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Post Traumatic Stress Disorder

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If I experience a trauma does it mean I have Post Traumatic Stress Disorder? Responses to trauma were for many years overlooked and understudied, but clear evidence of lasting effects following traumatic exposures or perceived traumatic exposures dates back through modern history. Referred to as ’shell shock’, ’soldiers heart’, ’railway spin’, and ’battle fatigue’ among other names, Post Traumatic Stress Disorder has been long observed and misunderstood. Commonly associated with military personnel, Post Traumatic Stress Disorder is not confined to wartime experiences and can be experienced by anyone that has experienced or perceived a traumatic event. Yet not everyone that experiences a traumatic event with developing Post Traumatic Stress Disorder, so how do you know if you experiences are normal processing of stress/trauma or something you need further support to manage?

Post Traumatic Stress Disorder Definition

It is estimated that on average 8 million Americans are affected by Post Traumatic Stress Disorder each year, on average 7.8% of Americans will experience Post Traumatic Stress Disorder at one point in life. Woman are twice as likely as men to develop Post Traumatic Stress Disorder in America. Post Traumatic Stress Disorder can impact the way an individual feels, thinks and behaviors, causing difficulty in their ability to manage daily tasks, impairing sleep patterns, and impacting relational dynamics. Post Traumatic Stress Disorder can impact individuals differently and present in many forms and differing circumstances.

Forms of PTSD

Some forms of Post Traumatic Stress Disorder include:

  • Acute Stress Disorder- Individuals may experience a multitude of symptoms including panic responses, intrusive thoughts, difficulty managing daily self-care (bathing, eating, etc.), loss of focus, avoidance of distressing stimuli/triggers, negative mood, confusion, disassociation, insomnia, and irritability. Symptoms are observed following an experience or perceived traumatic event and last more than 3 days and up to 1 month after the traumatic event occurred.
  • Uncomplicated Post Traumatic Stress Disorder: Symptoms of intrusion, mood, disassociate, avoidant, and arousal symptoms similar to those described with Acute Stress Disorder and are present for more than 1 month. Uncomplicated Post Traumatic Stress Disorder is present when repeated exposures to trauma are present. This repeated and continuous exposure to traumatic events can also commonly cause individuals to emotionally and relationally detach to manage symptoms.
  • Co-morbid Post Traumatic Stress Disorder: Post Traumatic Stress symptoms that present in individuals that are already experiencing another mental health condition that’s exposure or treatment of the disorder creates trauma for the individual.
  • Complex Post Traumatic Stress Disorder:  Complex Post Traumatic Stress Disorder may occur in individuals that have experienced multiple, repetitive, or long-lasting trauma. Symptoms impair individuals ability to manage relational dynamics, work, daily living, or emotional responses. Complex Post Traumatic Stress Disorder has also be associated with the development of secondary disorders including anxiety and depression.

What is Post Traumatic Stress Disorder?

According to the Diagnostic and Statistical Manual 5 (DSM 5) Post Traumatic Stress Disorder is described as:

Exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence followed by seven (or more) symptoms experienced for longer than 1 month after exposure.

The following categories must be met:

  • Criterion A (one required): Exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in one of the following ways ( 1 must be met)
    • Direct exposure
    • Witnessing the trauma
    • Learning that a relative or close friend was exposed to a trauma
    • Indirect exposure to aversive details of the trauma
  • Criterion B (one required): The Traumatic event is persistently re-experienced in the following way (s):
    • Intrusive thoughts
    • Nightmares
    • Flashbacks
    • Emotional distress after exposure to trauma reminders
    • Physical reactivity after exposure to traumatic reminders
  • Criterion C (one required): Avoidance of trauma-related stimuli after the trauma in the following way(s):
    • Trauma-related thoughts/feelings
    • Trauma-related reminders
  • Criterion D (two required): Negative thoughts/feelings that began or worsened after the trauma, in the following way (s):
    • Inability to recall key features of the trauma
    • Overly negative thoughts and assumptions about yourself or the world
    • Exaggerated self-blame or blame of others for causing the trauma
    • Negative affect
    • Feeling isolate
    • Decreased interest in activities of previous interest
    • Difficulty experience positive feelings
  • Criterion E (Two required): Trauma-related arousal and reactivity that began or worsened after that trauma, in the following way(s):
    • Irritability/aggression
    • Risky or destructive behaviors
    • Hypervigilance
    • Heighten startle reaction
    • Difficulty concentrating
    • Difficulty sleeping.

The symptoms must cause significant distress or impairment in individuals ability to function in the home, school, work or relational settings.
When considering if you have a form a Post Traumatic Stress Disorder it is also important to rule out other possible causes of symptoms including underlying medical conditions, substance use, or other mental health disorders.

Do I have Post Traumatic Stress Disorder?

Post Traumatic Stress Disorder impacts individuals differently, everyone may not experience all the symptoms listed above or may experience different symptoms at different times. If you are worried that you may have Post Traumatic Stress Disorder talking to your doctor or a mental health professional may be a helpful resource to assess symptoms and if further support or treatment is needed.

Overcoming Post Traumatic Stress Disorder

Post Traumatic Stress Disorder, even when experienced severely, can be treated. The purpose of treatment is to reduce the intensity and frequency of symptoms. There are many different types of treatment approaches to consider. Some of the most commonly used treatment approaches are:

  • Trauma-Focused Psychotherapy: Also known as ‘talk therapy’ or counseling is a common and helpful approach to treating Post Traumatic Stress Disorder. A few types of specialized researched to lessen the effects and symptom presentation of Post Traumatic Stress Disorder.
  • Prolonged Exposure Therapy: Supports individuals in using coping and self-regulation skills to manage symptoms while discussing their trauma in order to gain more control over symptoms and visceral reactions to trauma triggers.  Cognitive Processing Therapy: Addresses narrative associated with the trauma and reframing negative thoughts and unhelpful narrates related to the trauma. Eye- Movement Desensitization and Reprocessing (EMDR):  A form of therapy that targets bilateral stimulation of the brain and attempts to target the brain stem in order to further process trauma.

Other evidence-based psychotherapy approaches may also be used to treat Post Traumatic Stress Disorder including Cognitive Behavioral Therapy (CBT), with research supporting their effectiveness in alleviating symptoms of Post Traumatic Stress Disorder. Use of psychotherapy approaches to treating Post Traumatic Stress Disorder have changed significantly over the past decade as we are now learning more about how the brain processes and stores trauma. It is important to look into different approached before deciding which is right for you.

Medications

Pharmaceutical medications have been used to treat symptoms of Post Traumatic Stress Disorder. The most commonly used medications for treating Post Traumatic Stress Disorder are Antidepressants (typically SSRI, SNRI) designed to impact brain chemicals that impact mood. It is important to work closely with your doctor to find out if medication is the right approach for you. Depending on the medication used effects can be noticed quickly or up to 2-4 weeks following start of medications. Medications are typically not an isolated ‘fix’ or silver bullet to treating Post Traumatic Stress Disorder. It is strongly recommended that individuals seek counseling services in conjunction with medication in order to further treat underlying causes and triggers to Post Traumatic Stress Disorder.

The Take-Away:  Post Traumatic Stress Disorder can come in many forms and impact anyone at any time in life. It’s important to remember that it’s not your fault if you are experiencing Post Traumatic Stress Disorder and there is help and support available! Reaching out and getting information about PTSD counseling is the first step toward feeling relief from symptoms.

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