Post-Traumatic Stress Disorder
Definition
Post-Traumatic
Stress Disorder (PTSD) is a specific form of anxiety
that comes on after a stressful or frightening event.
Description
While some stressors are a
predictable part of most people's lives - for example, bereavement or chronic
illness - others lie outside the range of these common experiences. These
include hurricanes, floods and other natural disasters; airplane accidents and
car crashes where considerable injury occurs; rape
and assault; and armed combat, torture, and existence in a death camp. Such traumatic
events would produce distress in almost everyone at any age. In
some, they give rise to PTSD.
Causes
PTSD is one of the few psychological
disorders with a clear point of origin. Although there are some people who have
been exposed to trauma and do not develop PTSD, there are certain
susceptibility characteristics in people who develop PTSD. These susceptibility
factors include the following:
Previous chronic exposure to stress. Susceptibility depends primarily on the survivor's
interpretation of the event. Thus, an event that is merely troublesome to one
person can be devastating to another. Moreover, each of us may have a stress
threshold, so that those who have endured more stress in life are considered
more susceptible to PTSD.
Preexisting psychological disorders. People who suffer from depression
or anxiety or have a family history of anxiety are more likely to develop PTSD.
Inadequate support systems. A failure by loved ones to acknowledge the trauma, or loved
ones who downplay its importance and place blame on the victim, increase the
risk of PTSD.
Genetic predisposition.
Recent (acute)
stressful life changes.
Feeling of lack of control. The state of having "learned helplessness" or
giving total control to another individual can give rise to PTSD.
Recent excessive alcohol intake.
Symptoms
The post-traumatic reaction often
begins immediately but may emerge after days, weeks, months or even years after
the event. There are three kinds of symptoms, hyperalertness/hyperarousal,
intrusion and emotional constriction or numbing.
1. Hyperalertness/hyperarousal.
People are often edgy, irritable, easily startled, constantly on guard, have
poor sleep habits, are agitated and find it difficult to concentrate.
2. Intrusion. People tend to
re-experience the event in painful memories, flashbacks, dreams or nightmares.
People with PTSD also may experience a worsening of their symptoms when they
find themselves in situations that resemble the original trauma or that may be
taken as symbols of it - for example, a spell of hot, humid weather for a
Vietnam veteran, or a dark street for a woman who has been raped. In avoiding,
or attempting to avoid, such situations, an individual's ability to function
socially and at work may be severely impaired.
3. Emotional constriction or
numbing. Another symptom is called "psychic numbing" or
"emotional anesthesia."
Sufferers exhibit a pervasive feeling of being detached from other people, from
the outside world, and from activities that used to be enjoyable.
They also have a greatly diminished
ability to experience emotion, especially tenderness and the feelings
associated with intimacy and sex. Other symptoms reflect an over-aroused
autonomic nervous system. Sufferers have difficulty falling asleep or staying
asleep; they are keyed up and their startle response is heightened.
Anxiety and depression are common in
those with PTSD. Irritability
is a further problem. Guilt about surviving when others did not, and about the
behavior that was necessary for survival, may be constant and painful. Some of
those with this disorder turn to alcohol or drugs for escape, others may become
self-defeating or suicidal.
Diagnosis
According the Diagnostic and
Statistical Manual of Mental Disorders the following symptoms must be present
for a diagnosis of PTSD:
- Recurrent and intrusive distressing recollections or
dreams about the event
- Feeling as if the traumatic event were recurring, such
as through hallucinations
and flashbacks
- Intense psychological distress at cues that symbolize
the event
Additionally, these symptoms must
endure for more than a month and must cause clinically significant distress or
functional impairment.
Treatment
As with many other psychiatric
disorders, the most effective treatments are psychotherapy and drug treatment.
Psychotherapy
If functional impairment occurs, or
if the symptoms are severe and prolonged, some form of psychotherapeutic
treatment is indicated.
With psychodynamic psychotherapy,
the individual has the opportunity to discuss the event, relive it, and achieve
a better understanding of why it has triggered so severe a psychological and
physiological reaction. Cognitive-behavioral techniques may be used to reduce
anxiety and depression, aid with insomnia,
and treat any phobic symptoms that may have developed.
Psychotherapists treating PTSD try
to provide a way for the patient to feel safe in confronting the traumatic
event and linking it emotionally as well as intellectually to the symptoms.
Patients must learn to think about the trauma without intrusive reliving and
exercise self-control without avoidance and emotional numbing.
Some patients are reluctant to talk
because they believe the therapist cannot possibly understand what they have
been through. Some resist any suggestion that the traumatic event is related to
their symptoms. Their helplessness is confirmed by nightmares
and flashbacks that remind them of their inability to protect themselves during
the trauma. Some have become convinced that the world is hopelessly unjust,
others that they themselves are defective or evil. Some patients make emotional
demands and direct their accumulated anger at the therapist, they may quit therapy
because they can no longer tolerate being exposed to their feelings about the
trauma.
Drug Treatment
Drug treatment is aimed at relieving
fear and anxiety and restoring normal sleep patterns. Tricyclic
antidepressants, such as Tofranil and Elavil, or SSRIs such as Prozac or Zoloft,
are helpful. Additionally, Catapres and Inderal are known to relieve agitation,
while Xanax may help some people sleep.
POSTED BY ATTORNEY RENE G.
GARCIA:
For more information:- Some of our clients have suffered this kind of injuries due to a serious accident. The Garcia Law Firm, P.C. was able to successfully handle these types of cases. For a free consultation please call us at 1-866- SCAFFOLD or 212-725-1313.
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