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Battlefield experience helps FHC psychiatrist treat PTSD

| Date Posted: 2/25/2010

Battlefield experience helps FHC psychiatrist treat PTSD
February 25, 2010

Steven Alexander, M.D.
Fernando Cobos, M.D.

PINEHURST – Depending on the war, the debilitating anxiety disorder that can result from the unique trauma of combat might once have been called shell shock, battle fatigue or combat stress reaction. It is a problem that has been noted in the annals of the American military at least since the Civil War.

According to a psychiatrist with FirstHealth of the Carolinas, the more modern terms of acute stress disorder and post traumatic stress disorder (PTSD) are more clinically oriented and identify the conditions as true illnesses that require medical treatment.

Fernando Cobos, M.D., is medical director of FirstHealth Behavioral Health Services and is experienced in treating PTSD patients. When he counsels patients who have combat-related PTSD, he draws from his personal experience of the combat zone.

Dr. Cobos joined the U.S. Army Medical Reserves shortly after the terrorist attacks of Sept. 11, 2001, and has been deployed to Iraq three times since.

“I think that having been there myself allows me to relate better to my patients’ experiences and to have a better understanding of what they have been through and are going through,” Dr. Cobos says. “I also think that knowing I’ve been there helps them feel more comfortable with me and with treatment.”

FirstHealth Behavioral Services has begun a group therapy geared toward men who are suffering from combat-related PTSD. “It’s just taking off,” Dr. Cobos says. “Because of FirstHealth’s relative proximity to Fort Bragg and Womack Army Medical Center, we are making an effort to collaborate with the mental health professionals there and develop an ongoing relationship with them.”

Dr. Cobos calls PTSD a treatable condition that is increasingly recognized as a serious disease that needs to be addressed.

“I am optimistic that the stigma associated with PTSD, as well as with mental illness in general, will continue to decrease,” he says.

According to Dr. Cobos, PTSD is characterized by four basic classes of symptoms:

  • Memories and intrusive recollections, often involving nightmares or flashbacks, during which the individual relives his traumatic experience or a portion of it
  • Hyper-vigilance, which causes the individual to feel on edge, be unable to relax and startle easily even at such common occurrences as a door closing or a telephone ringing
  • Avoidance and alienation in an effort to decrease reminders of the traumatic event (According to Dr. Cobos, this can lead to a sense of alienation from friends and family and a narrowed range of daily activities.)
  • A sense of emotional numbing or remoteness that can be very distressing, not only to the individual but also to his loved ones

Sometimes, Dr. Cobos points out, the PTSD sufferer may worry about friends who are still in harm’s way or experience a sense of loss or bereavement because of others who have died or been injured in combat.

“A big part of the treatment of PTSD is to try to prevent further harm or complications from happening,” he says.

People suffering from PTSD may even turn to alcohol or drugs in an effort to address their symptoms. “This causes new problems and sometimes progresses to frank addiction,” says Dr. Cobos.

The symptoms of PTSD and the resulting behavior changes sometimes result in failed marriages and relationships leading to a further sense of loss and personal failure. Depression can, and often does, complicate PTSD, Dr. Cobos says.

“All of these potential complications should be considered and addressed early on,” he says, “and the patient’s family should be included in treatment as much as possible.”

Treatment for PTSD can involve a range of therapies including behavioral approaches, support family therapy and medications. The shared experience of a group format can help the sufferer feel less isolated and alone while providing a place to learn how others cope and thrive in spite of similar symptoms.

Although improvement can be slow and challenging, especially if it is complicated by substance abuse or other mental illnesses, it is possible and many people recover.

“Many people bounce back from some pretty terrible experiences,” says Dr. Cobos. “I am always amazed by how resilient people are.”

The PTSD Group for Men at FirstHealth Moore Regional Hospital meets each Monday at 11 a.m. in FirstHealth Behavioral Health Outpatient Services. For more information, call (910) 715-1535 or (910) 715-3370.

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