Week 1 (3/12-3/18): Introduction

Hello everyone, and welcome to my first senior project blog post! 

My name is Shreya Math, and for this project, I will be examining and tracking the progress of veterans undergoing addiction treatment under the guidance of Dr. Anbalagan, a psychiatrist at the Palo Alto VA Medical Center. For this week’s post I will be going over what substance use disorder or addiction is as well as three primary mental health concerns encountered by those who have served in the military and what I aim to achieve through my research.   

Substance Use Disorder 

Substance use disorder is a complex condition where there is an uncontrolled use of a substance despite any sort of harmful repercussions. People who have substance use disorder have an intense focus on using substances like alcohol, tobacco, or illicit drugs that inhibits the person’s ability to function in day-to-day life. The most severe substance use disorders can sometimes be called addictions. 

People who have substance use disorder may experience distorted thinking or behavior as the use of substances can lead to changes in the brain’s structure and function creating intense cravings, personality changes, and abnormal movement. Studies done using brain scans have shown changes in the areas of the brain that help with decision making, learning, memory, and behavior. Oftentimes, as those with substance use disorder repeatedly use substances, the effects of the substances can last long after the period of intoxication. Symptoms of substance use disorder are split into four different categories: impaired control, social problems, risky use, and drug effects. 

Treatment for substance use disorder often uses a combination of medication along with individual or group therapy and differs based on an individual’s needs. Medications help to control cravings, relieve withdrawal symptoms, and prevent relapses while therapy helps patients understand their behavior, develop self-esteem, and cope with stress or other psychiatric issues. 

Further reading: https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder 

Post Traumatic Stress Disorder (PTSD) 

Post Traumatic Stress Disorder or PTSD is a psychiatric condition that can occur in people who either experienced or witnessed a traumatic event. Individuals may experience this as physically or emotionally harmful and affect mental, physical, social, and spiritual well-being. Some traumatic events that may lead to PTSD include natural disasters, serious accidents, terrorist acts, combat, and bullying. People who have PTSD may experience intrusive memories, exhibit avoidance, show negative changes in thinking and mood, and changes in physical or emotional reactions. 

Treatment for PTSD includes psychotherapies like cognitive behavioral therapy, cognitive processing therapy, prolonged exposure therapy, and eye movement desensitization and reprocessing; and medications like antidepressants. Oftentimes, a combination or the two is used as this has been shown to be more effective. 

Further reading: https://www.psychiatry.org/patients-families/ptsd 

Depression 

Depression is a serious and common psychiatric condition that affects the way people feel, think and act. It causes feelings of sadness and a loss of interest in activities along with various emotional and physical problems that can decrease ability to function in day-to-day life. People who have depression may experience feeling sad or having a depressed mood, loss of interest in activities that used to be enjoyed, changes in appetite, changes in sleep routine, increased fatigue, feelings of guilt or worthlessness, difficulty thinking or making decisions, and suicidal thoughts. 

There are several different effective treatments for depression including things like self-care. The first is the use of medication or antidepressants which are prescribed to help modify an individual’s brain chemistry as this can play a role in their depression. Another option is psychotherapy or talk therapy which is typically used alone when an individual has mild depression and used along with antidepressants when an individual has moderate to severe depression. The primary form of psychotherapy used for treatment of depression is cognitive behavioral therapy which is used to help an individual recognize negative or distorted thinking patterns with the goal of changing behaviors to respond in a more positive manner. When neither of these treatments have not worked for an individual who has severe major depression, electroconvulsive therapy may be used. This involves a brief electrical stimulation of the brain while the patient is under anesthesia. 

Further reading: https://www.psychiatry.org/patients-families/depression/what-is-depression 

Anxiety 

Anxiety is a normal reaction to stress and can actually be beneficial in some situations as it helps alert us of potential dangers. Anxiety disorders are different as they involve excessive fear or anxiety. There are several different anxiety disorders such as specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, and separation anxiety disorder. 

Specific phobias are characterized by excessive and persistent fear of a specific thing, situation, or activity that is typically not harmful. Social anxiety disorder is characterized by having significant anxiety and discomfort about being embarrassed, humiliated, rejected, or looked down upon in social interactions. Panic disorder is characterized by recurrent panic attacks which cause palpitations, sweating, trembling, shortness of breath, chest pain, light-headed or dizziness, nausea, feelings of losing control, or fear of death. Agoraphobia is the fear of being in a situation where escape may be difficult or embarrassing like using public transportation, being in open spaces, being in enclosed places, standing in line, being in a crowd, or being outside alone. General anxiety disorder is characterized by persistent and excessive worry that interferes with daily activities. Separation anxiety disorder is characterized by an excessive fear about separation from those with whom an individual is attached to. 

Anxiety disorders can cause people to try to avoid situations that trigger or worsen their symptoms which can lead to job performance, school work, and personal relationships to be affected. 

There are several different effective treatments for anxiety including things like self-care. One is the use of psychotherapy and in particular cognitive behavior therapy. This can help a person learn different ways of thinking, reacting, and behaving to help feel less anxious. Another is the use of medications like anti-anxiety medications, beta-blockers, or antidepressants. Although medications aren’t a cure, they can help reduce and provide relief from symptoms. 

Further reading: https://www.psychiatry.org/Patients-Families/Anxiety-Disorders/What-are-Anxiety-Disorders 

My Objective 

My project is a longitudinal case study, an in-depth analysis into specific cases, that aims to track how a veteran’s progress aligns with their goal for this addiction treatment program. This study will be done through interviews with the patient as well as the healthcare team to track the patient’s progress through different perspectives. In contrast to prior case studies that have been done on addiction treatments, I will also be taking into consideration the ways in which external factors like family and outside support play a role in treatment while also looking at how disorders like PTSD can affect treatment.    

And that’s it for my first post. Thanks for reading!