difference in my demeanor or mood swings.

The doc’s think they are treating anxiety, depression, and anger issues. The more I read about the symptoms of PTSD the more I realize why their treatment methods (which are non medicinal therapy) aren’t effective. It is my personal belief that we are addressing the wrong things here. This leads me to my next question, which is “why are providers so hesitant to diagnose PTSD?”

According to the Anxiety and Depression Association of America (ADAA) “PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years later. The disorder is characterized by three main types of symptoms:

• Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
• Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
• Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.” (ADAA, 2018, para 1)
• My therapist (who is actually just a social worker due to lack of qualified providers) has not even inquired about any of this. I am almost positive that every service member who has seen their buddies detonate, or have been blown up themselves, qualify for these parameters to some degree. My case would be mild at best thank god, since I’m not rocking back and forth in the corner, but again I must ask, “why is the health system so hesitant to explore this?” I don’t have an answer, but this is an issue I have heard many service members complain about since I started serving in ’07, and hasn’t really gotten any better. So now I’m stuck in this vicious cycle of questions like “how do you feel?” and “what’s been bothering you since out last meeting?” when in reality it is almost impossible for me to accurately answer those questions, since I don’t know how to quantify all of that, hence the reason I’m there. Sorry about this long rant.

Back to the subject at hand; treatment options. For this scenario, I will focus on the military population specifically since that is who I can relate to the most. First and foremost, I do not believe drugs help anyone. I have seen many dudes sitting in the corner at work drooling on themselves because of Pharmacological Intervention. I also do not believe Antidepressant Therapy is effective, since PTSD is much more than just depression. Furthermore, in my personal case, conventional therapy has helped me very little, but it has helped a bit.

My choice for suggested treatment is a mix of therapy and medicinal cannabis. Before accurate therapy can be administered, providers should try to figure out the “what” of what is wrong, instead of the “wrong.” What I mean is, if you are treating someone for anxiety, depression, and mood swings, you can’t really help them unless you know what is causing it. You’ll get stuck in a vicious cycle like I’m in currently. In regard to medicinal pot, “lead author Dr. Alexander Neumeister stated, “There’s a consensus among clinicians that existing pharmaceutical treatments such as antidepressant simply do not work. In fact, we know very well that people with PTSD who use marijuana — a potent cannabinoid — often experience more relief from their symptoms than they do from antidepressants and other psychiatric medications. Clearly, there’s a very urgent need to develop novel evidence-based treatments for PTSD” (Moss, 2018, para 10). The only thing stopping service members from receiving it is the Federal restriction on marijuana, which in my opinion is ridiculous. They’d rather us treat ourselves with copious amounts of alcohol and anti-depressants that don’t work. Typical government logic.

Resources:

Anxiety and Depression Association of America (ADAA). (2018). Symptoms of PTSD. Retrieved on 13 March 2019 from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/symptoms

Moss, A. (2018). Cannabis Could be the Key to Treating People with PTSD. Retrieved on 13 March 2019 from https://healthcareinamerica.us/cannabis-key-treating-ptsd-b4abf432215?gi=bd00526b50ad

#3

Last week, my husband and I bought a house south of Seattle, and I’ll be moving in April to a new, unknown area. Throughout my career and degree program, I’ve focused primarily on Northern California disaster situations and possibilities, but I’m fixating this week on the Pacific Northwest. The city of Seattle considers earthquakes, winter storms, wind storms, and terrorism as the highest risk hazards due to likelihood and potential consequences (Seattle.gov, n.d.). In the area where we bought the house, our top hazards would be an earthquake or winter storm. I’m choosing to focus on populations and treatment options following an earthquake. I would deploy and use the American Red Cross and Crisis Counseling Program, to include outreach, counseling, public education, and referrals to community resources (Teasley & Framingham, 2012). Treatment options immediately after a response would be psychological first aid by qualified people, active listening, psychoeducation, and teaching coping skills; moving towards more long term recovery there would be individual counseling and established group counseling sessions focused on the potential diagnosis of posttraumatic stress disorder (PTSD).

Seattle specifically lists resources for meeting mental health needs: the King County Department of Community and Human Services and the American Red Cross (Seattle Office of Emergency Management, 2012). This department and agency provides qualified individuals to provide emotional support following a disaster, such as an earthquake. I would put psychological first aid workers with disaster shelters, areas where supplies are given out, and family reunification centers. That way, they are accessible and ready to help and assist people while they don’t know what has happened to their home, collecting supplies, or are going through the stress of trying to find family members. This service (psychological first aid, active listening, psychoeducation, teaching coping skills) would overall help everybody, no matter the age, gender, etc. The goal is to help as many people as possible initially until more long-term, specialized help can happen.

After initial contact, people can start to cope and understand their mental and physical reactions, and as they start to rebuild their lives, they can start to attend group counseling or seek out a referral for individual counseling. This could help more with people that are struggling, such as substance abuse users or children that were heavily impacted.

A big part to all of this is the availability, education, and advertisement of resources. Local and state jurisdictions need to get information out to all types of communities, whether it’s by hand-delivering flyers, radio commercials, or attaching the information to any and all supplies that are given out. Normalizing care and making it more socially acceptable will help those off-put by the stigma of seeking help.

Resources:

Seattle.gov. (n.d.). Emergency Management: Hazards. Retrieved from https://www.seattle.gov/emergency-management/hazards.

Seattle Office of Emergency Management (OEM). (2012). Seattle Disaster Readiness and Response Plan. Retrieved from http://www.seattle.gov/Documents/Departments/Emergency/PlansOEM/SDRRP/Final%20SDRRP%20V11-13-12.pdf

Teasley, M. L., & Framingham, J. L. (2012). Behavioral Health Response to Disasters. Boca Raton, Fla: CRC Press. Retrieved from http://search.ebscohost.com.ezproxy1.apus.edu/login.aspx?direct=true&AuthType=ip&db=nlebk&AN=448580&site=ehost-live&scope=site