Posttraumatic Stress Disorder
Posttraumatic Stress Disorder is a common psychological disorder. According to the Adult Psychiatric Morbidity Survey, the prevalence of PTSD is estimated to be 3% in the United Kingdom. This article is aimed at providing information related to the core elements of PTSD, it’s symptoms, causes, and treatment options. Let’s get into the details.
PTSD belongs to the category of anxiety disorders that is triggered by experiencing or witnessing a frightening or traumatic event. People suffering from PTSD re-experience traumatic experiences through flashbacks, dreams, etc. They also avoid reminders of traumatic events. This can impact their personal, social, and professional functioning as well. All people who experience trauma do not necessarily develop PTSD. Some meet full criteria for PTSD, some people only experience a few symptoms while others experience none at all. PTSD was initially considered as a disorder specifically concerned with soldiers or veterans because they experience traumatic events frequently especially during wars. However, it has now been found that PTSD is not limited to soldiers’ experiences only because traumatic events can happen to other people too.
Symptoms of PTSD
According to Diagnostic Statistical Manual Mental Disorders (DSM-5), following are the symptoms of PTSD:
- Re-experiencing traumatic event through flashbacks, nightmares, or thoughts.
- Avoiding reminders (places, persons, activities, etc.) of the traumatic event.
- Experiencing negative thoughts and emotions (guilt, anger, fear, etc.).
- Finding problems with concentrating, sleeping, and other related matters.
- Symptoms being strong enough to impact the normal functioning of individuals in different domains (social, personal, professional, academic, etc.) of their life.
DSM-5 criteria of PTSD require exposure to actual or threatened death, injury or sexual brutality directly experiencing trauma, witnessing trauma, learning about trauma from others or repeatedly getting exposed to aversive details of a traumatic event.
Causes of PTSD
As mentioned earlier, PTSD is caused by experiencing, witnessing or learning about traumatic an event like actual or threatened death, injury, or sexual brutality. Common traumatic experiences that may cause PTSD include:
- Combat situations
- Natural disasters
- Serious accidents
- Sexual assault
- Physical assault
- Significant negative change in health status
PTSD can manifest immediately after the traumatic incident, some month or even years after the incident.
Risk factors for developing PTSD
- Repeated exposure to trauma for a long time
- History of mental illness
- History of abuse in childhood
- Exposure to severe trauma
- Lack of a support system
- Additional life stressor to an existing trauma
It is important to note that PTSD is not the only disorder caused by experiencing a traumatic event. Depression, agoraphobia, and GAD can also occur after a traumatic experience.
Treatment options for PTSD are aimed at helping individuals in gaining control over their life. The primary treatment option is psychotherapy but sometimes medications are also used. The treatment options work by:
- Teaching individuals to address their symptoms
- Assisting individuals in thinking better about themselves, others and the world
- Teaching them to cope if symptoms arise
- Treating any co-existing problems
There are many forms of psychotherapy that can be used with adults and children with PTSD. Let’s discuss some of them.
1. Cognitive therapy: Cognitive therapy targets unhelpful and negative thinking patterns that keep a person stuck. For example, people with PTSD have negative thoughts that traumatic experience may occur again. Changing these thoughts can be helpful as it will help them in moving forward with a positive outlook towards themselves, their lives, and the world.
2. Exposure therapy: Exposure therapy helps individuals in facing frightening thoughts and memories which helps them in coping with them effectively. This therapy is most effective for managing flashbacks and nightmares. Exposure therapy usually employs the use of virtual reality technology that makes individuals re-experience the traumatic event.
3. Eye movement desensitization and reprocessing (EMDR): This form of therapy combines exposure therapy with guided eye movement which assists in processing traumatic memories and changing the way people react to those memories and thoughts.
There are several medications that help in improving symptoms related to PTSD
1. Anti-depressants: Anti-depressants help in managing anxiety and depression symptoms that exist with PTSD. These medications also manage sleep and concentration problems. Common anti-depressants that are used for PTSD are selective serotonin reuptake inhibitor medications sertraline and paroxetine.
2. Anti-anxiety medications: These are used to manage anxiety symptoms related to PTSD but can be used for a short time.
3. Prazosin: This medication is also used but its effectiveness is not widely supported by research.
It is quite normal to experience disturbing thoughts, flashbacks, and negative emotions after a traumatic event and people get better naturally over time, mostly within a few weeks. However, if symptoms do not go away even after 4 weeks then one should seek help as soon as possible. One can also seek help early as well if their symptoms start threatening their normal functioning. A mental health professional can better assess, diagnose, and treat the problem effectively.
Stigmas associated with mental health issues prevent people from seeking help. However, society is offering more acceptance now. Following are the helplines offering help to PTSD survivors:
Anxiety UK https://www.anxietyuk.org.uk/
ASSIST Trauma Care http://assisttraumacare.org.uk/
Birth Trauma Association https://www.birthtraumaassociation.org.uk/
Combat Stress https://www.combatstress.org.uk/
Disaster Action https://www.disasteraction.org.uk
EMDR UK & Ireland http://www.emdrassociation.org.uk/
Freedom from Torture http://www.freedomfromtorture.org
Help for Adult Victims of Child Abuse (HAVOCA) http://www.havoca.org
NHS UK http://www.nhs.uk
PTSD Resolution http://www.ptsdresolution.org