Psych 101: PTSD

The DSM-IV-TR describes Posttraumatic Stress Disorder (PTSD) as the "the development of characteristic symptoms following ... direct personal experience of an event that involves actual or threatened death or serious injury; ... or witnessing an event that involves death, injury or threat of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. The person's response to the event must involve intense fear, helplessness or horror." The "characteristic symptoms" are 1. a reliving of the event (called a flashback); 2. avoidance of things associated with the incident, and difficulty responding to such things when having to deal with them; and 3. increased sensitivity and emotional arousal when in the presence of such reminders. These "reminders" are considered triggers, ie. they trigger the PTSD reaction.

So, just to review. PTSD is a reaction to some really bad thing that has happened to a person (or someone close to that person) earlier in their life. The stress reaction usually occurs several months after the event, but could also happen several years later. The initial event could be remembered or not. Not remembering may be because it happened when the person was too young to remember (including prenatally, as when a pregnant woman has been abused and the unborn child is affected), or because amnesia (or blocking the memory) is a symptom of the stress reaction. PTSD can include severe mood swings; self-destructive and impulsive behavior; somatic complaints (eg. stomach or headaches), feelings of helplessness, shame, guilt and hopelessness; hostility; isolation; paranoia; damaged relationships with others; personality changes. People with PTSD often suffer from depression, substance abuse, panic, agoraphobia (fear of public places) and other phobias, OCD and other anxiety disorders, and bipolar disorder. PTSD significantly interferes with the person's functioning in various areas of their life, including relationships, career, and general social functioning.

PTSD came to more popular awareness during the Vietnam War, when soldiers were coming home after experiencing the trauma of war. This is happening today as soldiers return from the war in Iraq. This illness also affects people who have suffered violent personal attack (including child abuse), torture, natural or man made disasters, automobile accidents, or have been diagnosed with a life-threatening illness.

I have found that many people are affected by significant events in their lives, that effect them with a stress reaction later, but not to the degree of someone with PTSD. People who have learned to function fairly well in spite of earlier bad experiences, but still have anxiety, or depression triggered by a current event or situation (likely in which they feel threatened). I'll talk more about that later, as well as discussing my approach to treating someone with PTSD.

TO BE CONTINUED...