Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) affects people who have survived any type of trauma, such as that which occurs with:

	Fires
	Earthquakes
	Hurricanes
	Airplane crashes
	Riots
	Rape
	Hostage situations
	Child abuse
	Wars and combat
	Loss of a loved one

Posttraumatic stress disorder is sometimes called “shell shock” or “battle fatigue” because soldiers who were involved in heavy combat are likely victims of this condition. It affects 35% of trauma victims and women are two times more likely to suffer from it than men.

People who have survived traume can develop PTSD.

Symptoms

The symptoms of PTSD surface after the event has ended, sometimes as long as several years later. A person suffering from PTSD often experiences the following:

	Flashback - Reliving the event with all its painful memories and emotions. When this occurs, the person’s attention is completely diverted from the present reality and their surroundings.
	“Unreal” Reality - A state of mind like sleepwalking in which the person behaves as if they are actually experiencing the event again. The person is not completely aware of what he is doing. It is like he is in a dream state. (He may, though, be aware of this state.) For example: A war veteran who hears a jackhammer pounding pavement may think he is “under enemy fire.” He becomes fearful, trying to find somewhere to hide.
	Nightmares - Reliving the traumatic experience in one’s sleep, usually waking up in a terrified state screaming.
	Insomnia - Becoming afraid to go to sleep if he has nightmares.
	Sudden Outbursts of Emotion - Having repeated outbursts of emotions through tears, anger, violent outbursts, extreme fear and/or panic attacks.
	Detachment from Others - Shying away from close emotional relationships with friends, family and/or co-workers. This usually follows a period in which the victim feels emotionally “numb” with few emotional responses and is only able to do routine, mechanical things.
	Guilt - Experiencing guilt if friends or family did not make it through the event. This is often called “Survivors Guilt.”
	Avoids Situations - Avoiding situations that remind them of the traumatic event. For example, a rape victim will avoid sexual contact with a partner, a riot victim may avoid noisy crowds.
	Abuses Alcohol/Drugs - Using alcohol and/or drugs to block out their emotions and help them forget the pain of the experience.
	Avoids Responsibility - Persons with PTSD, especially those who have witnessed the loss of human life, may feel they failed to protect someone from being killed. As a result, they may experience trouble on their jobs and trouble expressing loving emotions to friends and family.
	Poor Concentration - Trouble remembering recent events or staying focused in thought.
	Depression - Finding it difficult to work out their guilt and grief resulting from the loss of loved ones and/or loss of security. They may also be unable to feel like they are “back in the real world.”

Treatment

Posttraumatic stress disorder, in most cases, should be treated by a mental health professional, i.e., a psychiatrist, psychologist, social worker or counselor. Treatment can usually be done on an outpatient basis. However, if you have become a threat to yourself or others, you may need to be hospitalized for treatment. Treatment will help you:

	Discuss the event and the pain it has caused you
	Resolve your feelings of grief which you may find hard to express

Types of Post-Traumatic Stress Disorder Therapies

	Individual Therapy - This allows you to look at the things you value in life and how your behavior and experience during the event(s) may have violated or upset your values. You will work on: Resolving conscious/unconscious conflicts Rebuilding your self-esteem and self-control Developing self-responsibility
	Family Therapy - Your partner, children, siblings and/or parents may need to be included in your therapy because of your behavior toward them. This helps: Allow family members to cope with their emotions Foster good communication within the family Strengthen parenting roles, if appropriate
	Self-Help or Peer Counseling Groups - You may join “survivor’s” groups who share their experiences and reactions with each other. This helps to show that: You are not alone in your feelings Others may have reacted in the same way Your feelings/emotions are normal and common to the situation
	Phobias - Eye Movement Desensitization and Reprocessing (EMDR).
	Medication, such as anti-anxiety drugs, may be used in conjunction with the above therapies.

Questions to Ask

Have you been exposed to a traumatic event and were both of the following present? The event(s) involved actual or threatened death or serious harm to someone. This could have been personally experienced or just witnessed. Your response included intense fear, helplessness, or horror.

Do you keep on re-experiencing the traumatic event in one or more of the following ways? Images or thoughts of the event recur and cause you distress. Repeated dreams of the event cause you distress. Flashbacks, illusions, or acting out the event occurs as if it were happening again. Intense emotional distress occurs when you see or think of things that resemble any part of the traumatic event. Physical symptoms, such as headaches, stomachaches, etc. occur when you see, hear, or think of things that resemble any part of the traumatic event.

Do you avoid anything that reminds you of the traumatic event and feel a “numbness” to daily life events as indicated by three or more of the following? Avoid thinking or talking about the trauma and/or disregard your feelings about it Avoid activities, places or people that remind you of the trauma Can’t remember an important aspect of the trauma Have a noticeable lack of interest or participation in activities that are meaningful Feel detached from others Unable to have loving feelings Don’t expect to have much of a future or a normal life span

Are you more “jumpy” now compared to before the traumatic event as indicated by two or more of the following? A hard time falling or staying asleep Outbursts of anger or irritability A hard time concentrating Always on the look-out to protect yourself from being harmed Exaggerated startle response

If you have answered NO to all of the questions, you probably do not have posttraumatic stress disorder. If you are not sure, though, see a counselor for a professional assessment.

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March 16, 2007