PTSD or post-traumatic stress disorder is a type of mental health illness that people go through after they have experienced something traumatic and life threatening in their lives. These situations can be a car accident, natural disaster, sexual assault or during the war.
It is normal for people to experience upsetting memories, feeling on edge or even get trouble sleeping after they have experienced such traumatic events. During the first few days or weeks after the event, it may even be difficult to go through a daily routine of going to work, school or even spend time with people that you are close. However, most people start feeling better a couple of weeks or months after.
When the feelings of depression or other symptoms associated with PTSD gets worse and has gone more months than expected, there is a high probability that the person is experiencing PTSD. In some individuals, the symptoms of PTSD starts a little later on. Sometimes, they come and go.
History of PTSD
Little do most people know today, but PTSD around a century ago was known for something else. It was referred to as shell shock, with other names called as soldier’s heart, bullet wind, operational exhaustion and battle fatigue. It is a phrase coined during the first world war in describing the kind of post-traumatic stress disorder that happened in most soldiers that got afflicted in the war. It is the kind of reaction of the body to the magnitude of the fighting and bombardment that resulted in helplessness that appeared variously as being scared and panicking, flight, and even develop the inability to talk, walk, sleep or reason.
During World War I, the idea of shell shock was not defined well. It is because the cases associated with shell shock often gets interpreted as lacking the moral fiber, psychological or physical injury. You can still hear the term ‘shell shock’ used by the Veterans Administration as a way to describe certain areas of PTSD. However, it has already entered into mainstream memory and imagination, and the term is now often defined as a signature injury acquired during the war.
Factors Leading to PTSD
PTSD can affect anyone, just like a normal depression does. It is to tell people that it is not a sign of being weak. Some factors increase the case that someone has PTSD and many of these cases are not under the control of the person. One example would be having that long-lasting or very intense traumatic situation or getting injured on a certain event can make it highly likely for the individual to develop post-traumatic stress disorder. This kind of illness is also common to take effect after certain kinds of trauma like sexual assault and combat warfare.
Other factors like the personal one such as traumatic exposure in the past, gender, and age can affect whether the person develops PTSD or not. What likely will happen after a traumatic event is very important to understand, too. Stress can highly likely develop PTSD while getting the right social support will less likely develop this particular case.
Symptoms of PTSD
The symptoms of PTSD usually takes effect after a traumatic event, but in some cases, they may not appear for months or years. There are also situations wherein they come and go for many years. If the symptoms do last longer over four weeks, causes great distress to a person or it interferes with home or work life, the person has a high possibility of having PTSD.
There are four symptom types associated with PTSD, but they may not exactly be the same with everyone. Every person experiences PTSD symptoms differently.
Reliving an event – also referred to as re-experiencing symptoms, wherein the person may have nightmares or bad memories. They may even feel that they are going to the event all over again. Another term for this case is called the flashback.
Avoid situations reminding the person of the event – they may try to avoid people or situations that trigger their memories that traumatized them. They may even avoid thinking or talking about the said event.
Hyperarousal – the person always feel keyed up that they feel jittery or that they are always on alert, looking out for any danger that may approach. Or they could have trouble sleeping or concentrating. They might suddenly get irritable or angry, gets startled easily or even act in ways that are unhealthy to their bodies such as the use of drugs, smoking, and alcohol. There are also cases where they drive recklessly, too.
PTSD on Children
Children can get affected by PTSD as well. They may develop symptoms as described above or any other symptoms depending on their age. When children get older, the symptoms are likely to develop on the same scale like the adults go through. Below are some examples of symptoms common among children with PTSD:
- Children under six years of age may get irritated or upset when they are not close with their parents or when they are not nearby. They have trouble getting sleep, or they can act out their trauma through their play
- Children between the age of 7 and 11 may also act their trauma through their play, stories or drawings. Some may even have nightmares, may get aggressive or get more irritable. They even want to avoid school, have trouble getting along with friends or even with school work.
- Children between 12 and 18 will develop symptoms similar to what adults go through – withdrawal, anxiety, depression or even with reckless behavior like abuse with drugs or running away.
Other problems associated with PTSD
The ones listed above are common symptoms, but there are also other problems that link to PTSD.
- Employment problems
- Chronic pain felt throughout the body
- Drug or drinking problems or both
- Anxiety or depression
- Feelings of despair, shame or hopelessness
- Relationship problems like divorce
In most cases, the treatments designed for people living with PTSD help other problems that they are also facing since they are sometimes related to each other. There are coping skills taught during treatment which works well on PTSD symptoms and all other related problems.
Getting better from PTSD
Getting better from the effects of PTSD usually means that the person diagnosed with it must undergo treatment. However, the kind of “getting better” means differently on each person. There are various options for treating PTSD. These treatments, on most people, can help get rid of all the symptoms together. Others may find that there are fewer symptoms left or that they feel the symptoms are getting less intense. It can also be that the symptoms are still there, but it no longer interferes with daily activities, relationships, and work.
Treatments designed for PTSD
Treating PTSD comes with two main types, these are medication and psychotherapy, with the latter also referred to as talk therapy or counseling. Sometimes people with PTSD combine both treatments to get better results.
Also called as counseling, it involves talking with a therapist. There are various psychotherapy types:
Cognitive behavioral therapy (CBT) – among the two types, this is the most effective to use as a treatment for post-traumatic stress disorder. Under this type lies different types as well, like exposure therapy and cognitive therapy
- CPT – also known as Cognitive Processing Therapy, this a type of CBT that lets you learn skills in understanding how trauma has changed a person’s feelings and thoughts. By changing how they think about trauma, it will change on how they feel, too.
- PE – Prolonged exposure is where the person with PTSD talks about their trauma on a repeated cycle until the memories are no longer painful or upsetting them. It helps them get more in control over their feelings and thoughts about their trauma. They also got to do things or go to places that are safe for them. But these are things or places that the person has been staying away from because it reminds them of the trauma.
Eye Movement Desensitization and Reprocessing (EMDR) – another similar kind of therapy wherein it involves concentrating on the hand movements or sound while the patient talks about their traumatic event. It will help their brain work through their traumatic memories.
Other Types of Psychotherapy
The other types are also considered trauma-focused and the ones suggested below are also recommended for treating people who have PTSD.
BEP – Brief Eclectic Psychotherapy is a kind of therapy wherein the patient practices relaxation skills then recall the details of their traumatic experience, reframing of the negative thoughts about their trauma, writing a letter about it and even conduct a farewell ritual to leave the trauma back in the past.
NET – Narrative Exposure Therapy is for people that have experienced trauma from being involved in an ongoing conflict, organized crime, and war. The patient talks through stressful events in their life in order and gathers them into a story.
CBT – this one refers to a specific kind of cognitive behavioral therapies wherein it includes some psychotherapies proven to work on PTSD wherein the provider aids the patient in learning how to change thoughts and behaviors that are not helpful for them.
Based on the studies associated with treating PTSD, using antidepressants help control the symptoms of PTSD like worry, sadness, anger and even the feeling of being numb inside. Antidepressants, including other medications, are prescribed by the doctor together with psychotherapy. Other medicines are specified by the doctor and will differ depending on the case with their patient. They are usually targeting specific symptoms. For instance, there is one medication that is not approved by the FDA, but research shows that Prazosin may help address sleeping problems, especially patients that are suffering from nightmares, a symptom common among people living with PTSD.
Patients work together with doctors to find the best combination of medication that will help alleviate the symptoms. It also includes finding the right dose, too.
The medications that are shown to help treat people living with PTSD are also some of the similar medications used for treating anxiety and depression. These are SSRIs or selective serotonin reuptake inhibitors, and the SNRIs, which medically mean serotonin-norepinephrine reuptake inhibitors. Both affect the degree of chemicals that naturally occur int he brain referred to as serotonin and the norepinephrine. These chemicals have active roles in communication between brain cells, and it also affects how one feels.
The following are the prescribed anti-depressants for patients with PTSD:
- Venlafaxine (Effexor)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
In treating PTSD other medications are being used, but these four are the ones at the top and the most effective in treating PTSD.
Drug Abuse and PTSD
About 66 percent of the people living with PTSD is also reported to battle their addiction to drugs. They are far more in need of help compared to those without PTSD yet are into drug addiction, too.
Substance addiction, abuse and its relation with PTSD are very complex that it even complicates the modalities with treatments. The high degrees of stress makes it more likely for the person to turn to alcohol and drugs as a means for them to get away from their pain. When it gets out of control, it will become more difficult for the brain to regulate the amounts of adrenaline, dopamine, and GABA at normal speed. The cravings for drugs, alcohol and the uncomfortable symptoms of withdrawals even makes it more difficult for the person to stop using drugs when they become dependent on it.
When drug and alcohol addiction occur together with PTSD, it is important to seek treatment for both of these disorders. If the doctor sees that the drug dependence has become significant, the first step they usually take is detox. Going for medical detox is necessary when PTSD can heighten the intensity of the withdrawal symptoms. A specialized person will be at the facility that will oversee the treatment, who will stay with the patient for a couple of days. A combination of pharmacological tools and supportive care is used to help the patient reach the acceptable physical stability level and make them ready for admission in a specialized treatment center which specializes in healing co-occurring disorders.