Are service members' brains different?

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There are about 1.3 million active-duty troops and about 18.2 million veterans in the U.S. These service people often have to deal with various physical and emotional wounds.

But a new study shows their brains may also be different.

Research shows 19% of veterans may have a traumatic brain injury, and 20% have depression or post-traumatic stress disorder.

"It can mean having flashbacks, it can mean having nightmares, and as a result, they can have avoidance, so they avoid anything, any situation, any event that will remind them of that trauma," psychiatrist Dr. Polina Shats said.

A new study from the U.S. Department of Veterans Affairs found that veterans and active-duty troops with combat-related PTSD and mild brain injuries had larger amygdalas than those of people with only mild brain injuries. The amygdala is the area in the brain that processes emotions like fear, anxiety and aggression.

Being able to see the size of the amygdala could lead to a screening tool to identify people at risk and maybe even new treatments that target the brain.

"There's different medication options," Shats said. "There's different therapy options. It really depends what the main symptom that they're suffering with is."

Experts say treatment approaches include yoga, exercise and mindfulness. In a University of Michigan study, veterans who practiced mindfulness developed stronger connections between specific brain networks, which resulted in an easing of their symptoms.

The researchers did not find statistical differences in other regions of the brain in service members with PTSD and traumatic brain injuries.

RESEARCH SUMMARY
ARE SERVICE MEMBERS BRAINS DIFFERENT?
REPORT #2657

BACKGROUND: According to the RAND Center for Military Health Policy Research, 20 percent of vets who served in either Iraq or Afghanistan suffer from major depression or post-traumatic stress disorder. Of those vets in these two categories, 19.5% have experienced a traumatic brain injury. These service-related disorders alone have an enormous impact on the demand for veteran mental health treatment. This service is essential in order to help our returning vets recover from their combat experiences and mental health issues related to their military service. There are a number of troubling statistics which show that many of our veterans are not receiving the care they deserve. According to the U.S. Government Accountability Office, 2.1 million veterans received mental health treatment from the U.S. Department of Veterans Affairs in the five-year period from 2006 through 2010. A study by the Substance Abuse and Mental Health Services Administration revealed that only 50% of returning vets who need veteran mental health treatment will receive these services. (Source: https://nvf.org/veteran-mental-health-facts-statistics/)

MENTAL HEALTH TREATMENT BARRIERS: Both active duty service members and veterans can face barriers to treatment for mental health issues. Personal embarrassment about service-related mental disabilities, shame over needing to seek mental health treatment, fear of being seen as weak, or even a lack of understanding or lack of awareness about mental health problems and treatment options are just a few. There can also be logistical problems, such as long travel distances in order to receive this type of care, concerns over the veteran mental health treatment offered by the VA, and demographic barriers and false perceptions based on these demographics such as age or gender. According to the American Psychological Association, in the year 2005, 22% of veterans sought veteran mental health treatment in the private sector rather than getting help from the VA. That number has increased along with wait times at many of the VA mental health facilities around the country. (Source: https://nvf.org/veteran-mental-health-facts-statistics/)

BREAKTHROUGH THERAPY: The FDA has recognized that methylenedioxymethamphetamine (MDMA) may be a breakthrough treatment for people with post-traumatic stress disorder (PTSD). MDMA, also known as ecstasy, is a synthetic drug that alters mood and perception. After years of research, the medical uses of MDMA have officially been recognized by the U.S. government, with the FDA granting therapists the right to treat PTSD patients with the drug. According to MAPS, the nonprofit organization has reached an agreement with the FDA under the Special Protocol Assessment Process for the design of two Phase 3 trials for MDMA-assisted psychotherapy for patients with severe PTSD. "Reaching agreement with the FDA on the design of our Phase 3 PTSD therapy program and having the ability to work closely with the agency has been a major priority for our team," said Amy Emerson, executive director of the MAPS Public Benefit Corporation. Rick Doblin, founder and executive director of MAPS, said, "For the first time ever, psychedelic-assisted psychotherapy will be evaluated in Phase 3 trials for possible prescription use, with MDMA-assisted psychotherapy for PTSD leading the way." If the Phase 3 trials demonstrate significant efficacy and an acceptable safety profile, FDA approval is expected by 2021. Once approved, MDMA-assisted psychotherapy will be available by prescription in supervised therapeutic settings from specially trained mental health providers. (Source: https://www.usveteransmagazine.com/2018/06/breakthrough-therapy-ptsd/ and https://maps.org/news/media/7730-press-release-psychopharmacology-publishes-combined-analysis-of-phase-2-clinical-trials-of-mdma-assisted-psychotherapy-for-ptsd)