Post Traumatic Stress Disorder (PTSD)

Over the course of our lives, we may experience or witness certain traumatic events that will profoundly change the way we see the world. Unfortunately, these traumatic events may be relived through nightmares and flashbacks that may be detrimental to a person's mental and physical health. This is called post traumatic stress disorder.

Post traumatic stress disorder (PTSD) is a psychiatric disorder that is triggered by memories of a traumatic event. Events that trigger PTSD include, but are not limited to:

Most often the disorder develops within three months of the trauma, but some cases of PTSD have developed years later.

PTSD is not a new disorder. Since the dawn of civilization, PTSD has affected countless people, with clear documentation of similar symptoms. Medical documentation of PTSD started during the Civil War (known then as "Da Costa's Syndrome") and there have been numerous reports of people suffering similar symptoms after every major military conflict, including World War II, Vietnam and the Persian Gulf.

Men and women who have spent time in war zones are the most susceptible to PTSD—approximately thirty percent will develop a chronic form sometime during their life. PTSD does not only affect people in the military, however. Anyone may develop PTSD symptoms regardless of age, gender, ethnicity or socioeconomic background.

Approximately 5.2 million Americans (3.6 percent of the population) experience PTSD symptoms during the course of a year. About five percent of men and ten percent of women will develop PTSD at some point in their lifetimes. Men most often develop PTSD due to traumatic events such as military combat and childhood abuse. Women most often develop PTSD due to traumatic events such as rape and sexual harassment.

Like most psychiatric disorders, PTSD is difficult to diagnose and is subject to the discretion of the diagnosing professional. Experts believe that the best way to diagnose PTSD is to use a combination of questionnaires, structured interviews and psychological assessments.

PTSD symptoms fall into three categories:

Those suffering from intrusive PTSD symptoms experience unexpected "flashbacks." During these episodes, the person relives vivid memories of the traumatic event. Painful emotions such as grief, fear, and despair often accompany the memories. Sometimes, the memories are so strong that the person believes he or she is actually experiencing the event again.

People with avoidance symptoms avoid close emotional ties with family, friends and colleagues. The person usually experiences a reduction in emotions, oftentimes resulting in a feeling of "numbness." The person tries to avoid everything that is likely to trigger memories of the traumatic event because they are afraid the symptoms will worsen. When the person does recall the memories of the event, he or she alternates between a flood of emotions and a lack of emotions. Because these people avoid forming close relationships with people and try to separate themselves from their emotions, depression is a common byproduct of avoidance symptoms.

Those suffering from hyperarousal PTSD symptoms act as if they are constantly threatened by the trauma. They are always "on guard" because they fear that the minute they let up, they will be forced to experience another traumatic event. Many of these people are irritable and can "explode" even without provocation. And due to their constant vigilance, these people often develop insomnia.

 

Symptoms common to all people suffering from PTSD include recurring nightmares of the traumatic event and sleep disorders. People with PTSD usually have recurring vivid nightmares of the event, over a period of months or even years. Oftentimes, people with PTSD will try to rid themselves of the painful memories and associated feelings. Alcohol and substance abuse is common among PTSD sufferers. In serious cases suicide is attempted.

PTSD treatment depends on a number of factors, including the person's mental health, the severity of the disorder, and recommendations of the doctor or therapist. The most common form of therapy is a combination of cognitive-behavioral therapy and medication.

Cognitive-behavioral therapy focuses on correcting the patterns of behavior associated with PTSD by teaching relaxation techniques and examining the mental processes that may be causing the symptoms. Therapy often includes skills for coping with anxiety, anger management, communicating effectively, and eliminating substance dependence. Family and friends may also be asked to help with the healing process.

People suffering from milder cases of PTSD are advised to attend group therapy sessions where each person is encouraged to share their experiences and reactions. This method allows people suffering with PTSD to see that they are not alone and to deal with their emotions and fears with the support of others who are in similar situations.

Medication has also shown to be useful in treating post traumatic stress disorders. Selective serotonin reuptake inhibitors (SSRIs) are most often used to treat depression, but they are also useful in controlling the anxiety that is commonly associated with PTSD. Other medications such as clonazepam (Klonopin®) may also decrease feelings of anxiety and treat other symptoms of PTSD. Currently, no medication is specifically designated as a PTSD treatment.

Other treatment methods include psychodynamic psychotherapy, which focuses on dealing with intense emotions, and eye movement desensitization and reprocessing (EMDR). With EMDR the patient is encouraged to move his/her eyes from side to side while discussing the "problem". While EMDR does show promise it is still relatively new and requires additional research and clinical trials to determine its efficacy.

Resources

American Psychiatric Association. (nd). Let's talk facts about posttraumatic stress disorder. Medem Medical Library.

Mayo Foundation for Medical Education and Research. (2003). Post-traumatic stress disorder (PTSD).

National Center for PTSD. (2004). Effects of traumatic experiences. NCPTSD Fact Sheet.

National Center for PTSD. (2004). Posttraumatic stress disorder: An overview. NCPTSD Fact Sheet.

National Center for PTSD. (2004). Treatment of PTSD. NCPTSD Fact Sheet.

National Center for PTSD. (2004). What is posttraumatic stress disorder? NCPTSD Fact Sheet.

National Institute of Mental Health. (2000). Post traumatic stress disorder [NIH Publication No. 00-4675].

National Mental Health Association. (2001). Post-traumatic stress disorder.