PTSD: A Psychological Response to a Life-Changing Event

Posted by New Horizons Counseling Center

 

PTSD

  

What is Posttraumatic Stress Disorder?

Do you or someone you know experience irrational rage, are easily startled by a sudden noise or an unexpected touch or avoid certain situations that risk bringing traumatic memories? Have you or this other person experienced a catastrophic event?

Being upset after a shattering event is normal. However, if the symptoms last for more than a month or the bad feelings return anywhere from three months or even years later, you may be experiencing posttraumatic stress disorder. According to the American Psychiatric Association, PTSD is a “psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.”

Anyone can experience PTSD, from combat veterans to victims of crime; from children under six to children and teens to older adults, from different races, genders or countries of origin. Natural disasters, learning of a loved one’s violent death or frequently witnessing tragedies such as first responders constantly and continually live through can lead to the disorder. PTSD respects no boundaries or classifications.

The history of PTSD goes back many hundreds of years. Many prominent authors wrote about the experience. Homer, Shakespeare, Dickens and Stephen Crane all wrote about the traumatic events and the subsequent aftermath. The medical world attempted to help those suffering through PTSD during the aftermath of the Civil War. During World War II, it was called Shell Shock and pegged as Battle Fatigue in World War II. Beginning in 1980, PTSD was added to the Diagnostic and Statistical Manual of Mental Disorder. Today, the newest version of the manual, DSM-5 (2013), no longer lists the disorder as an anxiety disorder. It now has its category, Trauma – and Stressor – Related Disorders.

The APA points out the 3.5 percent of U.S. adults suffer from PTSD. Nearly one in 11 people will experience PTSD during their lifetime. Further and perhaps surprisingly, women are twice as prone to experience the disorder.

The Veterans Administration, a leader in PTSD research and treatment, lists four categories of symptoms. A person suffering from PTSD may experience the symptoms to varying degrees of intensity. These four categories are:

Reliving the event (also called re-experiencing symptoms). Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:
  • You may have nightmares.
  • You may feel like you are going through the event again. This is called a flashback.
  • You may see, hear or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:
  • You may avoid crowds because they feel dangerous.
  • You may avoid driving if you were in a car accident or if your military convoy was bombed.
  • If you were in an earthquake, you may avoid watching movies about earthquakes.
  • You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
Negative changes in beliefs and feelings. The way you think about yourself and others changes because of the trauma. This symptom has many aspects, including the following:
  • You may not have positive or loving feelings toward other people and may stay away from relationships.
  • You may forget about parts of the traumatic event or not be able to talk about them.
  • You may think the world is completely dangerous, and no one can be trusted.
Feeling keyed up (also called hyperarousal). You may be jittery or always alert and on the lookout for danger. You might suddenly become angry or irritable. This is known as hyperarousal. For example:
  • You may have a hard time sleeping.
  • You may have trouble concentrating.
  • You may be startled by a loud noise or surprise.
  • You might want to have your back to a wall in a restaurant or waiting room.

Of course, children also can develop PTSD. Again, causes arise from traumatic events that the child undergoes, such as natural disasters, vehicle crashes, physical or sexual assaults, man-made or natural disasters, animal bites and so forth. The child may become grumpy or depressed, can’t sleep or loses interest in previously fun activities. He may develop school problems, be unable to focus or he may act younger than his age (thumb sucking, bedwetting, insisting on sleeping with parents).

Diagnoses in children is parallel to diagnoses in adults, with a few different aspects. The symptoms usually start within three months after the catastrophic event. But with a child, she may not experience flashbacks or remember the events as vividly as adults. She may also put the events of the trauma in the wrong order. He may believe that there were signs that the traumatic event was about to happen. This means that he thinks he can prevent the event from happening again by watching out for these signs.

Teens, no longer being children but not yet adults, lean toward experiencing PTSD akin to adults with the exception that they are more aggressive or impulsive.

Treatment

To date, there are two leading forms of treatment. These are therapy and medications. A third option has begun to emerge, which include complementary and alternative methods.

Therapy

Therapy normally involves four major approaches. According to the National Alliance on Mental Illness, these include the following:

  • Cognitive Processing Therapy is a type of cognitive behavioral therapy (CBT) that works to address the negative thinking and self-blame symptoms that may come with having PTSD. There is specific training for the psychotherapist and materials to guide this treatment.
  • Eye Movement Desensitization and Reprocessing (EMDR) was specifically designed to treat trauma. This therapy uses measured exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with a health care professional certified to perform EMDR.
  • Exposure Therapy is a type of psychotherapy that enables a skilled practitioner to help people safely face what they find traumatizing so they can learn to cope effectively. One technique used in exposure therapy involves virtual reality programs that allow a person to experience the situation in which they experienced trauma to help process it.
  • Group Therapy with others who have similar experiences can help build resilience when someone feels alone and isolated. Group therapy helps lessen shame and provide support, as well as reduce feelings of helplessness. Groups for survivors of sexual assault and combat experiences frequently have members living with PTSD and related symptoms.
Medications

Antidepressants can be useful to help reduce symptoms of PTSD. Some serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for the treatment of PTSD in adults and are often the first line of treatment. Be sure to be informed about medication uses and side effects and ask your doctor about the latest research in this field.

The most common medications for the treatment of PTSD are:

  • Sertraline (Zoloft): 50 mg to 200 mg daily
  • Paroxetine (Paxil): 20 to 60 mg daily
  • Fluoxetine (Prozac): 20 mg to 60 mg daily

Other medication approaches are also available, although some are not FDA-approved specifically for the treatment of PTSD symptoms. Ask your doctor for more information about all medication options available.

Other biological interventions. Many states have legalized marijuana for medical use, and it includes an indication for PTSD. To date, there has not been a randomized controlled trial on the effectiveness of marijuana for PTSD, so it’s difficult to assess its potential viability as a treatment. Research is also underway to assess the potential use of Methylenedioxymethamphetamine (MDMA) to augment psychotherapy for PTSD. MDMA is currently not legal in the U.S.

Complementary and Alternative Methods

  • Service animals
  • Yoga
  • Aqua therapy
  • Acupuncture
  • Mindfulness and meditation strategies and practices

PTSD can be a rough situation to handle for the person with the disorder as well as friends and loved ones. Although not curable, it is definitely treatable. With the right therapist and medical provider, PTSD can be managed and controlled. But it is important to seek treatment. You don’t have to live in fear, sadness, rage or isolation. New Horizons can help you and stand with you in your journey to get better.