Life's Annoyances

Wait, can this be real? Is this two posts on this blog in the same week? Back to back? Wow. That is quite impressive. Today went better than yesterday, as I have not broken anything...yet. The only frustrations I have experienced today pertained to the heat, as it was nearing triple digits by 10 this morning. This made our morning walks a little sticky and I made sure all of the pups were doing alright. Three of our dogs get about a mile walk, with our oldest pup doing between ½ to ¾ of a mile, at a slower pace. Didn’t run into any dogs off leash, which was nice. I wish that people would think about the impact that they have on the lives of others, including the lives of animals.

This leads into my view on my diet. I went gluten-free at the suggestion of my primary care provider when we were discussing my psoriasis and IBS symptoms. That was about two years ago and I haven’t had any gluten-containing products and I have noticed a change in my health. At the beginning of this year, I went vegan. This wasn’t a new thing for me, as I went lacto-ovo vegetarian in my teens and remained one for over a decade. However, this year was the first time I went completely vegan. I like knowing that my choices don’t cause the deaths of others, especially since I am an animal lover who has five dogs and a newly acquired rescue turtle name Harold.

The only real annoyances that I have experienced today was the washing machine a few minutes ago. It has a tendency to “walk” during the spin cycle. I adjusted the levelling feet, again, and after yelling, “Fucking piece of shit. Why don’t you fucking work?!” I ran it through a spin cycle, after removing the sopping wet towels. The cycle completed fine and I put the wet towels back in and, it appears that my words of encouragement worked. When I buy something, I expect it to work. When it doesn’t, it really annoys me to the point of lashing out in physical violence, but never at living things, but rather at the washing machine or heavy bag.

I really think the heat has something to do with my general level of annoyance, as there is no way to escape the heat. Sure, inside it is relatively comfortable since we have the swamp cooler Master Cool going, but using it makes me think of all the money that will be going to the utility company for the water and electricity that makes it run. However, it is currently 105℉, which is quite far from my personal comfort temperature of 70℉. In the winter, you can put clothes on if you are cold. However, in the summer, at least here in the desert, there’s nothing you can really do to escape the heat. I enjoy spending time outside, but not in this weather!

Work can be annoying too, especially when clients don’t really know what they want and they expect me to basically pull information out of my butt. Sorry, it doesn’t work that way. Only one thing comes out of there, and it’s not data. I have a couple of work projects that I picked up today, which is nice, considering I am saving up to buy a new phone to replace the one that I broke yesterday. I also have a few personal projects in the work that really need my attention. Lots of things, only one me.

Upon writing out the annoyances, I realized that many of them are out of my control, such as dogs off leash, the temperature in the MF’ing desert (don’t worry, we are working on moving in the next year or two), and the ineptitude of some clients. If I just accept that I don’t have the power or responsibility to change them, along with a few deep breaths, it will all be OK. Hopefully.

How do you deal with minor or major annoyances? Any tips? If so, feel free to leave them in the comments. It might help me or others learn how to cope with these irritations in life.

See you tomorrow*

*most likely, but no promises

First World Problem, But it Sucks!

Okay, so I know that this may come across as one of those “First World Problems” such as getting the wrong order at Starfucks or getting your earbud cord tangled. However, that being said, today’s issue has led to a severe impact in my daily life. This morning as I was walking one of our dogs, an untethered dog came running towards us. In an effort to protect my dog from the loose one, my phone fell out of my pocket. So, let me preface this with the fact that I have never cracked a screen on a phone or tablet. However, this morning, when I picked up my phone after it falling, face down, of course, I noticed it had two cracks. Fuck. Even more fuck? The touch screen stopped working. I could see that I had notifications, but I was unable to respond to them.

This is where this issue turns from a “First World Problem” to a real problem. As a freelance writer and a remote employee for my university’s library system, I rely on my phone as a way to maintain communication with my clients and the professors who I assist as the library resource assistant. Without being able to communicate with them, it can cost me jobs, which, in turn, can affect my daily living abilities.

I have had this phone since 2015, so it has been with me a while. Luckily, my boyfriend was able to lend me his phone while we purchased him a $35 phone to use for the time being. As a graduate student and freelance writer, my income varies. Having to come up with money to buy a new phone, pay bills, rent, food for us and the dogs, utilities...it all adds up. It also sucks that I have to pay close to $350 this month to my school since they changed the drop deadline when I was enrolled in a course I wasn’t required to take and another fee when I had to reschedule my residency week due to poor health (fibromyalgia can be unpredictable). So, while I have the money, I don’t really have it.

I really like the Moto interface and the accessibility options, particularly the approach feature that allows me to see my notifications without having to physically touch the phone. I know I am spoiled. I try that with my other electronics, but it doesn’t work (LOL). I don’t know. It’s just been a stressful day, which piggybacked on a stressful night, as some dolt was lighting off fireworks last night. It’s June. It’s illegal. It’s inconsiderate. Don’t be a dolt. I am already dreading the first week of July, as last year it was nearly intolerable with the fireworks shooting off, but that is for another post.

I think I will look for estimates to repair my 2015 Moto X Pure, as well as save up for the upcoming Moto X4, which should be released within the next month or two. I guess it is a good thing that my birthday is next month. Any money I receive will be going towards my school loans and a new phone. Not exactly what I wanted to happen, but at least there is a way to remedy the situation. The hardest part about breaking my phone was the fact that I am HORRIBLE at remembering things such as passwords and user IDs.

Hopefully tomorrow is better!

Psychological Disorders: Neural Components of PTSD, Cultural Influence, and Treatment

Abstract

There are a number of psychiatric conditions that can affect the lives of military veterans and active duty members. One such condition is posttraumatic stress disorder, which can be accompanied by symptoms that can make life challenging. However, there are a number of underlying biological and neural causes that may contribute to the development of some of the symptoms. This recognition has helped to shape some of the treatment options and therapeutic interventions that are commonly used to address the symptoms of posttraumatic stress disorder.

Keywords: PTSD, veterans, neuroscience, mental health

Psychological Disorders: Neural Components of PTSD, Cultural Influence, and Treatment

            The body has a number of reactions to various stimuli, which are designed to alert and warn individuals of potential danger, leading to an increase in the likelihood of survival. However, in some instances, the reaction to these stimuli can lead to the development of various psychiatric conditions. One such reaction occurs to the exposure to one or multiple stressful events, which can trigger the onset of symptoms that are associated with a condition called posttraumatic stress disorder, or PTSD.

It has been shown that up to 15% of military members, both active duty and those who are veterans of the military experience symptoms that are associated with PTSD, with a significant percentage of these military members becoming debilitated and unable to participate fully in life (Dursa, Reinhard, Barth, & Schneiderman, 2014). As such, understanding the various influences on the development of symptoms that are associated with PTSD, along with the level of exposure and knowledge a mental health professional has on the topic of PTSD, can help to provide patients with the highest quality of care to adequately address his or her symptoms.

PTSD and Behavior

            It should be expected that following the exposure to a traumatic event, or even reading or watching media that details traumatic events, could lead to a change in one’s behavior. Traumatic experiences can lead to changes in a number of neural areas that can influence one’s behavior. For example, three of the brain regions that are often cited as being affected by the stress response that often occurs in the wake of a traumatic experience include the amygdala, hippocampus, and the prefrontal cortex (Bremner, 2006). Changes in these brain regions can bring about changes in behavior, including the symptoms that are commonly associated with PTSD such as hyperarousal, nightmares, difficulty in memory and concentration tasks, and a heightened startle response (Bremner, 2006).

Influences on PTSD

            Humans do not exist in a specimen jar, and as such, they are vulnerable to a number of internal and external stimuli and influences that can affect the behavior and experience of symptoms associated with various psychiatric conditions, including PTSD. These influences include structural, anatomical, physiological, and cultural factors. Through providing a foundation for the cultivation of a deeper understanding of the role these influences have on a person experiencing symptoms of PTSD, psychologists, therapists, and other mental health professionals can be prepared to treat patients in the most effective manner.

Structural

            There are a number of neurobiological changes that have been observed in the brains of individuals who have been diagnosed with PTSD. This includes neuroendocrine and neurochemical components (Sherin & Nemeroff, 2011). Changes in the volume of various neural structures, such as the left hippocampal section of the brain as well as gray matter volume have been found to be reduced in the brains of individuals who have been diagnosed with PTSD (Zandieh et al., 2016).

Anatomical

            As mentioned in an earlier section, the hippocampus, amygdala, and cortex are the neuroanatomical areas that are often affected in the wake of a traumatic experience. More specifically, a reduction in the volume of the hippocampus is thought to be responsible for altered stress responses (increased startle response); increased activity within the amygdala can also play a role in hypervigilance and threat appraisal issues (Sherin & Nemeroff, 2011). Additionally, when the cortex is affected, namely reduced volume and activation in the prefrontal, anterior cingulate, and medial prefrontal areas of the brain, can lead to cluttered thinking and fear appraisal (Sherin & Nemeroff, 2011).

Physiological

            The exaggerated startle response is one symptom that is often associated with PTSD and is a topic that has been explored in the body of literature in order to conceptualize this condition. According to a study conducted by Butler et al. (1990), individuals who have been diagnosed with or experience symptoms of PTSD, specifically the increased startle reactivity, can be observed via a lowered startle threshold when stimuli are presented. This may help to explain the ability for certain sounds, such as the backfire of a car and other auditory stimuli, to startle individuals who have been diagnosed with PTSD, while the same sounds do not have the same effect on other individuals who have not developed symptoms of PTSD.

            More recent research has identified the disconnect that is present between physiological state and the psychological and/or behavioral processes that are involved in daily activities. The rapid oscillation between the body’s fight or flight response and dissociation or emotional withdrawal has been found to be an identified risk factor for the development of a number of comorbid disorders (Williamson, Porges, Lamb, & Porges, 2014). Additionally, with the constant back and forth between fight or flight and dissociation can lead to premature aging of the brain, resulting in changes in the immune, autonomic, and endocrine systems of the body (Williamson et al., 2014).

Cultural Factors

            Within the military, it is often thought of as a culture within a culture, as the traditions and regulations or rules that people follow are akin to the traditions and values that are held by various ethnic cultures. However, in this paper, only the ethnic background will be identified as a cultural factor for the sake of time and space. Research that involved veterans from various eras of conflicts has revealed that certain ethnic minority groups were exposed to a greater number of traumatic events when compared to their Caucasian counterparts (Roberts, Gilman, Breslau, Breslau, & Koenen, 2011). Additionally, veterans who fall within an ethnic minority category were found to be more likely to disclose symptoms, but only when they are paired with a counselor or therapist who came from the same ethnic background (Rosenheck, Fontana, & Cottol, 1995).

Influence of Culture and Experience on Mental Health Professionals Conception of PTSD

            Just as with the patients who do not exist in a bubble, free from internal and external influences, the same can be said for the counselors, psychologists, and other mental health professionals who work with diverse patients or client bases. As such, it is imperative that the individuals who are tasked with caring for patients put aside their own personal opinions and beliefs, in favor of evidence-based practices (American Psychological Association, 2016). Additionally, patient input can be beneficial in helping to foster not only a therapeutic relationship that is necessary

Treatments for PTSD

            Providing effective and ethical treatments for patients with PTSD is one of the most important aspects of mental health. The research that has been conducted in regards to the neurobiological changes that occur as a result of experiencing a traumatic event have helped to contribute to the development of a number of treatment options for individuals, military veterans and civilians alike, to regain their quality of life. However, it should be noted that not all patients will respond equally to treatments and a qualified mental health professional should be attuned to his or her patient’s needs and responses to treatment.

Efficacy

            The efficacy of the various types of treatments that have been used in addressing the symptoms of PTSD vary, depending on the type, as well as individual characteristics of the patient. Some research has found that, for example, cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are ineffective for 1:4 to 1:2 patients who receive these types of interventions (Zandieh et al., 2016). However, this efficacy rate can also be influenced through the type and location of any structural changes in the brain. Poor treatment outcomes for patients who received CBT for the treatment of their PTSD symptoms were associated with damage to the ventral anterior cingulate activation response and parts of the amygdala (Bryant et al., 2008); poor treatment outcomes with EMDR treatment were linked to a decrease in gray matter volume (Nardo et al., 2010).

Ethics

            When it comes to treatment for patients with PTSD, there can be ethical issues that should be addressed as they arise. For instance, it is important to make an accurate diagnosis and assessment of the patient in regards to the symptoms present, with treatment focused on the patient and his or her experience of the symptoms associated with PTSD (Cahill & Anderson, 2013). Additionally, it is imperative that the risk for suicide is conducted in order to reduce the access to lethal means, if warranted (Cahill & Anderson, 2013). Healthy therapist boundaries are also important and should be an ethical consideration that psychologists and other mental health professionals are cognizant of when working with any patient, not just those who may have PTSD.

Case Study Analysis: David (Lifespan Development)

Although there are several developmental changes that occur during one’s pre-adult life, adulthood is no walk in the park, as there are other challenges that individuals in this developmental period of life experience. During adulthood, many of the struggles can affect not only the individual, but his or her family members as well, as it is typically during this time that marriages occur, which are often accompanied by children who are dependent upon parents, which can compound an already challenging time. For the current and final course project, the case of David will be reviewed through a developmental lens, identifying the challenges and issues faced by David, as well as some recommended interventions and treatment options to assist David through this difficult time.

The Case of David

            There are several individuals mentioned in the case study selected for this assignment, but the main focus will be on David, who is a 52-year-old college educated Caucasian male who has been divorced and is currently married to his second wife. Between both marriages, David fills the role as a father figure to five children, who range in age from 14-year-old twins that he is a step-father to with his current wife, with his other children, whom he had with his first wife, range in age between 16 and 22 years. David has worked in the human resource field for the past 24 years and has recently been informed that there is a potential for a promotion at his current workplace, which would mean more money to help in the support of his family, but the trade-off would be more time spent at work, rather than with his family.

            David experiences a high level of stress at work due to his growing list of responsibilities due to the changes that have been made at the local rural hospital in which he works. When coupled with his disturbed sleeping pattern brought on my residual pain following an accident several years ago and high levels of anxiety, it has led to the use of unhealthy coping mechanisms, namely the use of prescription medication from his doctor, combined with a few alcoholic beverages each night when he comes home from work. His ex-wife has mentioned that he should make more of an effort with his 16-year-old son, who has recently started to cut classes at school. At the same time, his current wife needs David to help out at home, as one of his stepsons has a severe learning disability that requires tutoring and parental support in order to maintain his current grade level. David appears to be pulled in several directions, and may be feeling overwhelmed by the stressors present at both home, as well as his place of employment.

Challenges and Primary Issues

            Through reviewing the information in the case study, it is clear that there are several challenges faced by David. These can be broken down into employment, family, and self-care issues, with each type contributing to the current level of anxiety and general distress that David is experiencing. At home, one of his son’s requires additional attention in order to cope with his learning disability, while the children he had with his first wife are also demanding additional time and resources that David may not be able to provide at this time.

            In regards to his work-related stressors, the company in which he is currently working has experienced several changes recently, which has meant that David’s workload has increased, while at the same time, the amount of time that he is allotted to complete his work has been decreased. The task requirement of working without enough resources, in this instance it is time that is insufficient, can lead to high levels of stress and anxiety (Boyd, Tuckey, & Winefield, 2014). Although there is the possibility of David receiving a promotion since his current supervisor will be retiring soon, it is not currently known what that position would entail and if there would be less stress associated with that position. However, it would take away time that he could spend with his family in exchange for an increase in pay.

            The final dimension that should be included in the challenges and issues that David is currently experiencing is self-care and his physical and emotional health. He has noted that he has some low back pain, which he attributes to an accident that he was involved in when he was younger. However, rather than being due to a previous injury, the pain could be due to the stress and anxiety that are associated with his work and home challenges. Some research has indicated that the presence of stress, anxiety, job dissatisfaction, and low levels of social support in the workplace can be risk factors for the development of low back pain (Hoy, Brooks, Blyth, & Buchbinder, 2010). The fact that David is mixing his prescription medication with alcoholic beverages in order to reduce his level of anxiety and help him to sleep, both of which are currently not being alleviated sufficiently by the use of the prescription medication and alcohol, can be quite dangerous, depending on the medication.

Lifespan Development Theoretical Explanation of Challenges

            When viewing David’s challenges through a lifespan development, theoretical lens, specifically Erikson’s stage of development, David falls within the Generativity vs. Stagnation stage of psychosocial development (Schoklitsch & Baumann, 2012). During this stage, which is the longest out of Erikson’s psychosocial developmental theory, individuals are typically busy raising children and contributing to society through the work performed. However, if the crisis is not adequately addressed and resolved, meaning that the individual does not feel as if his or her work is contributing to society, there is a possibility the development of feelings associated with stagnation (Schoklitsch & Baumann, 2012).

Looking at the challenges and issues present in David’s life through the psychosocial stages of development, he is at risk of falling into stagnation. For example, David has stated that the paperwork associated with his position at work, and perhaps to a greater degree his position in general, has begun to lack in ways that are meaningful to him. This could mean that he does not feel as if he is contributing to society through his current position. Additionally, with his inability to be present and tend to his home life responsibilities, which include a wife, an ex-wife, and five children who depend on him for financial and emotional support, can lead to feelings that his personal life is lacking in the realm of contributing to those around him.

Potential Impact of Individual and Cultural Differences in the Development of David

            David’s perception of the responsibilities that he is tasked with, both at home and at work, can be working against him, causing an increase in his stress and anxiety levels. Additionally, at his current age of 52, his main concerns are his family and career, based on Erikson’s psychosocial stages of development (Schoklitsch & Baumann, 2012). These are areas that he is currently experiencing a high level of stress, which can make tending to his responsibilities even more difficult. It is during this stage in life that people may experience a midlife crisis, as they search for meaning in their lives, with approximately 10% of men in the United States undergoing a midlife crisis (Wethington, 2000), with the mean onset age being 47.5 years (SD = 8.06 years) (Freund & Ritter, 2009). This places David at the age that a midlife crisis may occur.

Suggested Interventions

            David’s stress and anxiety, which could be contributing to his low back pain, racing thoughts in the middle of the night, and disturbed sleeping patterns, appear to be at the forefront in regards to the areas that may be beneficial in addressing first. If the stressors in David’s life are tended to, whether it means taking a break from work in his current position, asking his wife and ex-wife to take on more responsibilities, or employing more effective and healthy coping skills, it is likely that other areas of his life may benefit too.

            The downsizing that David’s company has been undergoing lately is one source of stress that he may feel powerless over. Some research has indicated that the deleterious effects to employee health and overall well-being are often affected by such moves within businesses and organizations (Boyd et al., 2014). It appears that David does not have much support in the workplace, which may make asking for help difficult. Talking to his supervisor regarding taking a break from his current position may not be feasible. As such, addressing the two other areas of his life may be a more effective method.

            David is currently under medical care for his anxiety and sleeplessness, for which prescription medication has been provided by his physician. However, some research has suggested that a comprehensive yoga program may be more effective at reducing pain severity, anxiety, and depression when present in individuals with low back pain, with relief experienced in as little as seven days of an intensive yoga experience (Tekur, Nagarathna, Chametcha, Hankey, & Nagendra, 2012). As such, it is recommended that David look into practicing yoga movements, meditation, and gaining a deeper understanding of the yoga philosophy, which may make his current method of coping, namely the use of prescription medication and alcohol, obsolete.

            Mindfulness meditation and time management exercises can also be effective at addressing the issues that David is currently experiencing in regards to his home and work lives. Mindfulness has been known to be effective at reducing stress and anxiety levels, as well as increase one’s sense of control (Astin, 1997). The uncontrollable and/or unpredictable aspects of David’s position at work are cited as the main causes of workplace stress (Michie, 2002). Through gaining an increased sense of control by mindfulness practice and medication, David may be able to reduce his levels of stress and anxiety.

Conclusion

            It is clear that David is experiencing high levels of stress and anxiety, with contributions coming from his work and home lives. This can make it feel as if he is unable to escape or see an end to his current state. As such, his mental and physical health is being affected, with both experiencing a decline. However, through some lifestyle modifications, including mindfulness and yoga, as well as developing better communication skills so that he is able to share his perceived burdens and frustrations with his supervisor, wife, and ex-wife, David may prevent the onset of additional health complications.

** References Available Upon Request **