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July 20, 2016 - Here are some PTSD talking points that may help

Posttraumatic Stress Disorder (PTSD)*

 Definition:   Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event like the Orlando nightclub attack.  It can also occur in people who have experienced a natural disaster, a serious accident, war/combat, rape or other violent personal assault.   These traumatic events can lead to distressing symptoms such as nightmares, flashbacks, and vivid upsetting memories. 

Important points:

1.       PTSD symptoms vary from person to person.  A person may not appear sad or afraid, but may be angry, reckless, moody, withdrawn, jumpy, forgetful, or hard to talk to and get along with. PTSD is diagnosed when the person has had symptoms for longer than 1 month.

2.       Symptoms often begin within the first 3 months after the trauma, but they may appear even later.

3.       DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) makes clear that the trauma must involve real or threatened death.  Learning that a family member has died from natural causes or watching a terrorist attack on the evening news does not meet the standards for the diagnosis.

4.        People with PTSD often relive the experience through sudden disturbing memories that involve what they saw, felt, heard, or smelled, as if the event were happening again. They may have distressing dreams, intense fear, helplessness, nightmares, and problems sleeping, and feel detached or distant.

5.        Some people with PTSD may have changes in thinking and mood. They may make vague and extreme negative statements about themselves or others, such as “I always had bad judgment” or “People in authority can’t be trusted.” They may blame themselves or others for the trauma.

6.        About one-half of adults who have PTSD will fully recover within 3 months, while some have symptoms longer than a year and sometimes for more than 50 years.

7.       Children can also develop PTSD and at first may be restless or confused after the traumatic event. They also may show intense fear and sadness. Their play often reflects the trauma they lived through or witnessed. DSM-5 has set guidelines for children age 6 and younger who have this disorder to detect their unique symptoms

 

The Tragedy of the Orlando Shooting

In the early hours of the morning on June 12 at Pulse, a club for the LGBT community in Orlando filled to capacity on Latin Night, a lone gunman opened fire with a semi-automatic rifle and a handgun, killing 49 people and wounding more than 50.  He was killed by law enforcement.  There were many heroes that night.  People at the club who helped those who survived, some with horrible injuries, law enforcement officers, first responders and trauma teams at the Level I trauma center just blocks way and countless volunteers who have come forward to help victims and their families in large and small ways with tremendous kindness and generosity.

 

FPS Helps

Sunday morning, as the shooting made the news, FPS members began to offer and provide help.    

FPS Press Release

Debra Barnett in Tampa identified the Zebra Coalition in Orlando, a network of organizations working with the LGBT community in Orlando that was enlisting volunteers to help counsel persons in need.  Thanks to the members who volunteered early with them.  More are needed.  If you can help please contact them at:

Website: www.zebrayouth.org   Facebook: www.facebook.com/zebracoalition/  Office number in Orlando (407) 228-1446  Go to the Facebook page for offering clinical help.

Louise Buhrmann in Orlando contacted Mayor Buddy Dyer’s office and added FPS to the referral network for persons needing help, using her office number.  Dr. Buhrmann and her staff continue to receive multiple calls a day, often multiple calls an hour, getting people into local psychiatrist and therapist offices for care.

Manal Durgin, working with psychiatrist and other colleagues at area Devereux facilities, mobilized a network of outpatient care including mobile response, immediate grief counseling, more traditional counseling and psychoeducation resources related to managing acute stress, including self-care and resiliency.  In addition, some of her team participated in the Red Cross event at the Citrus Bowl.

Alina Gonzalez Mayo is part of a VA team that will be coming from the Tampa Bay area to provide counseling and therapy in Spanish.

Richard Hall in Orlando, a national consultant on terrorism, has been in contact with local law enforcement and the FBI.

Glenn Currier and Regina Bussing, Chairs of the Departments of Psychiatry at USF and UF respectively have offered help, as has Stephen Cuffe, Chair of Psychiatry at UF Health Jacksonville.

 

Our list of names is not complete.  And our job is not complete either.  If you are helping, please let FPS know.  We will be updating our report to members.  If you are interested in helping, please let FPS know. Contact us at:  margo@floridapsych.org or fps@floridapsych.org.  We are in communication with the response structures in Orlando and many of the current volunteers will be temporary.  We are trying to assure that those who were impacted and need your help can receive it.

 

Who has been helping FPS

Sunday morning we also began receiving emails and messages offering other help.  Robert Ursano, current APA Disaster Psychiatry Chair, has provided resources that will be linked on this page and ongoing assistance.  Past Chair Anthony Ng is regularly in contact and has connected us with the Red Cross and other resources.  Special thanks to both of them and to Frederick Stoddard in Boston, one of the editors of an APPI text Disaster Psychiatry: Readiness, Evaluation, and Treatment which he has helped us obtain for providers working in Orlando.

In addition we would like to acknowledge and thank District Branch Disaster Psychiatry Chairs Shaukhat Khan from Connecticut, Alan Chrisman from North Carolina and AACAP and Edward Kantor from South Carolina, all of whom have experienced response to a shooting and provided counsel.  Ed Kantor has been particularly helpful with ongoing communication. 

We have been in touch with the Red Cross folks currently on the ground, Jack Hermann and Tara Hughes, the Orange County Medical Society Medical executive director and Donna Wyche who is the administrator for mental health services for Orange County.

 

Need, will be ongoing

All of this amazing activity notwithstanding, there is still a long way to go, and victims of this horrible event particularly members of the LGBT and Hispanic communities and their families will continue to need psychiatric and other services.  If you are willing to participate in the future, please contact margo@floridapsych.org or fps@floridapsych.org and we will let you know what you can do.

Again, thanks to those of you who have already given of your time.  FPS President Abbey Strauss would like to identify you.  Please let us know what you are doing or have done.   Those of you familiar with trauma know that help will still be needed at longer term needs begin to emerge.  People hurt by this event will still need care.

 

Stay tuned

We will be updating this page.  Please return for additional information.  Thank you for being an FPS member, or for visiting our website.

  

Resources

Resources from the emerging national disaster network. 

https://content.govdelivery.com/accounts/USSAMHSA/bulletins/14fc212

Center for the Study of Traumatic Stress Resources

Item Name Posted By Date Posted
Restoring Wellbeing in Children After Disaster PDF (229.09 KB) Administration 6/20/2016
Recovery After Witnessing a Traumatic Event PDF (75.21 KB) Administration 6/20/2016
Providing Safety Recovery and Hope to Communities PDF (219.89 KB) Administration 6/20/2016
PFA Support Well Being of Disaster Victims PDF (103.04 KB) Administration 6/20/2016
Stress Management after Disaster PDF (92.91 KB) Administration 6/20/2016
In the Wake of Tragedy PDF (138.78 KB) Administration 6/20/2016
Funerals and Memorials Part of Recovery PDF (90.91 KB) Administration 6/20/2016
Communication Anticipating Responding to Stressful PDF (98.98 KB)  more ] Administration 6/20/2016
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