Dear President Obama,

I am writing to you as a concerned citizen, with the hope that, as commander-in-chief of the armed forces, you can help prevent our soldiers and their families from suffering the effects of PTSD. Because the brain is constantly rewiring itself in response to our changing circumstances, and those mental states develop into traits over time, it is reasonable to expect that exposure to mild or severe trauma, especially in a war zone, will create neurobiological changes in how the brain functions. This is not a sign of weakness in the individual, but a normal human process for which there is an evolutionary purpose.

When confronted with a stressful or potentially dangerous situation, the brain responds by releasing cortisol and adrenaline to allow us to either fight or take flight and thereby increase our chances for survival. This strengthens the amygdala or fear center of the brain and overrides the middle pre-frontal cortex and limbic system. This creates the condition of hyper-vigilance that is a survival mechanism in times of danger but interrupts the feeling of security when the danger is no longer present. Without the development of the middle pre-frontal cortex and limbic system to keep the amygdala in check, the prolonged exposure to a dangerous setting like daily life in a war zone, is likely to cause that vigilant mental state to become a seemingly enduring hyper-vigilant trait. Especially after the threat is gone and the soldier is attempting to rejoin civilian life. This is one of the symptoms that people with PTSD report and is a gateway to sleep disturbances, depression and suicide. A life lived in fear is simply not worth living.

PTSD brain

Based on this understanding of the neurobiology behind PTSD, new treatments have emerged that attempt to rewire the brain after trauma. These include meditation and the sharing of our traumatic stories in a safe, supportive environment. These practices help us regulate our emotions by encouraging the growth and neural integration of the middle pre-frontal cortex and limbic system. I refer to this as the adaptive processing of trauma and it may also hold the key to prevention through creating greater resiliency towards future traumatic events. If we already have practice with these techniques, we are more likely to use them and respond adaptively to trauma. For this reason, I would like to propose that these therapeutic practices be introduced to soldiers during their basic training as it will better prepare them for, not just the future battle with an enemy, but the ongoing struggle for mental health. And a happy soldier is a healthy soldier.

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I want to thank you in advance for your time and attention to this matter. It is of crucial importance that we take steps to help those suffering from PTSD and prevent future generations from doing the same. The potential rewards for preventing PTSD in our soldiers is almost beyond words. By teaching simple neurobiology and adaptive processing techniques in basic training, we can remove the stigma that a soldier is weak for experiencing a change in brain chemistry in response to trauma and replace it with the understanding that neurobiological change is a normal process that we can influence with our thoughts and actions. If we can do this, (and by we, I mean you) this will create greater resiliency in our military, provide for longer careers, reduce health care costs associated with the treatment of PTSD and facilitate a greater quality of life for our soldiers and their families. It’s worth it on every level.

Please, for the sake of current and future generations, let’s create a culture within the armed forces that celebrates change, encourages dialogue and embraces neuroscience as the cause of and solution to, the crisis of PTSD.

As the old saying goes, “prevention is the greatest cure”.

Respectfully,

Scott Rahilly