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Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder
(PTSD)
Post-Traumatic
Stress Disorder (PTSD) is a debilitating disorder that follows a
terrifying event. People suffering from PTSD usually have persistent
frightening thoughts and memories of their ordeal and feel emotionally numb.
PTSD can result from any kind of traumatic incidents, including kidnapping,
serious accidents, natural disasters such as floods or earthquakes, violent
attacks such as a mugging, rape or torture, or being held captive. The event
that triggers PTSD is usually life-threatening.
People
suffering from PTSD repeatedly relive the trauma in the form of nightmares and
disturbing recollections during the day. They may also experience sleep
problems, depression, feeling detached or numb, or being easily startled. They
may lose interest in things they used to enjoy. They may feel irritable, more
aggressive than before, or even violent. They tend to withdraw and
isolate. Seeing things that remind them of the incident is very
distressing, which could lead them to avoid certain places or situations that
bring back those memories. Anniversaries of the event are often traumatic
reminders, triggering an intensity in symptoms.
The
disorder may be accompanied by depression, substance abuse, or anxiety.
Intensity of symptoms range from mild to severe. They may become easily
irritated or have violent outbursts. In severe cases they have trouble working
or socializing. In general, the symptoms seem to be worse if the event
that triggered them was initiated by a person, eg: a rape, as opposed to a
flood.
Ordinary
events that remind them of the trauma may trigger flashbacks or intrusive
images. A flashback may make the person lose touch with reality and re-enact
the event for a period of seconds or hours or, very rarely, days. A person
having a flashback, which can come in the form of images, sounds, smells, or
feelings, usually believes that the traumatic event is happening all over again.
Signs and Symptoms:
- Recurrent, intrusive and
distressing recollections of the event.
- Recurrent dreams relating to
the event.
- A sense of reliving the event
(flashbacks).
- Chronic anxiety.
- Insomnia.
- Difficulty in concentrating.
- Memory impairment.
- A sense of personal isolation.
- Diminished interest in
activities.
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Hypervigilance
- Exaggerated startle response
- Impairment in social, work and other areas of functioning
- Phobic reactions to
situations, or avoidance of activities, that recall memories of the event.
- Emotional effects (irritable,
restless, tremulous, explosive outbursts of behavior, a deadening of
feelings, painful guilt feelings).
Adapted
from:
Diagnostic and Statistical Manual of Mental Disorders. Vol. IV
American Psychiatric
Association. 1994
About PTSD
For years, this disorder was known as "shell shock"
and considered to be a condition that affected only war veterans. When
significant numbers of veterans returned from Vietnam, mental heath
professionals realized that this condition-- today called post-traumatic stress
disorder (PTSD) --was a psychiatric disorder that could be identified by
specific symptoms. Researchers have also learned that anyone who has endured
severe crisis, agony or torment can develop this disorder.
Among the people who may develop PTSD are those who are victims or witnesses of a violent crime. Murder, rape, robbery, kidnapping or sexual assault are just some of the criminal acts that are to blame in many cases of this illness. Others have survived or witnessed a disaster, whether through natural causes such as fire or flood, or man-made causes such as car or airplane crashes, riots or military combat.
For some, the symptoms of PTSD are short-lived and quickly resolved. But others will suffer for months or years, improving only with treatment.
Symptoms
PTSD usually appears within 3 months of the trauma, but sometimes the
disorder appears later. PTSD’s symptoms fall into three categories:
- Intrusion
- Avoidance
- Hyper-arousal
Intrusion
In people with PTSD, memories of the trauma reoccur unexpectedly, and
episodes called "flashbacks" intrude into their current lives. This
happens in sudden, vivid memories that are accompanied by painful emotions that
take over the victim’s attention. This re-experience, or "flashback,"
of the trauma is a recollection. It may be so strong that individuals almost
feel like they are actually experiencing the trauma again or seeing it unfold
before their eyes and in nightmares.
Avoidance
Avoidance symptoms affect relationships with others: The person often avoids
close emotional ties with family, colleagues, and friends. At first, the person
feels numb, has diminished emotions, and can complete only routine, mechanical
activities. Later, when re-experiencing the event, the individual may alternate
between the flood of emotions caused by re-experiencing and the inability to feel
or express emotions at all. The person with PTSD avoids situations or activities
that are reminders of the original traumatic event because such exposure may
cause symptoms to worsen.
The inability of people with PTSD to work out grief and anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it. Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others—particularly friends or family—did not.
Hyper-arousal
PTSD can cause those who have it to act as if they are constantly threatened
by the trauma that caused their illness. They can become suddenly irritable or
explosive, even when they are not provoked. They may have trouble concentrating
or remembering current information, and, because of their terrifying nightmares,
they may develop insomnia. This constant feeling that danger is near causes
exaggerated startle reactions.
Finally, many people with PTSD also attempt to rid themselves of their painful re-experiences, loneliness, and panic attacks by abusing alcohol or other drugs as a "selfmedication" that helps them to blunt their pain and forget the trauma temporarily. A person with PTSD may show poor control over his or her impulses and may be at risk for suicide.
Treatment
Today, psychiatrists and other mental health
professionals have good success in treating the very real and painful effects of
PTSD. These professionals use a variety of treatment methods to help people with
PTSD to work through their trauma and pain.
Behavior therapy focuses on correcting the painful and intrusive patterns of behavior and thought by teaching people with PTSD relaxation techniques and examining (and challenging) the mental processes that are causing the problem.
Psychodynamic psychotherapy focuses on helping the individual examine personal values and how behavior and experience during the traumatic event affected them.
Family therapy may also be recommended because the behavior of spouse and children may result from and affect the individual with PTSD.
Discussion groups or peer-counseling groups encourage survivors of similar traumatic events to share their experiences and reactions to them. Group members help one another realize that many people would have done the same thing and felt the same emotions.
Medication can help to control the symptoms of PTSD. The symptom relief that medication provides allows most patients to participate more effectively in psychotherapy when their condition may otherwise prohibit it. Antidepressant medications may be particularly helpful in treating the core symptoms of PTSD—especially intrusive symptoms.
References and Links:
American Psychiatric Association.
Let's Talk Facts Pamphlet Series
http://www.psych.org/main.html
Diagnostic
and Statistical Manual of Mental Disorders. Vol. IV American
Psychiatric Association. 1994
National
Institute of Mental Health
http://www.nimh.nih.gov/about/index.cfm
National Mental Health Association.. Information Fact
Sheets
http://www.nmha.org/
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