Differences in PTSD by Gender Identity

Even in the face of its seriousness, suicidal ideation often goes undiscussed because of the stigma that can surround it. But, as we're talking more and more openly about mental health, it's essential that we approach the subject of suicidal thoughts with as much empathy, openness, and support as possible. If you find yourself grappling with these thoughts, or if you're trying to understand and support someone you care about who is, this guide is for you.  Suicide prevention support If you're thinking about acting on suicidal thoughts, reach out for help immediately.  Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Call 988 for the National Suicide Prevention Hotline. What is suicidal ideation? Suicidal ideation transcends mere fleeting thoughts about death; it's a whole range of thinking that might start with not wanting to wake up and can go all the way to planning how to end one's life. Often accompanied by a sense of hopelessness, these intrusive thoughts can be potentially dangerous. Despite the severity, feeling this way doesn't have to be permanent. Instead, these thoughts can be a signal that indicates deeper psychological distress and emotional pain that need to be addressed.  The prevalence of intrusive thoughts  While it can feel isolating to experience, this mental health condition affects many. Every year, millions of people report these thoughts to medical professionals. Between 2015 and 2019, the CDC found that an estimated annual average of 10.6 million U.S. adults had thoughts of suicide in the past year, which accounted for about 4.3% of the adult population. Intrusive thoughts don't discriminate — depression can affect individuals of any age, gender, education level, socioeconomic status, or background. Suicidal ideation is part of a broader mental health landscape; it’s not a ‘character flaw.’  What causes suicidal thoughts? The causes of suicidal ideation are as varied as the individuals who experience it. They often stem from life circumstances, mental health disorders, or personal resilience levels. Common underlying conditions can include:  Major depressive disorder Bipolar disorder Post-traumatic stress disorder (PTSD) Social isolation Chronic pain Substance use disorder Understanding the warning signs of suicidal ideation in others For friends and family, recognizing the warning signs for suicide is paramount for timely intervention. The signals can look similar to the signs of depression and anxiety, but are typically more severe. Look for these behaviors: Withdrawal from social circles  Giving away possessions Sudden calmness after a period of depression Statements of feeling hopeless or having no purpose  Remember: Not everyone exhibits clear ‘red flags,’ and a person at risk might go to great lengths to hide their pain. How is suicidal ideation diagnosed? Identifying suicidal ideation typically occurs during a supportive conversation with a mental health expert. These caring professionals will talk with a patient, sometimes using questionnaires, to better understand their feelings and the severity of the thoughts they're facing.  They will also look for any underlying mental health conditions or life experiences that may be contributing to or exacerbating the intrusive thoughts. The recognition of suicidal ideation is less about certainty and more about concern. The presence of suicidal ideation often prompts an immediate need for intervention, regardless of other diagnoses. It's about recognizing that these feelings are a call for help and responding with the urgent care and support needed. What to do if you are experiencing suicidal ideation When you’re experiencing suicidal ideation, seeking help and taking action are crucial. Getting urgent help Seek help immediately if you're thinking about acting on suicidal thoughts. The 988 Lifeline provides 24/7, free, confidential support and crisis resources. Your options also include calling 911 or going to the nearest emergency room. No matter what course of urgent help is seen as the best fit at the moment, you will want to seek the support of a mental health professional as soon as possible. That also can be your first step when experiencing distress. Steps to take when it isn’t an emergency If you’re not in immediate danger, these are the first steps you could take toward getting the judgment-free help you deserve. 1. Make an appointment with a mental health professional Professional intervention is crucial in managing the risk of suicide or self harm. A mental health professional will provide a safe space to explore the thoughts and feelings you are experiencing. They can guide you to understanding the factors and strategies to manage your mental well-being effectively. 2. Identify and remove triggers Start by identifying the triggers that lead to these intrusive thoughts. They might be certain places, people, or events that consistently lead to distress. It might not necessarily mean avoiding them permanently, but it can allow for a safer environment while you address this mental health condition. 3. Reach out to a close friend or loved one  You’ll need a strong support system. You may be nervous about opening up, but doing so with a trusted, supportive connection can be a critical step in alleviating the burden, finding relief, and embarking on recovery. 4. Call a suicide hotline If you don’t feel comfortable talking to someone close to you at the time, a suicide hotline can be an invaluable mental health resource. Specialists on these hotlines are trained to support and assist those in crisis.  Managing suicidal ideation is a process; there will be ups and downs. The most crucial thing is to keep moving forward and continue seeking help from mental health resources. Treatment options for suicidal ideation There is no one-size-fits-all approach to treating suicidal ideation. Treatment will vary based on the individual’s needs but may include psychotherapy, medication, or a combination of the two. Hospitalization or intensive outpatient programs may be necessary for those at immediate risk of self-harm.  Additionally, new approaches to reducing suicidal ideation are continually being explored and implemented, often creating expanded access to care.  Treatment goals Regardless of the course of treatment, the focus will be on achieving several key goals. Address the underlying factors contributing to the intrusive thoughts.  Build coping strategies for preventing suicide. Create a support network for the individual.  Individuals will be actively involved in their treatment plan, working collaboratively with their care team. The path to recovery Recovery from suicidal thoughts comes with its own challenges, but many individuals who have once experienced these thoughts have gone on to live fulfilling lives. Recovery often involves finding the right treatment, building a solid support system, and learning healthy coping mechanisms. We know that each person's road to recovery is unique, but it’s important to avoid projecting set timelines or expectations. Celebrating the small victories can make a world of difference. Whether it’s practicing a new coping skill or continuing to seek help, these concrete steps signify resilience and strength. Remember: Patience and consistency in support are key if you’re standing by someone in recovery.  The myth and reality of suicidal thoughts and creativity There is a common misconception that suicidal ideation is a byproduct of creativity. While individuals with artistic inclinations might be predisposed to deeper emotional experiences, it’s crucial not to romanticize or normalize the suffering that comes with suicidal thoughts. The art lies in expressing your emotions in a healthy manner that supports your well-being rather than harming it. Art, writing, and other creative outlets can be a powerful force in recovery. However, these outlets should be harnessed under the guidance of a mental health professional so their benefits can enhance structured therapy and/or medication like anti-depressants or mood stabilizers. The role of community in suicide prevention Support can take many forms, from suicide prevention organizations and support groups to simply being there for someone in need. By building a community that is educated on the warning signs of suicide and the steps to take to support someone in crisis, we can provide a safety net for those who are in need.  Engaging in open, honest conversations about mental health and suicide removes the stigma that often surrounds these topics. Creating a safe space to talk makes it easier for people to seek help and for those around them to provide support. If you or someone you know is struggling with suicidal thoughts, please know that there is hope and help available. Reach out to a mental health professional, call the national suicide prevention hotline at 988, or talk to someone you trust.  Remind yourself: You are not alone — there are people who care and want to help.  Working to stop suicidal thoughts Cerebral is continuing to make strides in improving clinical quality and safety for those experiencing suicidal ideation. With systems in place to connect you to care quickly in crisis situations, not only can unnecessary emergency room visits and hospitalizations be avoided, but meaningful improvements in symptoms can be made in a short period. Of the patients who come to Cerebral considering suicide, half of the individuals stopped having thoughts of suicide within an average of 6 months of treatment. This highlights the powerful impact of seeking support and the real possibility of regaining a sense of hope and purpose. Critical resources 988 Suicide & Crisis Lifeline offers free and confidential support via phone, text, or chat. Crisis Text Line allows one to text with a trained crisis counselor for free by texting TALK to 741-741. Veterans Crisis Line enables veterans to get help via text by sending one to 838255. Vets4Warriors provides free, 24/7 peer support for veterans via phone at 855-838-8255 or by email. The Trevor Project offers immediate crisis support for LGBTQ+ youth via phone at 1-866-488-7386 or by texting START to 678-678. Image by rawpixel.com on Freepik.

Veterans face a unique set of challenges upon ending active duty, with caring for their mental health as arguably the most significant. Traumas they may have experienced while deployed don’t simply disappear once they take off their uniform. Veterans may suffer any one of numerous invisible wounds during service or while reintegrating back into civilian life. For example, nearly 1 in 3 are reported to struggle with PTSD. And the National Alliance on Mental Illnesses (NAMI) reports veterans are five times more likely to have depression than non-veterans.  Unfortunately, many barriers stop veterans from seeking the mental health services they need to overcome their challenges and lead happier lives. In this article, we explore the barriers veterans face in getting proper treatment and how Cerebral is expanding access to online care to better serve those who served our country.  Barriers to accessing mental health services Military servicemembers report facing stigma when trying to address their mental health issues. In a study involving active-duty military soldiers, 44.2% of participants admitted to being deterred from seeking mental health services due to fear of how their unit leadership might perceive them. Additionally, 42.9% expressed concern about being viewed as weak by their peers. As a result, many current and former soldiers suffer in silence. But that’s not all.  Research highlights that a staggering 70% of veterans avoid seeking mental health services out of fear of being diagnosed with a mental illness. This fear serves as yet another barrier to veterans achieving mental wellness.  Veterans not only face a higher risk of experiencing PTSD compared to the general population but also encounter distinct challenges in accessing adequate treatment. These challenges involve prerequisites such as needing an honorable or general discharge to access Department of Veterans Affairs (VA) medical benefits and extended waiting lists at VA medical centers.  A study by the RAND Center for Military Health Policy Research found that less than half of returning veterans in need of mental health services actually receive any treatment. Additionally, of those undergoing treatment for PTSD and major depression, less than one-third are receiving evidence-based care. Online care expands access to mental health services for our heroes Cerebral’s mission is to provide high-quality, affordable mental health services to all. In support of that objective, we’re launching our Cerebral Heroes program which expands access to life-changing care to America’s heroes. Veterans, active duty service members, and their families can join to receive professional therapy and medication management—100% online.   The online nature of Cerebral brings a transformative advantage to our heroes by providing virtual access to mental health professionals. This approach eliminates geographical constraints, enabling individuals to connect with a broader range of specialized therapists and medication prescribers from the comfort of their homes. For those in remote areas or facing mobility challenges, this virtual accessibility is a game-changer, ensuring they receive high-quality care regardless of location. The convenience of virtual meetings also addresses the often-cited barrier of time constraints for veterans and active-duty members. Moreover, our online platform offers a level of privacy that is particularly crucial for those dealing with the stigma surrounding mental health in military communities. By conducting sessions from the privacy of their own space, individuals can seek the support they need without the fear of judgment, fostering a more open and confidential environment for their mental health journey.  And when it comes to efficacy, research published by the Journal of Clinical Psychology found that virtual therapy sessions were equally as effective as standard in-person treatment, and led to a significant reduction in PTSD symptoms. Exclusive savings on our mental health services All of Cerebral’s subscription plans are cost-effective and insurance-free, so patients can affordably access the help they need without complicated bureaucracy. And under our Cerebral Heroes program, we now offer veterans, active military, and their families exclusive savings of 15% off any Cerebral plan when using discount code HERO at checkout. It’s our way of serving those who served our country. Join Cerebral today and start your journey to better mental health and a happier life.

With the COVID-19 pandemic, the experience of grief and other mental health issues have spiked*. Many people are struggling to understand what exactly they may be feeling. And many have lost loved ones, become unemployed, or experienced other losses during the pandemic.  If you’re dealing with intense feelings of trauma or grief, for any reason, you may be experiencing posttraumatic stress disorder (PTSD). PTSD is a serious condition that people may experience after exposure to a traumatic experience. It’s typically characterized by severe anxiety, flashbacks, nightmares, and intrusive thoughts about the event that caused it. But, the good news is that it can be treated in a number of ways. When discussing PTSD, it’s also important to discuss grief. Grief is a strong, often overwhelming emotion that involves sadness, anger, and numbness related to or following a loss. Experiencing grief or bereavement after a loss is extremely common and a completely normal reaction. But if that grief turns into trauma or cannot be overcome, it may be linked to PTSD. Like grief, another emotion closely linked with PTSD is trauma. Trauma is the emotional response to experiencing a dangerous or frightful situation. This response can be different for everyone. And the triggering situations commonly includes things like natural disasters, combat, physical violence, or sexual assault.  Like a lot of other mental health conditions, people who have PTSD often experience it differently from one another. Also, many people who experience trauma might not meet all the criteria for PTSD, but that doesn’t make their experience any less valid.  Although PTSD isn’t as common as anxiety and depression, it isn’t exactly rare either. In fact, PTSD affects 3.5%** of the U.S. population. That’s over 10 million people. What are symptoms of PTSD? Most people who go through traumatic events may have temporary symptoms. It can be difficult to cope, but most people typically recover from trauma over time.  However, you may have PTSD if:  your symptoms get worse your symptoms cause significant issues in social or professional situations your symptoms impact your relationships or interfere with your ability to complete daily tasks Symptoms of PTSD typically start within one month of the traumatic experience. Sometimes, they might not appear until years after the event.  PTSD Symptoms are typically grouped into four categories:  1. Avoidance  Avoidance means you actively avoid people, places, or situations that might remind you of the traumatic experience. 2. Intrusion flashbacks or feeling like you’re reliving the traumatic event frequent nightmares about or related to the event  overly vivid, detailed, and uncomfortable memories of the event intense distress when thinking about the event and effort to suppress your thoughts about the event  3. Cognition and mood difficulty remembering certain details about the event disproportionate feelings of guilt, shame, or blame, especially surrounding the event  generally negative thoughts or feelings about oneself  reduced interest or pleasure in usual activities  4. Arousal and reactivity  In this last category, symptoms may include: difficulty concentrating (in general and due to intrusive thoughts) being easily startled or having an exaggerated response when startled  persistent feelings of irritability  bursts of anger and feeling like you are “on edge” What other conditions are associated with PTSD? When experiencing intrusive thoughts or flashbacks associated with PTSD, many individuals can often experience a panic attack.  Symptoms of a panic attack can include:  chest pain dizziness sweating,  difficulty breathing an accelerated heartbeat PTSD can also exist in tandem with several other mental health conditions. Some of these include: anxiety and anxiety disorders depression substance misuse and abuse  alcoholism  increased risk of suicide  Who’s at risk of developing PTSD? People of all ages are affected by PTSD. However, women are twice as likely as men to develop it.  There are also certain factors that can make you more at risk, such as: having other mental health conditions previously, especially panic disorder or OCD  having a relative with a mental health condition having experienced previous trauma, especially childhood abuse  having smaller hippocampal volume. The hippocampus is the region of the brain that regulates emotional memories. Having abnormal levels of cortisol in the brain. Cortisol is a stress hormone that controls our “fight or flight” response. How is PTSD treated? PTSD can impact relationships and daily life, making it difficult to work, sleep, or function. Because of the stigma associated with PTSD, many people may feel guilty or blame themselves for their traumatic experience. This may make them afraid to tell their loved ones or seek professional help. Fortunately, treatment is greatly effective in reducing the symptoms and distress associated with PTSD. And PTSD can in fact be treated online. Although PTSD is different from anxiety and depression, it’s treated similarly. Treatment typically includes SSRI medication, psychotherapy, and daily lifestyle changes. The most common and successful therapies for PTSD include cognitive behavioral therapy (CBT) and exposure therapy, which involve identifying triggers and talking through the traumatic event in a safe environment to help process it. Cerebral can treat PTSD with medication, cognitive behavioral interventions, and talk therapy. Our trained psychiatric specialists, therapists, and Care Counselors can build a custom treatment plan for you, and your care team is flexible, depending on which plan you choose.  And because it’s all conveniently online, you can get the treatment you need from one convenient place, even without having to leave home! Medically reviewed by: David Mou, MD, MBA *https://psycnet.apa.org/fulltext/2020-37338-001.pdf **https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd#:~:text=PTSD%20can%20occur%20in%20all,as%20men%20to%20have%20PTSD.