Post-traumatic Stress Disorder
by Aliya Hasan
Even though it has been some time since the tragic events of September 11th,
for many it is still difficult to move on to normal life. As I wrote about in
my last column, it will take time to mourn what has happened. Of concern is
the far reaching psychiatric problems this tragedy could produce in some people.
One of the more severe problems to arise in this sort of situation is Post Traumatic
Stress Disorder (PTSD).
PTSD has been estimated to affect between 1-12% of the U.S. population. The
rates are even higher in those at greater risk for developing it, including
professional firefighters, individuals in law enforcement, survivors of motor
vehicle crashes, and rape victims. Symptoms of PTSD can come on immediately,
and go away after a few months; but they can also take a while to set in, and
last for many years.
Diagnosis
To diagnose PTSD one would have to meet criteria for it; as well the symptoms
should have persisted for at least one month, and significantly disturb the
patient’s social and/or occupational functioning. The criteria as outlined
by the American Psychiatric Association in their Diagnostic and Statistical
Manual of Mental Disorders are the following.
- A traumatic event occurred in which a person witnessed or experienced actual
or threatened death or serious injury, and responded with intense fear, horror,
or helplessness.
- Memory cues causing the person to re-experience symptoms, like their recollections
of fear or helplessness, nightmares, flashbacks, or other psychologic distress.
- The person avoids trauma related stimuli and feels emotionally numb.
- The person is at a heightened state and can be more irritable or experience
difficulty sleeping.
Prevention
Of greatest important in stopping PTSD from occurring, of course is prevention
of violence. Unfortunately many tragedies happen that are out of our control,
including natural disasters. We should try to do our part to curb violence,
especially in such circumstances as rape, child abuse, and domestic abuse.
Preventing PTSD once exposure to a traumatic event has already occurred hasn’t
been studied so well. A behavioral program for the prevention of chronic PTSD
has shown promise in preventing or reducing the symptoms of PTSD, if started
within 14 days of the trauma. It combines confronting the fears of the victim
with relaxation techniques and education. Based on these findings victims of
trauma are encouraged to discuss the traumatic event, and their feelings about
it, soon after it has occurred. Studies have found that in the short term such
sessions decrease the victim’s anxiety, and give them a greater feeling
of empowerment.
Treatment
Each patient is different, and often requires different forms of treatment
to meet their needs. Generally the first line treatment for every patient is
education about PTSD. After that the patient should receive counseling from
a mental health professional, as well as guidance from a PTSD group. Psychotherapy
aims to break the pattern of self-defeat. It is done by re-examining the traumatic
event and talking with the patient about his/her feelings. Cues or certain situations
can trigger the symptoms, so it is important to try to recognize such triggers.
Especially since systemic desensitization may help control the symptoms when
the triggers present themselves. Psychotherapy also helps teach the patient
coping mechanisms including relaxation techniques. Sometimes one member’s
PTSD affects the whole family. In that case the family needs to be educated
about the disease, and may need to join the patient in family counseling sessions.
Medicine given for PTSD is more aimed at treating the symptoms caused by the
PTSD including the anxiety, re-experiencing phenomenon, or insomnia. Done in
concert with each other, these treatments should help treat the PTSD significantly.
It is important to treat any other problems the patient may have to help optimize
their chances for recovery including: substance abuse problems, medical problems,
or other psychiatric problems they may have.
Hopefully, this column gives you a good introduction to Post Traumatic Stress
Disorder. People can be seriously disabled by it, and can have trouble leading
a normal life. Whether it is you or someone you care about, it is important
to recognize that something isn’t right. You don’t have to diagnose
a psychiatric illness yourself, leave that up to the doctor; you just have to
ask for help. Often we find ourselves in denial about psychiatric illness, perhaps
because we are embarrassed to admit it. Society doesn’t look down on you
if you have heart disease, but unfortunately, psychiatric problems have a stigmata
associated with them. The only way to combat that prejudice is by education.
By writing this column I have done my part, now it is up to you. Seek help if
you need it. Force someone you care about to get help, if they need it. Most
importantly don’t be judgmental or casual when it comes to your mental
health or the mental health of your loved ones.
For more information on PTSD check out the National Alliance for the Mentally
Ill’s website at www.NAMI.org, or call 1-800-950-NAMI.
[taken from http://pakistanlink.com/health/09282001.html]
Date/Time Last Modified: 12/2/2003 9:16:04 AM
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