Top 5 Secondary Conditions to PTSD | VA Disability

Hey guys, it's Leah B. from Prestige Veteran Medical Consulting. I'm a U.S. Army Veteran, Physician Assistant, and former Compensation and Pension Examiner. Today I wanted to come on and discuss the top five conditions that I see as a medical professional related to PTSD or Post Traumatic Stress Disorder on a secondary basis. So what does it mean to have something related on a secondary basis? So what I mean by that is a condition that is caused by or aggravated by the primary service-connected disability, right? So PTSD in this case that we're discussing would be the primary service-connected disability. You may have developed PTSD as a result of an incident in combat. You may have developed it due to a military sexual trauma. It could be unrelated to either of those issues and be related to some other kind of issue that happened while you were serving stateside or wherever, okay? Germany, whatever country it is, not related to combat. So developing a secondary condition could be anything from, we're going to get into them, could be anything from headaches to erectile dysfunction to sleep apnea. There are a myriad of conditions that veterans are service-connected for as a result of their service-connected disability, okay? So the top five that I see generally, and these are not in any specific order, are going to be number one, headaches, right? So whether they're tension headaches or migraine headaches or just nonspecific generalized headaches, I often see veterans develop headaches as a result of their PTSD. Or perhaps they had headaches prior to their PTSD and their frequency is just much more intense and much more constant since they've developed this disorder. So one of the articles that I frequently cite, and I have other videos on this, I recommend that you guys go and check them out so that you can get a few more journal articles that maybe you can review or you can give to your primary care doctor and they can review to help you out with a supporting letter for your case, is an article called Migraine Maladaptive Brain Responses to Stress, and that was published in Headache, and it investigated how repeated stressors can alter the normal response of physiologic symptoms. It discusses the concept of allostatic load and how that can impair and cause chronic headaches, okay, related to stress. So the next condition, or I guess group of conditions that I'd like to discuss are sexual dysfunction disorders. So erectile dysfunction, female sexual arousal type disorders, things like that. So these can often be related to not only the stress and emotional components of the PTSD, but oftentimes the medications that veterans are prescribed to treat these conditions. So one of the most common medications that are prescribed or medication categories that are prescribed for PTSD are called serotonin, serotonin, selective serotonin rehab take inhibitors. Sorry, I had a senior moment there. So SSRIs are medications like Zoloft, also referred to as sertraline, Celexa, Paxil, Prozac, things like that. So these medications are known to have side effects that can cause sexual dysfunction. So one of the articles that I use is called sexual dysfunction and selective serotonin rehab take inhibitors and potential solutions and narrative literary review, which was published in 2016 and the mental health clinician. And it just discusses the relationship between SSRIs and sexual dysfunction. So that's a pretty good one. Gastrointestinal disorders, moving on. So gastrointestinal disorders are often related to PTSD and depression and anxiety. So IBS and GERD are a couple of them that I see frequently, but when it comes to IBS, one of the articles that I use for that is going to be irritable bowel syndrome. Is it irritable brain or irritable bowel? That is from the journal of neuroscience and rural practice in 2015. So the authors demonstrated that stress acts on the emotional limbic system and can lead to increased release of adrenal corticotropic hormone and cortisol, which then influenced the enteric nervous system resulting in the symptoms of IBS. So moving on to sleep apnea. So this is a really controversial one. A lot of veterans are service connected for this, and there are a lot of veterans that have applied for this and been denied over and over again. So it's really tough because a lot of times I read tons of decision letters when I'm reviewing files. So a lot of times what I see is that, you know, there may be articles submitted by the veteran or opinions written that show a lot of correlation, right? Meaning that the veteran or not the veteran, the subjects in the articles suffer from both OSA and PTSD, but that doesn't really show causation or aggravation, which is, you know, what we kind of need to show is how, how did this issue cause this issue, right? So one of the aspects and points that I like to make a lot is based on fragmentation of sleep and abnormalities of REM. Okay. These issues can cause disruption and hypotonia of the upper airway, which can lead to a physiologic obstruction resulting in obstructive sleep apnea. The bigger way is my segue into this fifth and final component that I'd like to talk about is any condition that can be caused by weight gain as an intermediate step to include OSA, right? So what do I mean by that? So I have a ton of videos about weight gain as an intermediate step on my channel. So I highly recommend that you guys watch those individually so that you can kind of get specifics on whichever condition it is that may pertain to you, but things like, um, plantar fasciitis, coronary artery disease, hypertension, sleep apnea, diabetes. If you have PTSD and you have developed compensatory, um, coping mechanisms to include things like binge eating or emotional eating related to your stress, or perhaps you have agoraphobia, you don't like to go outside because it is, or you don't like to go to specific places that are crowded, like the gym, because of some of the symptoms related to your PTSD, you get triggered, um, you get anxious in crowds, things like that. You just stay home and don't, don't like to leave the house, right? That is very common in many veterans. So that coupled with perhaps some emotional eating, things like that, you can't, if you develop weight, weight gain as a result of that, let's say you put on 150 or 200 pounds and your BMI is in the forties, that can cause significant stress on other body systems. Like for example, I mentioned plantar fasciitis, right? So if you've got plantar fasciitis, your little plantar fascia are getting worn out, or perhaps your posterior tibial tendon, which helps support your foot is getting stretched out and worn out due to the weight, things like arthritis in your knees, all that extra weight that your body may be carrying around. Um, coronary artery disease again, um, now you have to keep in mind that we have to look at the risk factors, right? So if for hypertension, for example, if you've got, you're a smoker, you've got family history, you've got, um, you know, a slew of other things going on, it may not apply. So that weight gain has to really, you have to be able to really show that this weight gain is, is due to that service-connected disability. So, um, a couple of the studies, um, oh, also hiatal hernia. That's one that I see often to wait with weight gain as an intermediate step. Okay. So a couple of the studies that I like to cite, I'll just throw them out here for you guys. So you can look them up three-year follow-up of participants in a commercial weight loss program. Can you keep it off was published in the archives of internal medicine. Um, another one that I'd like to use is psychosocial stress and change in weight among us adults, which was published in the American journal of epidemiology. Those are a couple that I like to use. Please go back and check out some of my specific weight gain as an intermediate step videos. Also all of these subjects that we talked about today, whether it's IBS secondary to PTSD or, um, ED secondary to PTSD, I have specific, um, individualized videos on those that you may find helpful. So I hope you guys enjoyed today's video, um, drop some comments for me and I will try to answer them as, as soon as possible. And thanks for watching as always. And please subscribe. Yeah.