Post-traumatic Stress Disorder

Abstract

            Although trauma has for a long time been known to have adverse effects on a human being’s psyche, it was not until as recent as 1980 that the term Post-traumatic stress disorder appeared in the Diagnostic and Statistical Manual of Mental Disorder (DSM). Way back in the 19^th century, PTSD was referred to using such terms as railway spine, effort syndrome, or Dacosta Syndrome among others. After the First World War, traumatized soldiers returning home from active duty were described to be suffering from soldier’s heart or shell shock. Since then, such other terms as combat neurosis, post-rape syndrome, accident neurosis and post-Vietnam syndrome among others have been used to describe what if today referred to as post-traumatic stress disorder (PTSD) (Kinchin & Turnbull 2007).

Post-traumatic stress disorder

            The term Post-traumatic Stress Disorder refers to a health condition that affects victims of major traumatic or shocking events. Such experiences are often beyond normal human experience and PTSD becomes the normal human being’s response to such abnormal situations. Traumatic experiences occur unexpectedly, over turning normal everyday experiences. Such events often make victims blame themselves for being in the wrong places at the wrong period of time as a result of which they will often withdraw into some sort of depression. PTSD affects not only disaster survivors but also witnesses of trauma, relatives to the victims as well as emergency workers (Sindran Institute 2000).

            PTSD is not restricted to any particular age group and people of every age can become victims. However, it is not all people that go through the same traumatic experience who end up suffering from PTSD probably because of different genetic makeup, personalities or up bringing. Women are however more prone to PTSD than men and the disorder has also been identified to run in families. Military men and other people exposed to war or combat also stand a high risk of PTSD because of high risk trauma exposure. In the US, PTSD currently affects about 7.7 million adults out of the total US population. War veterans returning from wars such as Afghanistan and Iraq have for example been diagnosed with PTSD and traumatic brain injury (TBI). The most common causes of PTSD in modern society are war, torture, kidnappings, mugging, car and train accidents, bombings, plane crashes, child abuse, domestic violence, rape and natural disasters such as earthquakes and/or floods. During and after a traumatic experience, the victim becomes helpless due to the overwhelming effect that the traumatic event brings to the natural system that gives people a sense of connection, control and meaning. Victims of physical trauma are likely to develop PTSD especially if exposure has taken place over a long time (Kinchin & Turnbull 2007; NIH 2009).

            Symptoms vary among different individuals with symptoms appearing in as short a period as one month after a traumatic experience or even years later. In some cases, symptoms may disappear after a short period while in others; they may last for several years. Common characteristics of PTSD are recurring thoughts about the traumatic experience; dulling of the victim’s emotions; increased excitement or tendency to be aroused; and sometimes very dramatic changes in victim’s personality. Flashbacks are however the most disturbing symptoms of PTSD because they are easily triggered by such simple aspects as feelings, certain sights, smells or sounds; and in the process, a victim temporarily loses touch with reality. During a flashback, a PTSD victim is living the traumatic experience all over again (Scott & Palmer 37-38).

            Various standards have been developed by health professionals that help in diagnosis of PTSD. Through the standards, PTSD victims are grouped under either avoidance symptoms, intrusive symptoms, or arousal symptoms. Avoidance symptoms include inability to recall a traumatic event; attempts to avoid feeling anything or thinking about a traumatic experience; a loss of any ability to express or feel emotions; as well as a new sense that past experiences are recurring. Intrusive symptoms include sleep disorders, flashbacks, and intense distress at the simple mention of a traumatic event. Arousal symptoms on the other hand range from moodiness, memory problems, violence, concentration problems, sleep problems as well as reactions to sudden noise that may either be sudden or very extreme. Victims of PTSD often become emotionally numb especially in their relationship with people whom they had previous close contact. PTSD symptoms are however different in children and often range from self-abuse, attention or memory problems, increased anxiety, overdependence upon others and learning disabilities (Sindran Institute 2000; Kinchin & Turnbull 2007; Scott & Palmer 2003).

            Diagnosis of PTSD can be a simple process if a patient readily reveals that he or she has been exposed to serious trauma and accepts that such the traumatic event has a role to play in his/her current condition. PTSD diagnosis can however become complex when other diagnosis such as anxiety disorders; Axis II diagnosis, depression and, alcohol and substance abuse are identified in the process. In order to achieve good result, other symptoms should be addressed during therapy in During diagnosis, one of the most difficult tasks that therapists have to put up with is dealing with the client’s belief that they have become victims of fate and should therefore not spend too much effort or energy trying to redirect their lives. On average, PTSD clients suffer from mild depression and the treatment process should take place through small manageable that should smoothly lead to the next goal (Scott & Palmer 2003; NIH 2009).

            Treatment for PTSD takes place through a combined course of medications and counseling. Medications are administered to help reduce anxiety in the patient and in such way help him or her to overcome depression. Various drugs are used for treatment but the most common are fluoxetine (Prozac) and benzodiazepine. These are referred to as selective serotonin reuptake inhibitors (SSRIs) and are known to have very serious and long-term side effects. Counseling fro PSTD victims is often administered through the popular cognitive-behavioral therapy (CBT) as an attempt to help the patients understand the basis about their condition and  in the process devise ways of confronting and handling the disorder.

Family and group therapy can also be beneficial in treating PTSD. Through group therapy, victims going through the same problems meet through discussion forums to try and come up with solutions to their common problems. Group therapy helps victims because they gain a sense of belonging among others facing the same problems. Meeting others may help a victim to openly express his or her emotional experience for the first time since the trauma. Family therapy involves a patient’s family members in the treatment process by helping them to understand the patient’s condition and advising them on ways in which they can combine efforts to assist the patient through the recovery process (Scott & Palmer 2003; Sindran Institute 2008).

            Research into PTSD has also come up with the exposure therapy (ET), a new kind of psychological treatment that helps the patient to recall the traumatic experience that he or she went through; or exposes the patient to similar but safe situations that can still trigger traumatic feelings. Through exposure therapy, a patient re-learns the appropriate response to a traumatic experience through what is referred to as extinction learning. But it is a lengthy process and patients continue under the traumatic condition even while undergoing treatment. Scientists are however investigating drug therapies that could be used alongside ET to enhance its effectiveness. MDMA or ectasy has been identified as one such drug. Ectasy used combination with ET is under clinical trials with PTSD patients and results from two recent trials have been promising (Mukherjee 2009).

Conclusion

            The electronic and print media has exposed the public to the realities of PTSD and recognizes that such common occurrences as domestic violence, war, trauma, sexual assault, natural disasters and individual trauma are major causes of PTSD. Media coverage of traumatic events such as child abuse in the Bosnia genocide, Hurricane Andrew, Persian Gulf War and more recent events like 9/11 and Hurricane Katrina have helped to enlighten a public that until late 2980s knew very little about PTSD (Kinchin & Turnbull 2007; NIH 2009).

References

Kinchin, D. and Turnbull.G. (2007). A guide to psychological debriefing: Managing        emotional decompression and post-traumatic stress disorder. London, UK: Jessica     Kingsley Publishers.

Mukherjee, M. (March 9, 2009). Ectasy could help patients with post-traumatic stress      disorder. Journal of Psychopharmacology. SAGE. Retrieved 23 March, 2009 from      http://www.eurekalert.org/pub_releases/2009-03/spu_ech030609.php

National Institute of Health. Medline Plus (Winter 2009). PTSD: A growing epidemic.   Retrieved 23 March, 2009 from    http://www.nlm.nih.gov/medlineplus/magazine/issues/winter09/articles/winter-    09pg10-14.html

Scott, M.J. and Palmer .S. (2003). Trauma and post-traumatic stress disorder. Seminole, FL:     SAGE.

Sindran Institute (2008). What is post-traumatic stress disorder (PTSD)? Retrieved 23 March    2009 from http://www.sindran.org/sub.cfm?contentID=76&sectionid=4