Monthly Archives: October 2014

What is PTSD?

Post Traumatic Stress Disorder also known as PTSD is a psychological disorder that can occur following the experience or witnessing of a life-threatening event such as military combat, natural disasters, terrorist incidents, serious accidents, physical or sexual assault in adult or childhood. (Nebraska Department of Veteran Affairs, 2007) It can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma. (Smith & Segal, 2014)

This doesn’t mean that all people who undergo traumatic experiences end up with PTSD. While most people go back to their life routines after some time, some people fail to do so. These people end up with PTSD which could last for a considerable period of time unless treated or else as long as they live. The degree of PTSD differs from individual to individual where some have a deep impact and some only up to a certain extent. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person’s daily life. (Nebraska Department of Veteran Affairs, 2007) PTSD is different from a normal response to a trauma. It is expected that once a person encounters a traumatic incident he/she is overwhelmed and frightened by the incident. It is even possible that people face some symptoms of PTSD once they have faced a traumatic event. However the difference between PTSD and a normal trauma is the duration of time. While normal trauma is short lived, PTSD keeps the individual in a state of shock, denying normal functioning.

According to research people with PTSD show a variety of symptoms which can be mainly categorized under three sections. The first category involves a set of symptoms such as reliving the trauma in some way such as becoming upset when confronted with a traumatic reminder or thinking about the trauma when trying to do something else. The second category includes symptoms which involve either staying away from places or people that remind of the trauma, isolation from people, or numbness. The third category includes feeling on guard, irritable, or startling easily.

Despite the fact that PTSD has clear symptoms both psychologically and biologically the identification of PTSD can sometimes be rather difficult because once a person is diagnosed with PTSD, he/she may show a number of other psychological disorders as well which develop along with PTSD. For an example depression, substance abuse, problems of memory and cognition can occur. This is also associated with impairment of the person’s ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting. (Nebraska Department of Veteran Affairs, 2007) However PTSD can be treated with the sage of medical treatment and therapy. Yet the diagnosis at an early stage is vital to avoid long term symptoms. Firstly it is necessary to gain a better understanding of the symptoms of Post Traumatic Stress Disorder.

Symptoms

PTSD symptoms can come up right after the traumatic experience or else after some time. However the diagnosis for PTSD is only completed if it creates a distress, disruption or a significant change in the life of the individual. It could be within the premises of relationships, work life or even daily chores. There are mainly three types of symptoms as,

  1. Re-experiencing symptoms
  2. Avoidance and numbing symptoms
  3. Arousal symptoms.

Re-experiencing symptoms deal with symptoms that are linked to reliving the traumatic experience. Individuals who undergo traumatic events diagnosed with PTSD may relive the experience in a number of ways. Firstly they may come up with memories that are full of distress which are linked to the traumatic event. These may come up at instances when the individual is least expecting them. Secondly, there may be occasions where incidents in daily life work as a trigger which awakens the traumatic experience. For an example for a rape victim who sees a news headline of a rape that has happened recently, the news may work as a trigger to awaken and relive the trauma. This can cause both emotional and physical reactions. When a memory becomes very real as if the incident is happening again, it is called a flashback. Also the individual may experience nightmares and Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating) Reliving the event may cause intense feelings of fear, helplessness, and horror similar to the feelings the individual has when he/she was experiencing the trauma.

The next symptom of Avoidance and Numbing symptoms are the effort of the individual to repress and avoid the traumatic experience. In such situations, people with PTSD try to avoid the trauma by avoiding any memory triggers. For example they may avoid going near places where the trauma occurred or seeing TV programs or news reports about similar events. They may avoid other sights, sounds, smells, or people that are reminders of the traumatic event. Some people find that they try to distract themselves as one way to avoid thinking about the traumatic event.

Numbing symptoms are another way of avoiding the traumatic experience. Individuals with PTSD may find it difficult to be in touch with their feelings or express emotions toward other people. For example, they may feel emotionally “numb” and may isolate from others. They may be less interested in activities they once enjoyed. Some people forget, or are unable to talk about, important parts of the event. Some think that they will have a shortened life span or will not reach personal goals such as having a career or family. (Nebraska Department of Veteran Affairs, 2007)

The final set of symptoms is Arousal Symptoms. Individuals who have PTSD are always vigilant and are on alert after the traumatic experience. This is also known as hyper-vigilance or else red alert. This is identified as increased emotional arousal, which causes a number of symptoms within the individual. They are difficulty in sleeping, outbursts of anger or irritability, and difficulty concentrating. Individuals may find that they are always ‘on guard’ and on the lookout for signs of danger. They may also find that they get startled. (Nebraska Department of Veteran Affairs, 2007)

Other than these symptoms, studies done on PTSD highlight, that it is common for other conditions to occur as well. They are as follows;

  • Anger and irritability
  • Guilt, shame, or self-blame
  • Substance abuse
  • Feelings of mistrust and betrayal
  • Depression and hopelessness
  • Suicidal thoughts and feelings
  • Feeling alienated and alone
  • Physical aches and pains

(Smith & Segal, 2014)

More than half of men with PTSD also have issues with alcohol. The next most common co-occurring problems in men are depression, followed by conduct disorder, and then problems with drugs. In women, the most common co-occurring problem is depression. Just under half of women with PTSD also experience depression. The next most common co-occurring problems in women are specific fears, social anxiety, and then problems with alcohol. (Nebraska Department of Veteran Affairs, 2007)

Individuals diagnosed with PTSD face issues in daily life specially in relation to functioning. In general, they have more unemployment, divorce or separation, spouse abuse and chance of being fired than people without PTSD. They also may suffer from a broad range of physical symptoms. This is a common occurrence in people who have depression and other anxiety disorders. Some evidence suggests that PTSD may be associated with increased likelihood of developing medical disorders. Research is ongoing, and it is too soon to draw firm conclusions about which disorders are associated with PTSD. (Nebraska Department of Veteran Affairs, 2007)

When it comes to the case of children and adolescents, the symptoms that they display are a bit different from those displayed by adults. These symptoms can be listed as follows,

  • Fear of being separated from parent
  • Losing previously-acquired skills
  • Sleep problems and nightmares without recognizable content
  • Somber, compulsive play in which themes or aspects of the trauma are repeated
  • New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)
  • Acting out the trauma through play, stories, or drawings
  • Aches and pains with no apparent cause
  • Irritability and aggression

(Smith & Segal, 2014)

Treatment

Treatment for PTSD allows the individual to deal with the trauma they have experienced, through the identification of symptoms and relieving them. The treatment creates an ambiance for the individual to recall and process the feelings rather than avoid the trauma. The treatment encourages the individual to recall and process the emotions and sensations felt during the original event. And release the bottled up emotions restoring a sense of control by reducing the powerful hold the memory of the trauma has on the individual’s life. There are a variety of treatments that can be used.

Types of treatment for post-traumatic stress disorder (PTSD)

Psychotherapy

Psychotherapy allows the individual to talk with a mental health professional. It can occur one-on-one or in a group. This treatment for PTSD usually lasts 6 to 12 weeks, but can take more time.

One helpful therapy is called cognitive behavioral therapy, or CBT. There are several parts to CBT, including:

  • Exposure therapy. This therapy helps people face and control their fear. It exposes them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
  • Cognitive restructuring. This therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
  • Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way. (National Institute of Mental Health, 2013)
  • Family therapy.Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help the loved ones understand what the individual is going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
  • Medicationis sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD. Other than these medications some more are also used. They are as follows.
  1. Benzodiazepines. These medications may be given to help people relax and sleep. People who take benzodiazepines may have memory problems or become dependent on the medication.
  2. Antipsychotics. These medications are usually given to people with other mental disorders, like schizophrenia. People who take antipsychotics may gain weight and have a higher chance of getting heart disease and diabetes.
  3. Other antidepressants. Like sertraline and paroxetine, the antidepressants fluoxetine (Prozac) and citalopram (Celexa) can help people with PTSD feel less tense or sad. For people with PTSD who also have other anxiety disorders or depression, antidepressants may be useful in reducing symptoms of these co-occurring illnesses. (National Institute of Mental Health, 2013)
  • EMDR (Eye Movement Desensitization and Reprocessing)incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress. (Smith & Segal, 2014)

Thus it can be concluded that given the necessary treatment, PTSD can be completely cured, however it is vital that the individual is given proper treatment as early as possible and a positive environment is created for the benefit of the individual and the society at large.

Reference List

Mental Health America. (2010). Post Traumatic Stress Disorder. Retrieved from the Mental Health America Website: http://www.mentalhealthamerica.net/conditions/post-traumatic-stress-disorder

National Institute of Mental Health. (2013). Post Traumatic Stress Disorder. Retrieved from the National Institute of Mental Health Website: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Nebraska Department of Veterans’ Affairs. (2007). Post Traumatic Stress Disorder. Retrieved from the Nebraska Department of Veterans’ Affairs Website: http://www.ptsd.ne.gov/what-is-ptsd.html

PTSD Alliance. (2014). What is PTSD?. Retrieved from the PTSD Alliance website: http://www.ptsdalliance.org/about_what.html

Smith, M, & Segal, J. (2014). Post Traumatic Stress Disorder. Retrieved from the Help Guide Website: http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

WebMD. (2014). Post Traumatic Stress Disorder. Retrieved from the WebMD Website:  http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder

Nedha de Silva