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Published in Great Falls Tribune on June 17, 2007

Promising Treatment for PTSD Offered in Great Falls

BILLINGS — Mandy Smith can feel the tension in her forehead and all but see the etched lines that arch up from the bridge of her nose.

It's been a day of tears and anger for the 24-year-old abuse victim and former drug addict.

Smith suffers from post-traumatic stress disorder, and she seeks relief from the thoughts shooting uncontrollably through her mind.
That relief comes from a new form of neurotherapy, Alpha-Stim, offered through the Rimrock Foundation.

Rimrock has been offering neurotherapy to civilians for the past few months.

And Veritas Psychotherapy and Neurofeedback in Great Falls is beginning to use similar technology to treat combat vets.

Both companies swear by it.

"This particular intervention has been one of the most significant therapies that we've found," Rimrock's chief operations officer, Mona Sumner, said last week.

"It was a defining moment for the Rimrock Foundation when we began to use it," she added.

But Rimrock can only use Alpha-Stim on civilian trauma victims. Although it treated 176 combat vets between 2002 and 2004, Veterans Affairs has since switched its contract to Billings Mental Health.

"If we'd had Alpha-Stim when we were doing our vets, every one of them would have been on this," said Sumner.

Veritas has just begun to receive referrals for Great Falls combat vets with PTSD, said co-director Jenni Leach.

"It's a fantastic therapy, and much better than medication," she said. "Sometimes our patients have such a reduction in their symptoms that they don't need talk therapy.

"It improves their cognitive functioning and is very useful in combating addictive behavior," Leach added.

Soft music is playing and the lights are dim as Smith plugs an electrode, attached to a device resembling an iPod, onto each earlobe. Her session will last for 20 minutes.

Developed by Dr. Daniel L. Kirsch, who has been clinical director of the Center for Pain and Stress-Related Disorders at Columbia-Presbyterian Hospital in New York City, the device blows a gentle electrical current through her brain.

It has the same frequency as an alpha brainwave, which people who meditate seek to achieve. It's described as being awake but relaxed, the peace a person feels on awakening or just before going to sleep.

The current is believed to stimulate groups of nerve cells located near the stem of the brain. Those clusters produce the neurotransmitters serotonin and acetylcholine, which modulate brain activity.

"This has been a brutal week for me because of a relationship I was in and because I'm having delusional thoughts of an eating disorder," Smith says as the treatment begins. "Now that I don't drink or do drugs anymore, the eating disorder is a way of messing up my head."

After her best friend died in a car wreck at age 15, Smith became an alcoholic and then a drug addict. Now she's in recovery.

"I've been smoking a lot of cigarettes this week, and I've been isolating because I don't want to be around people," she says.

Therapist Shelly Hocking sits with Smith, watching her face for signs of relaxation.

"For the first three or four minutes, my thoughts were just racing," Smith says. "But now I'm feeling some relief."

One intrusive thought is often the brutal beating she took outside a Phoenix crack house before dawn one morning a few years ago.

"It was just a total act of violence," she says. "He beat me nearly to death, stabbed me eight times, including one good shot to the arm that went in one side and out the other."

The treatment is beginning to work.

"Before this started, I was thinking about a lot of things, but now I'm just focusing on this conversation," Smith says.

Although she survived the assault in Phoenix, Smith has seen her share of death as she abused LSD, cocaine and methamphetamines.

"I saw one friend die who was drinking and driving," she says. "He was racing and wrapped his car around a tree.

"We ran up to pull him out, but he was gargling blood so it was no use," she adds.

With about four minutes left in her treatment, the tension lines in Smith's forehead dissolve and she looks tired.

"I've been medicated for years, but this is the best way of dealing with this anxiety," she says. "You feel a lot better, and you're not numb."

For Sumner, the therapy is simply extraordinary.

"Mandy is pretty much a miracle child," she says. "Her disease (addiction) is so far progressed that our staff says she doesn't have one more relapse in her. If she relapses again, she'll be dead."

After a session, the peace can remain for days. Patients who have been stabilized usually use the machine once or twice a week, Sumner said.

It's particularly helpful for treating depression, anxiety and insomnia, all of which are symptoms of PTSD, said Jon Gjersing, Rimrock's director of nursing.

Also called cranial electrotherapy stimulation, it has been approved by the U.S. Food and Drug Administration as a treatment. Stimulators cost $400 to $600, but are available only with a doctor's prescription.

The Center for Mental Health in Great Falls doesn't offer neurotherapy, and its medical director, Dr. Michael Mason, said he was unfamiliar with Alpha-Stim.

Teresa Bell, spokeswoman for the VA at Fort Harrison, said the agency doesn't normally use neurotherapy as a treatment. Instead, it relies on cognitive therapy, medications and a program called Vet to Vet, in which combat veterans help each other with common problems.

Gjersing said neurotherapy has proven valuable in treating depression.

With PTSD, the brain is hyperactive and can't slow itself down, he added.

"A lot of people go from the sleep mode directly into the anxiety mode," Gjersing said. "This machine sets up a low-frequency radio wave, and the brain responds to it by slowing down."

The anxiety will probably return in hours or days, but it won't be as severe as it was before, he said.

The treatment also is effective on traumatic brain injuries, said Sumner, adding: "It seems to target the damaged part of the brain to work on."

It also can be used to reduce chronic pain, Gjersing said.

"It seems to change how the brain processes pain," he added. "We do know that depression and anxiety exacerbate pain."

A study group of 3,200 patients in Texas showed no adverse side effects to the neurotherapy, Sumner said, although it shouldn't be used by patients with medical implants.

Rimrock is now using Alpha-Stim on most of the young women it treats for trauma and drug abuse, she added.

"And it's made a tremendous difference for them," she said.

Anxiety attacks have been severe for Cara, a 26-year-old mother of two sons who asked that her last name not be used because she fears her ex-husband.

"There's a restraining order against him," she says softly, "but that's only a piece of paper."

At 13, she says, she was molested by a family member for several years before she ran away and turned to drugs for relief.

When she got pregnant, she stopped doing drugs and got married. Meth tore that marriage apart, she said.

"I started using meth again shortly before our divorce, but it didn't save our marriage," Cara said.

Actually, it made things worse. He beat her badly, she said, and she had to leave their home in Idaho with their children.

"But after I filed for divorce, he wouldn't let it go," Cara said. "It was a scary time."

Cara came to Montana and sought treatment at Rimrock. She lived in constant terror, she said.

"I had to have all the blinds at the house pulled down, and I wouldn't go outside," Cara said. "I had to peek out the windows all the time, keep track of all the cars coming and going, make notes of all the different license plates.

"Living in a state of fear all the time made my heart race," she added.

The Alpha-Stim treatment has eased that anxiety a lot, she said.

"The first two weeks I was here, I couldn't sit and watch a movie with my kids," Cara said. "But now I can sit and relax with them.

"I know that change is because of the Alpha-Stim, because when one of my kids got sick and I missed my treatments for two weeks, I could feel the difference," she said. "I was back up at the windows again."

Cara was originally prescribed Wellbutrin, an antidepressant, but the neurotherapy treatments have been so successful she's quit taking medications.

"I'm grateful for that," Cara said. "It numbed me, and I didn't want to be dependent on drugs again."