Posttraumatic Stress Disorder


Definition:

PTSD is something that NORMAL people get in response to an ABNORMAL situation.  Specifically, it is an anxiety disorder that some people get after seeing or living through a dangerous event.
When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.

Who gets PTSD?

Anyone can get PTSD at any age. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events. Sometimes, someone will get PTSD after a friend or family member experiences danger or is harmed. The sudden, unexpected death of a loved one can also cause PTSD.

What are the symptoms?

PTSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:
* Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
* Bad dreams
* Frightening thoughts.
Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms:
* Staying away from places, events, or objects that are reminders of the experience
* Feeling emotionally numb
* Feeling strong guilt, depression, or worry
* Losing interest in activities that were enjoyable in the past
* Having trouble remembering the dangerous event.
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms:
* Being easily startled
* Feeling tense or “on edge”
* Having difficulty sleeping, and/or having angry outbursts.
Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

How does PTSD show up in children?

Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include:
* Bedwetting, when they’d learned how to use the toilet before
* Forgetting how or being unable to talk
* Acting out the scary event during playtime
* Being unusually clingy with a parent or other adult.

Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

Why do only some people get PTSD?

Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD, such as genetics, brain structure, and previous mental illness. Other factors can help reduce the risk of the disorder, such as strong and supportive relationships.

How it PTSD treated?

First it is important to know that early treatment is associated with a better prognosis.  PTSD is treated with psychotherapy and/or medication. Both ‘talk’ therapy and cognitive behavioral therapy have been found helpful. Because PTSD significantly affects the people around the patient, family and friends can be an important part of therapy. Another helpful therapy is called cognitive behavioral therapy (CBT). There are several parts to CBT, including helping make sense of bad memories, dealing with guilt or shame, helping face and control fears, and reducing anxiety.

While there is no one medication specifically for PTSD, there are a few that can reduce certain symptoms. Antidepressants, benzodiazepines, and antipsychotics are all prescribed for specific symptoms.

This handout was prepared by Dominique Samuels, PsyD. Much of the information was found on http://www.nimh.nih.gov
To contact Dr. Samuels, please call 415.358.4906 or email her at samuelspsyd@gmail.com

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