Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder

Constantly re-living a traumatic event, war, traumatic accident, abuse is post-traumatic stress disorder, or PTSD. It can cause severe depression and anxiety for many years after the initial event. If you have flashbacks, episodes of anger, nightmares, get help. Medications and talk therapy can help you find peace.

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    A , Physical Medicine & Rehabilitation, answered

    Resiliency Training is being researched as a way to prevent post-traumatic stress.  The Army has initiated a program for all of its troops that will train them in resiliency. The training, the first of its kind in the military, is meant to improve performance in combat and head off the mental health problems, including depression, post-traumatic stress disorder and suicide,  that affect about one-fifth of troops returning from Afghanistan. Though there has been no direct research conducted on soldiers to see if such a program will be beneficial,  other research in this area suggests that by teaching people some of these basic psychological coping skills, a person will be better positioned to deal with stress and stressful situations in a more positive manner. The Army is also going to track the results of this program, in time providing them with some hard data about its effectiveness.

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    Post-traumatic stress disorder is diagnosed based on a psychological examination. During the evaluation, a mental health professional may ask you to describe symptoms, the intensity of the symptoms, when they occur, and the history leading to the onset of the symptoms. A diagnosis of post-traumatic stress must meet some of the criteria of the illness described in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The criteria includes

    1. Experienced an event like a death or injury resulting in intense fear or hopelessness;
    2. Disturbing flashbacks, dreams, or physical reaction of the event;
    3. A sensation of heightened alertness to signs of danger;
    4. Trouble concentrating or sleeping;
    5. A sense of emotional numbness following the event; or
    6. Symptoms interfere with normal life activities and continue for longer than one month.
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    Diagnosis of PTSD begins with an evaluation of your symptoms. The requirements for diagnosis of PTSD are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). If your symptoms are severe and last longer than a month, discuss them with a health care professional. Getting treatment as soon as possible can help PTSD symptoms from escalating.

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    If you experience disturbing feelings and emotions for a month or longer, an appointment with a doctor can help with a diagnosis. The doctor can explain terms that can help you understand the disorder and can make recommendations for treatment or a specialist. Write down any symptoms you have been having and for how long. Provide information about any family history of mental disorders or depression. A list of medications you are taking, even over-the-counter, will assist the doctor in treatment. If you are thinking of harming yourself or others, seek emergency care.

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    A , Adolescent Medicine, answered

    Yes, an expert in PTSD can complete an in-depth review of the diagnostic methodology used in a case and reliably diagnoses PTSD using reliable and valid psychometric instruments.

    The following are some basic facts about what constitutes a sound diagnosis of PTSD:

    One of the critical components of a PTSD diagnosis is that the individual must have been exposed to a traumatic event. In order to qualify as a traumatic event, the event must meet two DSM criteria:

    • "the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others." 
    • "the person's response involved intense fear, helplessness and horror." 

    A second critical component of a PTSD diagnosis is that the person must have symptoms consistent with PTSD. Evidence of exposure to such a stressor alone is not sufficient to establish a diagnosis of PTSD.

    The DSM-IV-TR specifies the pattern of symptoms that must occur in order for an individual to be diagnosed with PTSD. There are three categories of PTSD symptoms: re-experiencing, avoidance/numbing, and increased arousal. PTSD can only be diagnosed if one symptom of re-experiencing, three symptoms of avoidance/numbing, and two symptoms of increased arousal are present.

    A third critical component of a PTSD diagnosis is that the person's level of functioning pre- and post-trauma must be significantly different. This is the requirement that symptoms "cause clinically significant distress or impairment in social, occupational, or other important levels of functioning." 

    Finally, the symptoms of PTSD must persist beyond thirty days.

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    There can be a tendency in veterans with post-traumatic stress disorder (PTSD) to “self-medicate” with alcohol or drugs, to help them temporarily forget the pain of the trauma. It is not unusual for PTSD sufferers to show poor control over their impulses, and engage in risky or self-destructive behaviors.

    Alcohol abuse and PTSD often go together; either because veterans who already had a history of alcohol abuse are more likely to develop PTSD after a traumatic event, or because PTSD leads veterans to abuse alcohol to dull their symptoms. PTSD symptoms can actually be made worse by alcohol use, and the treatment for PTSD is less effective when the patient abuses alcohol. Older veterans with PTSD are at higher risk for suicide if they also have problems with alcohol use. Using drugs and alcohol may alter your brain chemistry, and make you more susceptible to PTSD.
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    Depression is commonly found in people diagnosed with post-traumatic stress disorder (PTSD). According to the National Institute of Mental Health, depression occurred in 40% of PTSD patients one to four months after the event. The good news is that both PTSD and depression respond well to medical and talk therapy treatment, particularly if they are caught early.

    Studies show that trauma can change the actual chemistry in the brain. In fact, a severe external event can bring on depression. Further, any previous trauma you've experienced can impact (worsen) your current reaction.
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    Post traumatic stress disorder (PTSD) is type of anxiety disorder that occurs after experiencing a very frightening event such as a crime, accident, bombing or terrorist attack. While not everyone who experiences the trauma needs treatment, PTSD can affect some individuals so horrifically that their daily lives become dysfunctional.

    When someone with PTSD lives with pent-up fears and anxiety, they are at higher risk for drug or alcohol abuse, job loss, and even suicide. PTSD is linked to some illnesses such as high blood pressure, chronic pain and sleep problems.

    PTSD symptoms can happen instantaneously or they may not occur for months to even years after the trauma. Someone with PTSD may experience avoidance and isolation, flashbacks, sleep disorders, feelings of helplessness, guilt feelings and even feeling as if you’re mentally ill.

    Acute PTSD symptoms last from one to three months after the trauma. Chronic (long-term) PTSD symptoms last longer with at least six months between the symptoms and the trauma.

    PTSD is treated with cognitive behavioral therapy and exposure therapy. Medications may be prescribed by the physician or mental health professional.
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    Yes. Veterans who suffer from post-traumatic stress disorder (PTSD) may find it contributes to or causes other disorders such as depression. According to the Department of Veteran’s Affairs, depression is three to five times more likely to occur in someone with PTSD than in the general population. The painful feelings that come from a traumatic event -- grief, anger, fear, “survivor’s guilt” -- are difficult for a PTSD sufferer to work through, and depression can be the result. Depression has overlapping symptoms with PTSD, such as inability to focus, alienation from other people, and irritability.
     
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    Anyone, no matter their mental or physical health, can experience post-traumatic stress disorder (PTSD). Those with mood disorders may even find their lives even more disrupted than usual.

    Full-blown post-traumatic stress disorder tends to begin within the first three months following the event. Sometimes, however, six months pass before an individual begins exhibiting symptoms. Half of those stricken with PTSD recover within three months. Those who can't shake the symptoms for over a year must receive treatment if they want to improve.

    Those with clinical PTSD typically:
    • have experienced an immediate response to a traumatic event
    • reacted with extreme fear, horror and/or helplessness to the event
    • continually re-live the event ("flashbacks) through dreams, hallucinations and images
    • try to escape anything that would remind him or her of the event
    • demonstrate some apparent memory loss about the event
    • experience increased irritability, anger, difficulty sleeping or concentrating
    • sense heightened awareness, over-react when startled, feel overwhelmed by impending doom or danger
    • struggle at work and in relationships for one month or longer
    Some forms of these symptoms occur in nearly everyone exposed to a devastating event. If an individual recovers from them in four weeks or less, doctors consider them to have experienced a milder form of PTSD known as "acute stresss" disorder.

    A significant number of trauma survivors, however, cannot defeat these symptoms within a useful time period. If you experience these symptoms in addition to exacerbated symptoms from your mood disorder for longer than three months, it's imperative you discuss your situation with your healthcare providers.