Mental Health Matters: Misconceptions about PTSD and anxiety

AUGUSTA, Ga. (WJBF) – The Means Report’s Mental health matters because you matter series continues with Dr. Tracy Casasova, a psychologist the Department of Psychiatry and Behavioral Health at the Medical college of Georgia at Augusta University. She gives us a closer look at post-traumatic stress disorder – something that is not exclusively a veteran or first responder issue – as well as anxiety.

Brad Means: We wanna welcome Dr. Tracy Casanova to the Means Report to talk about some of these issues. She is a psychologist. She is with Dr. Casanova, thanks for all you do and for being here today, I appreciate it.

Dr. Tracy Casanova: Thank you for having me.

Brad Means: Well, it means a lot especially for people like me who don’t know a ton about mental health. And then we can walk away from these conversations much better informed. Like with PTSD, and I said a moment ago, it’s something that a lot of people associate with the military, maybe first responders. Do you see other folks dealing with PTSD? And if so, what might that patient look like?

Dr. Tracy Casanova: So PTSD really did come out of the military and we started seeing that with combat trauma. But when it comes to trauma, if someone experienced something that was very scary to them, maybe they feared for their life, they feared for someone else’s life, or maybe they even witnessed somebody dying or being seriously injured. They might develop PTSD. But one thing to remember that’s really important is that if we’ve experienced something scary, say we get in a car accident but we’re okay, we all might develop those symptoms of PTSD and that’s normal for a short period of time. We have these reactions to trauma that maybe we don’t want to drive in the car for a while right after we’ve been in an accident. The car’s a little scary we don’t want to approach it. That’s very normal. Maybe we have bad dreams about it. Or maybe we keep thinking about that accident and what we could have done differently. That’s very normal. Most people have that reaction to something traumatic, to something scary. When it turns into PTSD is when we can’t move past it and we get stuck. Maybe these dreams stick around, maybe we get very anxious and it starts interfering with our life.

Brad Means: All right. So if somebody recognizes exactly what you’re talking about and says, oh my goodness, doctor, that’s my life. How long is the duration of being incapacitated if you will? Before you should say, okay, this is real, I need help.

Dr. Tracy Casanova: So when it gets over a month long, when those symptoms persist after a month that’s when you really want to seek treatment and to maybe start addressing it with a provider.

Brad Means: Can you cure PTSD? Can you make it go away forever?

Dr. Tracy Casanova: >>Yes.

Brad Means: How, what do you do?

Dr. Tracy Casanova: So there’s a lot of different kinds of therapy. We have some called cognitive processing therapy or prolonged exposure therapy, and there are different approaches. One piece is really confronting the trauma. A big piece of PTSD is avoidance. People don’t wanna think about the bad thing that happened. It’s scary, it was a horrible event. So they try it as hard as they can to push it away and not think about it. So part of therapy can be actually approaching it. And it’s helpful with a provider who can give you that safe space and that support to confront something that was very scary to you. And so that’s just one piece of what therapy could look like for someone coming for PTSD.

Brad Means: Yeah. It sounds terrifying though. I mean, you’re not making me want to come see you, but you did say in the right setting y’all can hold our hand through it.

Dr. Tracy Casanova: Yeah.

Brad Means: Does it make it less terrifying than I’m guessing?

Dr. Tracy Casanova: It’s still gonna be scary. You’re avoiding thinking about it anyways. The problem is that it keeps sneaking back in. As much as people try to push it away, when they’re sleeping at night they have that dream, they can’t control it. If they’re just relaxing that memory might pop in their head. And so confronting it in that safe space while it can still be scary, helps it to not pop up at those other times.

Brad Means: Dr. Casanova have you seen more folks come to you for help during the pandemic? Did that bring out some mental health issues?

Dr. Tracy Casanova: So I actually work primarily in east central regional hospital which is an inpatient hospital, and we always see trauma there. So it’s not like it’s been something newer recently. However, if we think about COVID as being almost this like chronic long-lasting experience of trauma, where people can be scared for a long time, that definitely has a lasting impact and contributes to feelings of anxiety.

Brad Means: You talk about anxiety, there have been many anxious moments on our political and social scenes for the past few years for sure. Does that ever manifest itself or morph into a mental illness when somebody is so stressed out, so anxious? No matter why, because of political or societal issues, can that make people sick?

Dr. Tracy Casanova: It can definitely make people sick. Just the culture of our community can cause something called chronic stress. We often talk about chronic minority stress. So if someone is a member of a disadvantaged group or an oppressed group, they can experience chronic stress where they experience a lot of discrimination or fear of discrimination, which can ultimately contribute to mental health.

Brad Means: All right. So you’re making me think of LGBTQ, the movement that has really come front and center recently. What are members of that segment of our community feeling and experiencing that could lead them to the point where they need help?

Dr. Tracy Casanova: So society is set up for like the majority group, right?

Brad Means: Sure.

Dr. Tracy Casanova: So most people are straight, most people are cisgender, which means they’re, the sex and their gender match each other versus someone that is transgender. And so when they… Think about if you meet someone, most likely you’re going to assume that their partner is a different gender than them. And so that kind of influences someone like, oh, I have to maybe keep who my partner is private or every time they meet a new person, they have to come out as gay and say, hey, my partner is the same gender as me . And that just causes a little uneasiness and anxiety especially if they don’t know how the new person that they’re meeting might interact with them or feel about it.

Brad Means: So what are some ways that you help get those folks to a comfortable place, a confident is place?

Dr. Tracy Casanova: I think it’s a balance of being realistic about the community. ‘Cause some communities can be dangerous. and people can’t be open in those communities. But then it’s also finding your own community of supportive people. And we have a very large and vibrant diverse LGBTQ community here and we have wonderful pride events. The weekend of June 24th is our pride event. And so it’s finding your people and then learning how to cope with that stress.

Brad Means: So what do you think is more stressful? The way that people treat each other or the constant seemingly uphill battle for recognition and equality? Which is worse? The big picture or the small picture?

Dr. Tracy Casanova: I think they go hand in hand. When people are accepted and society just welcomes people in, they treat each other better. When we just accept of groups, we treat them better.

Brad Means: This sounds like an obvious question but I want your answer. What can we as individuals do to help make sure everybody feels better? I mean, really what specific actions can we take when we’re meeting someone or hearing about their lifestyle? What’s the proper reaction so that we make this world a better place?

Dr. Tracy Casanova: I think no reaction sometimes. This is normal because it is normal. People have partners of different genders. People have different gender identities. And I think avoiding assumptions. So not assuming someone will have a partner of the opposite gender or assuming what someone’s gender is just being curious and asking them about themselves.

Brad Means: I hate to ask you doctors about timetables, but if this is resonating with the viewer right now that they’re experiencing this type of anxiety, this type of stress because of who they are, how long might it take for you to get them back to a good place in life?

Dr. Tracy Casanova: I think there are a lot of different pieces that could affect that. Do they have a strong social support system? People that don’t have supportive people in their lives, it’s gonna be harder for them to feel better when they don’t have someone to talk to outside of maybe that therapy session. So it really, it varies, and social support is such a big piece of that.

Brad Means: Does insurance cover a lot of what we’re talking about? If someone does seek your assistance, is that going to kick in?

Dr. Tracy Casanova: If an insurance company does cover mental health services, they should be able to come in for that. But every insurance company is different. One good thing is that the Georgia legislature is actually really focusing on mental health this year. And that should include expanding access to services through insurance coverage.

Brad Means: I was gonna ask you about big picture, where do you think we are right now? Are we where we need to be when it comes to legislation? When it comes to a more widespread movement toward acceptance or is there a long way to go?

Dr. Tracy Casanova: There’s a long way to go. I think we still view physical health and mental health very differently. And that comes out in the budget and support from insurance companies and the legislature, I think it is changing. But we do still have our ways to go on that.

Brad Means: Last question, we have probably 45 seconds. You mentioned social support. I’m guessing that is… That includes friends and family. We can do stuff in our own home to help.

Dr. Tracy Casanova: Yes. I just think that being accepting, treating someone as a member of the family, they’re no different than anyone else.

Brad Means: Thank you for talking to us. I knew our time would fly by and it did but we tried to squeeze a lot into our segment and I’m much better informed because of it. Thank you, Dr. Casanova.

Dr. Tracy Casanova: Thank you.

Brad Means: Absolutely. Dr. Tracy Casanova will have her back because we’ve hit on some topics that I know resonate with a lot of you.

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