Despite a great deal of research confirming that the reason psychology is failing to treat PTSD which is really only a side issue of Veteran Burnout also known as Allostatic Load is that they are trying to treat what is essentially a physical problem with a mental solution. It is reasonable to suggest that physical imbalances problems will produce mental imbalances.
I must point out that I have no problems with the fine work many in the psychiatric/psychology professions do in their field of expertise but this is not one of them despite the fact there is a role for their involvement at certain times in what is essentially a medical problem and should be looked at from that perspective. Especially now that research is identifying particular aggressiveness in veteran related cancers due to biological change NOT PTSD.
I believe that PTSD is really only a side issue of what I prefer to call Veteran Burnout and some researchers call Allostatic Load.

What is Allostatic load; the term Allostatic load was coined by Bruce McEwen (2000) and refers to the physiological costs of chronic exposure to the neural or neuroendocrine stress response. It is used to explain how frequent activation of the body's stress response, an essential tool for managing acute threats, can in fact damage the body in the long run. The management of allostasis within the body is largely due to a system called the HPA (hypothalamic-pituitary-adrenal) Axis. Allostatic load is generally measured through a composite index of indicators of cumulative strain on several organs and tissues, but especially on the cardiovascular system. The hormones and other physiological agents that mediate the effects of stress on the body have protective and adaptive effects in the short run and yet can accelerate pathophysiology when they are over-produced or mismanaged. Adaptation in the face of stressful situations and stimuli involves activation of neural, neuroendocrine and neuroendocrine-immune mechanisms. This adaptation has been called "allostasis" or "maintaining stability through change", which is an essential component of maintaining homeostasis. The main hormonal mediators of the stress response, cortisol and epinephrine (adrenaline), have both protective and damaging effects on the body. In the short run, they are essential for adaptation, maintenance of homeostasis, and survival “allostasis”. Yet, over longer time intervals, when called upon frequently, they exact a cost “allostatic load” that can accelerate disease processes. Allostatic load can be measured in physiological systems as chemical imbalances in autonomic nervous system, central nervous system, neuroendocrine, and immune system activity as well as perturbations in the diurnal rhythms, and, in some cases, plasticity changes to brain structures.
Four conditions that lead to allostatic load are:

Repeated frequency of stress responses to multiple novel stressors;

Failure to habituate to repeated stressors of the same kind;

Failure to turn off each stress response in a timely manner due to delayed shut down;

Inadequate response that leads to compensatory hyperactivity of other mediators.

The effects of these forms of dysfunctional allostasis cause allostatic load and this in turn leads over time to diseases. Allostatic load effects can be measured in the body. When tabulated in the form of allostatic load indices using sophisticated analytical methods, it gives an indication of cumulative lifetime effects of all types of stress on the body. Taking that on board it is little wonder the psychological approach has been such a dismal failure in regard to veterans.
I don’t believe I am breaking a confidence when I say that a new study that has already been funded is being planed in regard to the HPA Axis.
It is so important that they get this study right as it is indicated that this may be at the heart of Veteran Burnout VB. The fact that this will impact on the wider community certainly makes this the most important research ever done as evidenced by the current Nobel Prize for Medicine.

So tackling veteran health problems from a psychological viewpoint is very much the tail wagging the dog and because of this there is no understanding of what Veteran Burnout/Allostatic Load is or the reality of why veteran’s health gets destroyed after severe deployment which is exacerbated by multiple deployments. So a medical lead and approach is essential to investigate the medical aspect of HPA Axis.

There was a Gulf War Naval Research that won awards for excellence, that was until the day it was totally discredited. So that is one well known result of NOT understanding the subject in hand despite the fact the people involved had long associations with veterans and were SUPPOSED to have complete understanding of veteran problems, so bang goes another nail into the psychological approach coffin.

The fight/flight system function within animals and humans is managed in the most part by the HPA Axis.
Definition: The hypothalamic-pituitary-adrenal axis is a complex set of interactions between the hypothalamus (a part of the brain), the pituitary gland (also part of the brain) and the adrenal or suprarenal glands (at the top of each kidney.) The HPA axis helps regulate things such as your temperature, digestion, immune system, mood, sexuality and energy usage. It's also a major part of the system that controls your reaction to stress, trauma and injury.

As can be seen HPA function and the effects on the human body is very much a medical issue, not a psychiatric one.
Therein lays the problem as I understand the current proposal it is being psychiatric led without a prominent medical researcher insight, so any results will be biased towards a mental health outcome, as has almost every other research on veterans health. Without putting a too fine a point on it, the reason that a veteran who prior to deployment was the healthiest his nation could find, becomes the sickest IS biological NOT psychological and it is about time we stopped this nonsense and address the REAL issues.

I have been led to believe that the Research Proposal sponsored in chief by Del Heuke and advised by me could very well be piggy backed onto this research at very little additional cost. They could then collect the blood or buccal swab samples over the period required to address this long neglected MEDICAL problem and then with open terms of reference studied by MEDICAL researchers in Australia and probably more importantly take those results to the next level for further testing to see what in fact is really happening to the biology of people under long term stress that causes these biological breakdowns in such an aggressive way.
If biological samples are not collected in a measured way it will just be another wasted opportunity pouring money down the drain once again without coming to grips with the real problem while creating another farce like the previously mentioned project.

There is an article http://www.nlm.nih.gov/medlineplus/news/fullstory_89332.html Battlefield experience linked to Combat Exposure Tied to Chronic High Blood Pressure; which proves we are firmly in the area of medicine, it also brings out the point of degrees of exposure which is a subject I know a great deal about but never discuss because it like PTSD is not the main game and that is how it should remain at this point in time.
But this does point out the dangers inherent in the criteria selecting the control and study groups which has been addressed in our proposal and the importance of REALLY KNOWING THE SUBJECT to ENSURE that both groups are what they should be. And I can assure you no boffin could comprehend the intricate nature of that exercise, because they have no understanding of how and what people are affected.
One of my earlier writings which shows why my experience and understandings over a very long period are valid because my concerns were about the condition over a wide range of combat groups other than myself.
This article is an attempt to explain "Veteran Burnout"; what it is, and why we need to change not only our attitude but the treatment process.
To do this we must be very clear about what it is we are dealing with, so I must insist on using descriptive terminology to identify different types of Burnout as it is not in common practice within the current psychiatric approach to treating Burnout. Sadly the result is a one size fits all approach, when even on a cursory examination this is not appropriate.
Initially I broke Adrenalin Burnout down to two basic groups i.e. Event Trauma and Veteran Trauma.
Event Trauma is very easily identified and is something we all easily understand; people who experience life threatening events such as atrocities, accident, flood, fire, rape, assault, tsunamis and the list goes on. Their distress is a normal reaction to a traumatic incident. Sometimes however, their reaction becomes abnormal and requires treatment.
Veteran Trauma on the other hand is a very different kettle of fish, it takes a much longer period of time and often the development, or build up is not identifiable.
Ok you get the picture this is just continual unrelenting pressure, where all the fear/flight/fight mechanisms are continually active and people adapt to live eat sleep in this state of extreme awareness.
We know that any long term event of this nature will change the body biochemistry and can leave almost lifelong changes to the body long after the event.
So what we have is a biological change as distinct from a psychological change remembering any change of biology will also change psychology and these changes are very significant. Chemical and mineral requirements will be way out of balance, glands will be producing lord knows what because of it, all of which will be effecting neurotransmitters and we can only guess at what else is going on because there has been no research looking at the problem in this way.
There you have it a biological problem which will not allow you to fix the psychological problem until the biology has been fixed and the basic aspect of this can be fixed or at least corrected and maintained, I am living proof.
In the interests of humanity there is no room for conditioned ideology or vested interest to flaw the results as it has done so often in the past.

So please let’s get it right this time because if everything is as I expect and current research seems to indicate that it is, it would only be the beginning of a process that will turn medical science on its head and put Australia in the forefront of where this research is going, instead of tracking down the same well trodden path and condemning our combat veterans to lives full of medicated despair waiting to die from whatever disease their changed biology will inflict upon them.

Sydney A McLeod
Wulguru Q 4811

The following is my military history so it should be viewed in the context that I was a severe Burnout case that self rehabilitated, in other words NO drugs.
I first started to understand the problem over 25 years ago where the biological aspect became so obvious and yet was being ignored. I also developed several successful psychiatric techniques that some professionals are only just now starting to understand and use. The understanding of degrees of exposure including associative impacts was a natural extension. I do not talk about any of those procedures or understandings other then the biology because I know they are not the main issue, biology is the main game despite it being ignored.

My history; Ex RA Inf. 1/5801 and 1201143 ex 2, 3, 7 RAR and 1st MAT, Malay/Thai Border I/c ponies 9 months (2 War Dog British) Malay Peninsula Borneo 3 RAR 63/65, South Vietnam 67/68 1st MAT Lo Gom (1 ARU) 3 RAR (2nd FSB Coral 1&2 FSB Balmoral), South Vietnam 70/71 2 RAR ANZAC Bn.

The Challenge

Are you objective?

Do you have an open mind?

Can you think outside the box of your speciality?

Do you understand the effects on homeostasis of Allostatic Load?

You will need to if you are to come to terms with Allostatic Overload as it affects all aspects of the human body.

Have you ever thought that there might be areas of your study or speciality that might be influenced by Allostatic Load or Overload?

Have you realised that there was not as much attention paid to the criteria parameters of a human study that would guarantee a flawed or predetermined result.

Do you know how and who can have an AO problem, most people have no idea of the scale of the problem. It is extremely important in control groups and that is why many results are unclear or flawed outright.

If so send a paper and share it.

Together we hope to add to the increasing body of knowledge of the effects of long term stress (Allostatic overload) on human body systems in order to force meaningful research into the problem.

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