Post-Traumatic Stress Disorder - Post-Trauma Response

Anyone can develop anxiety from experience, and from this illness they form post traumatic stress disorder (PTSD). It affects hundreds of thousands of people who have survived earthquakes, airplane crashes, terrorist bombings, inner-city violence, domestic abuse, rape, war, genocide, and other disasters, both natural and man made. PTSD has been called "shell shock" or "battle fatigue syndrome". It has often been misunderstood or misdiagnosed, even though the disorder has very specific symptoms. Most people who are diagnosed with this disorder have it for the rest of their lives. Usually, medication can help overcome their anxiety, and sometimes they will never get rid of it. Ten percent of the U.S. population has been affected at some point by clinically diagnosable PTSD. Everyday more people show some symptoms of the disorder. Although it was once thought to be predominantly a disorder of war veterans, researchers now know that PTSD also affects both male and female civilians and veterans, and that it strikes more females than males. In some cases the symptoms of PTSD disappear with time, whereas in others they persist for many years. PTSD often occurs with, or leads, to other psychiatric illnesses, such as depression. Everyone who experiences trauma does not require treatment; some recover with the help of family, friends, religion, or through support groups. Many with PTSD do, however, need professional treatment to assist in the recovery process from the psychological damage that resulted from experiencing, witnessing, or participating in an overwhelmingly traumatic event.

PTSD is defined as "a DSM-IV psychiatric disorder characterized by an acute emotional response to a traumatic event or situation involving severe environmental stress, such as a natural disaster, airplane crash, serious automobile accident, military combat, or physical torture".

Signs and symptoms of PTSD differ from patient to patient. Symptoms can be cognitive, affective, or sensory. They include, but are not limited to: flashbacks, repetitive dreams/nightmares, excessive verbalization of event, guilt/survivor's guilt; psychic/emotional numbness such as impaired interpretation of reality, confusion, dissociation/amnesia, constricted affect; self-destructiveness behaviors such as substance abuse, suicide attempt, criminal activity; difficulty with interpersonal relationships such as development of phobia(s) regarding the trauma, poor impulse control, and irritability/explosiveness.

Causes of PTSD can also differ from patient to patient. As previously stated, PTSD can be caused by disasters, wars, epidemics, rape, assault, torture, catastrophic illness, or vehicle accidents. Despite the variability of PTSD causes, there are factors that contribute to one's risk in developing PTSD. Risk factors include, but are not limited to the patient's occupation, an exaggerated sense of responsibility, perception of event, role/participation in the event, displacement from home, inadequate social support or a non-supportive environment, diminished ego strength, and the duration of event.

Although trauma is experienced subjectively, there are specific events that are classified as traumatic by nearly everyone. In order to properly and effectively diagnose PTSD, the following criteria must be met:

1. "A" Stressor:

Exposure to an event involving actual/threatened death or injury or a threat to the physical

integrity of self or others.

Sub-responses include: intense fear, helplessness, and/or horror.

2. "B" or "Intrusive Recollection" Stressor:

The event remains long-term or life-long and the memory retains the power to evoke

extreme emotions or mental images and/or psychological reactions related to the trauma.

3. "C" or "Avoidance/Numbing" Stressor:

The patient uses strategies to reduce exposure to trauma related stimuli.

Avoiding any situation with the risk of confronting trauma.

Cut off all conscious experience of memories or feelings associated with trauma.

4. "D" or "Hyper-arousal" Stressor:

Resembles panic or general anxiety or may appear as paranoia; "vigilance is key".

5. "E" or "Duration" Stressor:

Duration of symptoms for 1 month or more.

6. "F" or "Functional Significance" Stressor:

Symptoms must have resulted in significant social, occupational, or other life-altering

distress.

Although certain criteria must be met for a definitive diagnosis of PTSD, this disorder has effects on those not diagnosed, such as family, friends, co-workers, neighbors, and whole communities. Usually, increased symptom severity will result in more severe incidences of decreased family, professional, and/or community function. Studies have specifically shown that in combat veterans, the decreased family function is manifested with increased marital problems because the partner is under more stress. Children typically respond with an increase in, or manifestation of behavioral issues. Family members and friends react to the patient's PTSD symptoms as uniquely as the symptoms themselves. It is not unusual for these reactions to be negative, sympathetic, angry, guilty, depressed, or avoidance. It is also not uncommon for family members to also seek support in dealing with these emotions. PTSD patients and their families can make positive lifestyle changes that can have a major impact on treatment goals. Some examples of positive lifestyle changes are: to have more contact with other trauma survivors (or families); exercise; volunteer; residence changes; and abstinence from drugs and alcohol.

Therapy options for the treatment of PTSD is evolving. Currently therapies are conventional and generally well-accepted and followed. In the beginning of therapy, one-on-one is usually preferred over group because confidentiality is maintained and progress is under the control of the patient. Group therapy is recommended and practices under the supervision/guidance of a