Post-Traumatic Stress
Disorder
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.
What To Do When PTSD Develops
The most important step to take if you, a friend or loved one has
symptoms of PTSD is to understand that it can be treated. No one
should struggle with the painful, intrusive recollections and
nightmares, with the overwhelming feelings of alienation and anxiety
that are part of this illness.
Learning more about the illness will
help you realize that the angry outbursts, emotional withdrawal, and
other symptoms are the result of the disorder and not caused by family
or friends. Finally, you can seek a complete evaluation with a
licensed psychiatrist or psychologist to obtain an accurate and
effective treatment.
PTSD, Like Trauma, Strikes At Random
The chances of developing PTSD are as random as the chances of
experiencing a disaster. The illness can develop in anyone of any age
and in any income bracket who survives or witnesses a terrifying or
horrifying event. Different people will experience the same traumas
differently. One person may develop PTSD after surviving a tornado,
while his or her neighbor has no problem coping with the disaster. The
severity of PTSD often depends on psychological and social factors.
Research indicates that the disorder is more severe among people whose
trauma resulted from human action rather than from natural causes.
What are the Symptoms Of PTSD?
People who have PTSD re-experience their trauma in some way. Most
often, they develop intrusive and recurrent memories of extremely
distressful and repeated nightmares about the experience.
Psychiatrists report that, some people seem to lapse into a trance and
may re-enact the traumatic event.
People suffering from PTSD develop
immediate emotional distress when they are exposed to situations or
conditions that resemble or symbolize their trauma in some way, such
as an anniversary or commemoration. A woman who was raped in a
snowstorm may get depressed every time it snows, a veteran may get
angry and aggressive each year on Memorial Day.
People with PTSD also avoid thinking
about or doing anything that reminds them of the event. A sexual
abusive victim may find it difficult to have normal, trusting romantic
relationships. In some people, this avoidance is so severe that they
actually respond less to their surroundings; they become detached from
others. They may no longer enjoy the activities they once loved, or be
able to feel their normal range of emotions anymore.
Finally, people with PTSD experience
persistent symptoms of increased anxiety, watchfulness or vigilance
about what is happening in their surroundings. Many have an
exaggerated startle response. For example, a survivor of a schoolyard
shooting spree may "hit the dirt" and cover his head when he hears a
car backfire.
Other people with PTSD have difficulty
falling or staying asleep. Some have trouble concentrating. Many may
burst into unpredictable explosions of hostility or anger or,
conversely, be absolutely unable to express any emotions at all.
Children's Symptoms Require Special
Consideration
Children can also develop PTSD as a result of experiencing a
traumatic event. Many youngsters who have been sexually, physically or
emotionally abused may develop the disorder. Children with PTSD may
express their symptoms somewhat differently that adults. Psychiatrists
warn that no one should assume that a child cannot remember the trauma
simply because he or she won't discuss it. Instead, children's
symptoms may include recurring nightmares about the event that, over
time, change of rescuing others or dreams in which they or their
family are threatened.
In addition, children with PTSD may
lose interest in activities they once enjoyed. Their old energy and
enthusiasm may disappear. Some youngsters believe that they have no
real future and, therefore, don't think about or plan for what they
want to be when they grow up.
Finally, youngsters may develop
unexplained headaches or stomachaches, as well as signs of vigilance
exhibited as extreme watchfulness or attentiveness. Children may also
cling to a parent or other loved one, show extreme fear of a
particular person or place, lose a developmental skill such as toilet
training, or demonstrate a lack of interest in a once-favorite toy or
game.
Loved Ones Can Suffer Too
Because PTSD numbs a person's positive emotions such as loving and
intimacy, while increasing irritability and anger, the disorder can
take a toll on loved ones. They may not understand why the person who
once was affectionate and caring no longer shows interest in spouses,
siblings, parents, children or close friends. Family and friends may
feel that they must "walk on eggshells" around someone with PTSD
because they never know when the person will burst into rage. They may
become frustrated trying to encourage a person whose outlook on the
future holds nothing but continued distress.
Not only can the disorder threaten the
person's personal and family relationships, but it can also result in
job loss or self-destructive behavior. Untreated, PTSD can develop
complications such as alcoholism, drug abuse, and depression. Many of
these conditions increase the risk of suicide.
Psychotherapy: A Key To Recovery
PTSD patients usually respond well to treatment. Generally, most
people benefit from individual or family psychotherapy. By talking
with a therapist, an individual is able to better understand the
illness and its effects on daily life and relationships. During
therapy, the person can learn to rebuild his or her self-esteem, to
cope effectively with symptoms and develop alternate ways of
responding to stress.
Another form of treatment is called
cognitive therapy, in which the person and therapist work to identify
ways in which the persons' thoughts and perceptions contribute to or
reinforce symptoms. People can learn to identify negative or unhealthy
thoughts and transform them into thoughts and assumptions that
encourage recuperation and recovery.
Behavior therapy can help people with
PTSD learn new ways of dealing with the stresses that worsen their
symptoms. For example, a woman who stopped driving because she was in
a terrible auto accident may be able to reduce or eliminate her
anxiety about automobiles through systematic desensitization. First,
she would learn deep relaxation, then she would list situations that
are likely to provoke anxiety and rank them from least to most
fearful. Working with her therapist, she would then envision or
experience the least frightening situation while practicing deep
relaxation. As her anxiety fades in that situation, she moves to the
next most fearful level and repeats the process until she can
participate in the most feared activity without anxiety.
Because PTSD has such an effect on
loved ones, some treatment plans may call for family therapy. By
working together, family members can learn to recognize and understand
the symptoms of the illness and more effectively cope with their
responses to those symptoms. In addition, families often work together
to improve their communication, parenting and stress management
skills.
Group therapy offers many therapeutic
advantages. Survivors of a trauma come together to share their
experiences and feelings. Nothing helps to understand as much as being
understood. In doing so, people realize they are not alone and are
able to provide support and feedback to each other. They also realize
that others see them as valuable individuals worthy of respect and
friendship. That realization bolsters their self-esteem and helps
reduce their sense of survivor's guilt. The group also works together
to improve participant's problem-solving and communication skills.
Medications May Help
Researchers have found that some people suffering from PTSD may
benefit from medications. Studies have found that both heterocyclic
and monoamine oxidase (MAO) inhibitor antidepressant medications can
alleviate the fear, tension, excessive vigilance and other symptoms of
PTSD. Other research shows that benzodiazepines, a type of medication
used to ease anxiety, are helpful when a person is suffering an
emotional crisis related to PTSD. Beta-blockers, medications normally
used to treat heart conditions, and another compound called clonidine,
have also been found to be effective in alleviating the intrusive
thoughts and explosive outbursts of emotion.
These medications help reduce the
symptoms of PTSD that interfere with psychotherapy. As a result,
patients can benefit more from therapy sessions and regain a more
fulfilling life.
Source: National Mental Health
Association
