[Music] of adults experience at least one traumatic event in their lifetime one-fifth of those people will post-traumatic stress disorder so what causes PTSD how do you spot it and how does one live with it in this episode of being well I pose all these questions to psychiatric nurse practitioner Zach backlin when Sarah Bush Lincoln opened in 1977 it was with the promise to serve the community's health care needs it has grown into a two-hospital system with nearly 60 clinics that provide trusted Compassionate Care for over 50 years Horizon Health has been keeping you and your family healthy and although some things have changed Horizon Health's commitment to ever-changing needs of our community has remained the same Horizon Health 50 years strong Carl is redefining Health Care around you innovating new Solutions and offering all levels of care when and where you need it investing in technology and research to Healthcare Carl with Health Al always at the Forefront to help you thrive [Music] thank you for joining us for this episode of being well I' Lacey Spence and today we are welc back a guest to the show we haven't seen him in a couple of years we're welc in Zach backlin thank you for coming back to being well I sure appreciate it well thanks for having me of cour so you had a little bit of transition in where you're serving these days so can you please fill us in um where you're a and what you're doing yeah so um I about a few months ago opened up an office down in Greenup right on Main Street there and um right now I do psychiatric medication management Psychotherapy and substance use treatment full so that is right in the alley of what our topic is today which is PTSD so I think just as a groundwork to kind of lay everything out first off what is PTSD what's it stand for so PTSD is th acronym that stands for post-traumatic stress disorder most commonly oc someone who's experienced a traumatic event psychologically or physically traditionally associate it with veterans coming back from war yeah but in the past few years with the struggles we've had with the pandemic ther more people who are not necessar soldiers or police officers who ar coming and they're struggling with these same symptoms of PTSD I mean in addition to that besides I mean obviously the pandemic has been a huge equalizer and we've all gone through so much in addition military service the pandemic what other causes could there be of PTSD oftentimes you see a lot of history of abuse or neglect as a child or in it as an adult people who are survivors of domestic violence also tend to have PTSD we tend to think of it as as this aspect of everyone is experiencing terrible things but there are people who experience you know traumatic events secondarily so like someone who has to care for somebody who has experienced a traumatic event and reliving and re-experiencing that event with them can also develop symp PTSD gotcha so are you talking like I have a loved one who has cancer and I have to watch them walk through that I can be very traumatic for me abso and so does it also does it have be an event can it be a period over a period of time does it present differently for different people absolutely um in in terms of periods of kn ow if someone is living in a terrible situation or you know maybe they've suddenly lost their job they no longer have the money the resources to take care of themselves or their an ything that really c event whether it be ongoing or intermittent or just one specific time it can come as these traumatic symptoms yeah and so let's talk about that so how does PTSD affect someone's mental and emotional well-being so the most common thing when I se PTSD people is they are constantly reliving and re-experiencing the traumatic event that happened th ey almost kind of become stuck in time in that they can't move past this terrible thing that has happened or this terrible thing they've watched someon else go throug causes things like sleep disturbances it can cause depression and anxiety associated with the event um one frequently in people with PTSD is nightmares very Vivid experiencing nightmares usually revolving around the traumatic event they experienced they just they get stuck in the moment and they can't move past this thing that happened to them that's what I wanted t um I you're the teacher here in ca n people also experience like flashbacks too when you're saying it's so real absolutely re-e reliving the event over and over again in their mind that was kind of fi rst started seeing it you know when we talk about people who are like ve terans coming back from wartim know they've experienced all these terrible things and th from the combat situation because they're constantly just feeling like they're there and I mean you're talking about some o the symptoms what other common symptoms are there of PTSD um on heightened alertness things that I s most frequently is a lot of people who had experienced trauma in their past and never gotten help for it or never recognized it as trauma oftentimes mimic the symptoms of havin attention and deficit hyperactivity disorder in that they're constant alert for danger because they're worried about what's the next thing th to happen to me or re-experiencing wh they'll come to me and they'll say yeah I went to my primary I went to the Urgent Care and they said this is A and I'll be like okay well let's Little Deeper you know when did this develop did this start suddenly start happening around the time you ex something terrible or is this th at you've had in childhood or is this you know we gotta tease out whether or not it's really an attention problem or it's a hyper vigilance constantly on alert for danger problem because those two can mimic each other very very easily and for a second let's step back and talk about what you do um you and I were talking before we started recording that services include helping people walk off from walk backward from drug addiction um assisted medication those types of things but you also offer therapeutic services for someone who's never been to a therapy session I mean what can they expect especially if they're trying to tease out or think that they might ha PTSD so usually what I'll do is you st the beginning you know I take a thorough history of you know have they had treatment before for depression anxiety yeah you know do they have a fami history of depression anxiety th like that and and then I kind of you know kind of take their life from the beginning and walk them through where they were then and where they and I'm really just trying to get a grasp of what's bothering them you know is it something like a depression or an anxiety by itself or is it all of these symptoms that are stemming from you know a traumatic event that happened in their past that they just can't you ar ound or get past and as you're about ADHD being something that can be a signal to PTSD those other conditions anxiety depression those can also be be not masked as but can also be part of PTSD are there any other conditions that maybe present as one thing but can really be tied to this Sleep Diso insomnia things like that people who have difficulty getting to sleep stay asleep waking up frequently thro night you know it's a matter of an organic biologic thing going on or is it that they're experiencing nightmares or you know reliving their traumati experience at night and they ca turn their brains off yeah well in the last time that yo here um you kno breaking down a like we're kind of doing that again how important is it to rea somebody to not be afraid to let someone know that you're having these feelings that's very important routinely as you know people we we oftentimes confide in friends and family and we talk about things that have bothered us but on some le know you're kind of just spreading it around you know talking to a professional can give you the objectivity you need to help th rough the traumatic event whereas you know it's it's great to get things off our shoulders and tell our fr family these things not they're not equipped to be able to handle people process them so making sure that you talk professional is very important yeah when uh when Aunt Jean has an opinion about everything and it's like that's not I need right now um and so you've kind of talked abou um you know these things can happen in childhood or in adulthood but um can we see PTSD develop earlier in those children who have experienced something traumati oftentimes unfortunately you'll find it in children that are in the fost or the adoption system you know si mply the act of being taken from their birth parents is a traumatic event in itself whether or not it was appropriate or not you're still taking you know a child away from a a parent that they've grown attached to that they've developed those nurturing bonds with and disrupting that in itself can de create traumatic events are there other instances um children who are abused you know not necessarily removed from the home or even knowing about it b you know we also see a lot of sexual abuse when it comes to young children children who are molested or you kn sexually abused by adults or other children that's a traumatic ev itself oh of course so does it pr differently in children or does it look similar to how it does in adults vary the big difference with children is is that you know as adults we've got the benefit of experience and life experiences so I wouldn't sa necessarily makes it easier but you know having the ability to rationalize on some level what's been going on is an advantage that oftentimes children don't have so they can do things like th ey can be aggressive towards other children you know they can isol themselves they can start having behavior problems and then we you know loop back into the is this traumatic is this ADHD because again these children if they can't sit still they're constantly on the lookout for th ey can't focus on th they can't focus on you know just a kid and growing up in a loving nurturing environment and either way whether it is ADHD or PTSD I mean medication is an option but making sure that you're going about the right channel I guess must be important too oh absolutely I mean the firs treatment for ADHD is usually stimulants or some non-stimulant you know drug that causes them to kind of be able to focus and concentrate on what they're doing but if you give a st who doesn't actually have ADHD you're going to make their hyper Vigilant Source you're going to problems worse you'r they're not getting the appropri treatment and that is obviously not the ro want to be going so how does PTSD affect a person's ability to function in daily life so when it comes t interpersonal relationships are damaged you know it is very difficult to l how to trust after you've been burned or hurt and when you have something these people have experienced to that level you know it affects their develop loving connecting relationships with other people because again someone or something has hurt them in the past so now they're you know not wanting to open up to be able to make those connections with other peop know as human beings we're social creatures but when you introduce something like this into the make it very difficult for people to trust right yeah we're suppose community and so then that just it t everything down before a lot of relationships maybe can you talk about the isolation d a lot of patients that come in who have self-isolated and want the root of that oh yeah social anxiety generalized anxiety or definitely associated with PTSD I mean you've you're putting these people in situations where they've experienced negative consequences whether it actions or not and you're expecting to have a different outcome without the help to be able to process what they've been through so once someone has come in to yo u've pinpointed that you are living with PTSD um what's next what does treatment and living with this look like treatment usually involves being specific to the patient you know a lot of times we'll try to treat the underlying symptoms whether it be a depression wi th it or an anxiety issue associated with it but there's also the gold standard for people with trauma and that's the EMDR therapy treatm movement desensitization reprocessing which actually allows them to pull up the traumatic memory they're experiencing and d while they're trying to re-experience that memory so that they and put it back into long-term memory where it's not constantly at the Forefront of their conscio now so this is the first time hearing of EMDR what does it look like is there like a device that helps them usually there is a device um it it looking into at an image or something that's non-traumatic but they're trying to call up the traumatic memory ex periencing and while they're that the image is causing them mo ve their eyes rapidly so they're focusing more on the motion cr eating with their eyes and enables them to heart start helping them to move past the trauma by processing in a different way that doesn't bring up all these negative emotions and ex wow so how successful have you seen this be maybe in your practice I don't do it personally but I've seen it pretty successfully done in other pl I work with a couple of groups where they have therapists who specia that form of therapy and th really good success with it interesting so other than that route treatment are there any other routes of treatment you'd like to talk therapy cognitive behavioral therapy on dialectical behavioral therapy all of the times the different types of therapies that help people recognize what's going on so that they can help process and move past it because that's really the key trying to get people b functioning where they can get ha ve those relationships with other people and get back to socie functioning you know ultimately a lot of what I do in terms of treatment is the goal is a return to function you know I want them to be able to feel like they can be contributing members of society again because they've become so ba ck and isolated and and distance from everything that they used to experience that would bring them joy and and without that they can't ye ah well and I think one of the the key things that someone should maybe take away if they're watching t that living with this is possible um being able to to cope and to talk about it is all you know it's it's a good thing it's a good way to process it um do you have people who come in who maybe are have been discouraged from seeking treatment absolutely um yo they're just afraid of what I' do or what's going to happen with t treatment you know they don't if never engaged in it before they don't know what to expect and circles back to you they're already leery about engaging in things no t familiar with because they're constantly looking for dan able to make that connection with them that therapeutic connection and them that you know this is a safe p for you to be and we can work an d I'm not going to push you past your boundaries but we're just going to try to piece by piece get you back no rmal level of functioning and so let's kind of go around th well so if I'm somebody at home who is living with PTSD are there any self-help techniques that I can maybe take on myself a good one that I find prett success with is blocked breathing and that's if they're experiencing or you know re-experiencing episode or they're experiencing nightmares th ey're trying to calm an d it basically jus sets of four seconds where you breathe in for four seconds you hold yo for four seconds and then you br out for four seconds and you th at as much as you need to and ki nd of focus on your breathing so you're not being pulled away from you're experiencing interesting so that is um you know the resetting you're breathing real some folks who are having the panic attacks when it's just l Catch My Breath the heart racing thing like you're describing um other than that is there anything else people can try at home um I find a lot of people who want to try meditation at home but they ha difficulty because it's kind of a nebulous thing people don't really understand how to you know me what it involves and so I'll usually tell them that you know if you're trying to focus your thoughts into a calmin situation you know putting something in your hand whether it be like a pencil or a pen or a rock or just something and just focusing on how that feels in y hand as you slowly breathe in and out you know you're bringing your attention down to something that's in the present and helping them from being pu into the past I feel like I've also heard of uh like grounding yourself like if you ca Barefoot on the carpet or Barefoot o the uh the grass doing the same ju st having that texture gives you something else to um so PTSD um Can it occur like long after someone has experienced the traumatic event does it happen immediately is it different fo so PTSD by definition is six months or more after the events itself okay anything less than that we call an acute acute stress response and that's whe it's still within that stage that they're still really close to ha ppened to them and there is ch ance in that acute stress response that they could process what an d move on and move forward but they don't after that six month period that's when it's classified as be cause it's now post Yep they're no longer you know right after what happened they're now still on it months a year two years ten years later and they're still fixated on what happened to them and they can't it well in I th I know we've talked about how talking to somebody I'm talking to a pr to a lesser level talking to our family but how important is it to have a good supportive system around you very important and I think that's part of the resilience aspect of it if you do have a support system around you when you go through these traumas you' likely to develop PTSD because you have a support system that's able to support you and help carry the load wh can't give you the time you need and t space that you need to be able to process what happened to you don't have a support system of friends and family around yo more likely to have this pr you don't have an outlet for it you don't have a way of working thro yeah well and so then I I have to ask people who maybe are inflicted with cancer they want to cure PTSD is it something that can be cured can you ever be PTSD free it goes into remission with appropriate treatment and time I me know I'm of the theory that you get out of things what you put into them and most people that I see with PTSD w get through it they want to get past it they don't want to live without constantly hanging ove every day and so they'll effort because they're trying to get through it it's ju them with what they need and empowering them to be able to help themselves sure so if somebody who has suffered from PTSD say they're in remission or they're they're receiving treatment they're doing bett events bring up old traumatically absolutely they can and that you know makes it more complex and more and compounds the problem because now you've gotten them to a point that they've started to trust again they've star to be able to be present i again and then you you know you hit them with t you know baseball that just comes flying out of left field and it makes the treatment that much more complex because now they have a second t compounding the firs and so then again so much more important to make sure that they're seeing seeing a professional seeking help so that can process everything in our last couple of minutes here is there anything about the topic of PTSD that covered that you think would be vital for a viewer to know um I would say the major thing that it's it's not permanent like you aske earlier it's it's something that can b worked through and you know I've yet to find a patient that is truly unfixable it's just a matter of finding the right mix of things to be able to help them with what they need you know meeting them where they're at is important and nobody is beyond we ll and oftentimes people will get in their own way that negative self-talk that I I'm broken I can't be fixed yada yada and that that negativity is not um it's not going to help you heal but always having an objective soundi board to kind of negate those yo u're telling yourself this is so important um are there any stories that be able to share obviously not in depth but of a patient or two that you've been able to help them walk through PTSD I mean a lot of it the ones that I've seen have worked through it has been revolving around substance use unfortunately you kn that caused them to start using whatever substance they're at you know helping them recognize that you know these are two separate problems but they're interrelated and so through the event that caused you know like if somebody was abused as a child you know and then they fell into starting to use substances beca they're trying to cope with happened to them and hel both of those problems so that they can you know stop using whatever it th ey're using and work through what h caused them to fall into that in the first place I've seen quite a those cases where once you get the whole aspect of it together you know you help them with both problems yeah have you as a professional ever had to collaborate with other professionals because someone's case oftentimes therapists are really good sounding boards you know part of my training involved therapy part of involved medication mana but when you come to therapists and social workers what they do is therapy so they've got a lot more experience with it and they'v got a lot more training around it so being able to kind Bounce suggestions or ideas off of them has been really helpful yeah so I have to ask I'm sure it's a rewardin you to be able to help people walk through this can you talk about that a little bit I mean yeah helping people has really been something I've done since the beginning of my career back when I started as a registered nurs mean and to be able to see the end outcome and the result of being able to help people achieve their best ve ry rewarding yeah and one more time just before we wrap up here where can folks find you now so I am down in Greenup right on Cumberland Street right there on the main stretch I am next door to the legion and across the street from the bar and it's called Noble Health Associates awesome well Zach you've a wealth of information again thank you for coming back on being well appreciate it thank yo course and we of course thank our viewers for joining us for this we hope this information was an d if you know someone who is suffering from this please share this episode with them and we hope to see our ti me for our next episode of being well Carl is redefining Healthcare around you innovating new Solutions and offering all levels of care when and where you need it investing in technology and research to optimize Healthcare Ca with Health Alliance is always at the Forefront to help you thrive for over 50 years Horizon Health has been keeping you and your family healthy and although some things have changed Horizon Health's commitment to ev er-changing needs of our community has remained the same Horizon Health 50 years strong when Sarah Bush Lincoln opened in 1977 it was with the promise to serve the community's health care needs it has grown into a two hospital system with nearly 60 clinics that provide trusted Compassionate Care [Music] thank you [Music]