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Post Traumatic Stress Disorder

Post Traumatic Stress Disorder (PTSD) - Symptoms, causes, diagnosis and treatment.

Post Traumatic Stress Disorder of PTSD is a mental health disorder that is triggered by a frightening or scary event or incident either by experience or witnessing it. Symptoms may be taken as flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about that incident.
Most people who witnessed traumatic events may have temporary difficulty in adjusting for the situation and coping it, but as the time gets passed and good self care, they usually get better. If the symptoms gets worse, they will last for weeks, months or even years, and interfering into the day to day life, then you may have caught with PTSD.

* Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve functions.

Symptoms of PTSD - Post Traumatic Stress Disorder symptoms may start within one month of a traumatic or painful incident, but sometimes symptoms may not appear until after the actual incident. These symptoms can cause significant problems in your personal as well as social life, they can disturb working conditions or situations and can harm your close relationship status. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally categorized into four types :

1) Intrusive Memories.

2) Avoidance.

3) Negative changes in moods, thinking and thought processes.

4) Changes in emotional and physical reactions.

* Symptoms can vary over time or from person to person.

Intrusive Memories - Symptoms of intrusive memories may include the following :

1) Recurrent, unwanted distressing memories of the traumatic incident.

2) Reliving and remembering the traumatic incidents as they were happening again as flashbacks.

3) Upsetting dreams or nightmares about the traumatic event.

4) Severe emotional distress or physical reactions to something that reminds you of the traumatic episode.

Avoidance - Symptoms of avoidance may include the following :

1) Trying to avoid talking or thinking about the traumatic incident.

2) Avoiding activities, places or people that reminds you about the traumatic event.

Negative changes in moods, thinking and thought processes - Symptoms of negative changes in moods, thinking and thought processes may include the following :

1) Negative thoughts about yourself, other people, society or even the world.

2) Being hopeless about the future life.

3) Having memory problems, including not remembering important aspects of the traumatic incident or life.

4) Difficulty in maintaining close relationships due to negative and poor moods.

5) Lack of interest in activities once you've enjoyed.

6) Feeling of detachment from family and friends.

7) Feeling of emotionally numb.

8) Difficult to experience positive emotions and moments.

Changes in physical and emotional reactions - Symptoms of changes in physical and emotional reactions, they are also called as arousal symptoms and they may include the following :

1) Being easily frightened or startled.

2) Always being on guard for dangerous moments or situations.

3) Having self destructive behaviour, such as drinking too much or driving vehicles too rashly.

4) Having a trouble in sleeping.

5) Concentration problems.

6) Irritability, angry outbursts or aggressive behaviour.

7) Overwhelming guilt or shame due to past incident.

* For children of 6 years old or younger, signs and symptoms may also include the following :

1) Re-enacting the traumatic incident or aspects of the traumatic event through play.

2) Frightening and nightmarish dreams that may or may not include the aspects of the traumatic incident.

Intensity of symptoms - PTSD symptoms can vary in intensity in time. You may have more PTSD symptoms when you are stressed in general or when you come across reminders of what you have went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a news report about a sexual harassment and feel overcome by memories of your own assault.

When to see a doctor ?

If you have disturbing feelings and thoughts about a traumatic incident for more than a month, if they are serious and severe in nature or if you feel you are having trouble getting your life back under control, then it's a high time to talk to your doctor or consult a good mental health expert. Getting the treatment as soon as possible can help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts.

If you or someone you know has suicidal thoughts, get help right away through one or more of these resources :

1) First of all, call or reach out to a close friend or loved one.

2) You can seek help from government hospitals, officials or employees working in counselling centres, spiritual leaders from different religious institutions or someone in your faith community.

3) Call an emergency number for suicide prevention if provided or you can even call to police and police will arrange or provide proper counselling.

4) Make an appointment with your doctor or a mental health expert.

When to get emergency help ?

If you think that you may hurt yourself or attempt, always call 100 or your local emergency number immediately. If you know someone who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe. Or if you can do safely take that person to the nearest hospital emergency room.

Causes of Post Traumatic Stress Disorder - You can develop post traumatic  stress disorder when you go through or revisit, see, think, remember or learn again about an event involving actual or threatened death, serious hurt or sexual violation. Doctors and researchers are not sure about PTSD that why some people got involved. As with most mental health problems, PTSD is caused by a complex mixture of the following reasons :

1) Pressurized, stressful and traumatized experiences, including the amount and severity of trauma you have gone through in your life.

2) Inherited mental health risks, such as a family problem of anxiety and depression.

3) Inherited features of your personality often called your temperament.

4) The way your brain regulates the chemicals and hormones in your body releases in response to stress and trauma.

Risk factors involved in PTSD - People of all age groups can have post- traumatic stress disorder. However, some risk factors may make you more likely to PTSD after a traumatic events or incidents such as :

1) When you are experiencing intense or long lasting trauma.

2) When you have experienced other trauma earlier in life, for example, childhood abuse, mental harassment etc.

3) When you are doing such a job that increases your risk of being exposed to traumatic events, for example, military and police personnels, first rescuers and responders, people who are working in ambulance and mortuary services.

4) If you are facing any other mental health issues, such as, anxiety and depression.

5) Having problems with substance misuse such as, excess drinking alcohol or drug use.

6) When you are lacking a good support system of family and friends.

7) When your blood relatives with mental health problems, including anxiety or depression.

Kinds of traumatic events - The most common events leading to the development of PTSD include :

1) Combat and rescue exposure.

2) Childhood mental and physical abuse.

3) Sexual violence.

4) Sudden death of a loved one.

5) An accident.

6) Being threatened with a weapon for death.

7) Physical assault.

Many other traumatic events also can lead to PTSD, such as, fire, natural disaster, riot killings and violence, mugging, robbery, plane crash, torture, kidnapping, life threatening medical diagnosis, terrorist attack, losing judicial suit and other extreme or life threatening events.

Complications of PTSD - Post traumatic stress disorder can disrupt your whole life, it will include your job, relationship, social bonds and even your health and enjoyment of every day activities. Having PTSD may also increase your risk of other mental health problems such as :

1) Depression and anxiety.

2) Issues with drugs or alcohol use.

3) Eating and sleeping disorders.

4) Suicidal actions and thoughts.

Prevention of PTSD - After surviving a traumatic incident, many people suffered from PTSD like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt all are common reactions to trauma.
However, the majority of people exposed to trauma do not develop long term post traumatic stress disorder. Getting timely help and support from family members and friends may prevent normal stress reactions from getting worse and developing into PTSD.

This may mean turning towards family members who will listen and offer comfort. It may mean seeking out a mental health expert for a brief course of therapy. Some people may also find helpful when they have turn towards their faith community. Getting support from others also may help prevent you from turning to unhealthy coping methods such as over drinking or excessive use of drugs.

Diagnosis of PTSD - To diagnose post traumatic stress disorder, your will likely :

1) Perform a physical examination - To check for medical problems that may be causing your symptoms.

2) Do a psychological test - It will include a discussion of your signs and symptoms and the event or series of events that led up to them.

3) Use the criteria in the Diagnostic and Statistical Manual of Mental Disorder - As it was published by the American Psychiatric Association about the mental health disorders.

Diagnosis of PTSD requires exposure to an event or incident that involved the actual or possible threat of death, violence or serious injury. Your exposure can happen in one or more of these ways :

1) You directly experienced the traumatic event.

2) You witnessed, in person, the traumatic event occurring to others.

3) You learned someone close to you experienced or was threatened by the traumatic event.

4) You are repeatedly exposed to graphic details of traumatic events, such as, if you are a first responder to the scene of traumatic events.

You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.

Treatment of PTSD - Treatment of post traumatic stress disorder can help you in regaining a sense of control over your life. The primary treatment is psycho-therapy, but can also include medication. Combination of these treatments can help improve your symptoms by :

1) Skill teaching to you for addressing your symptoms.

2) Doctor can help you to think better about yourself, others, society and the world.

3) Learning new ways to cope if any symptoms arise again.

4) Doctor can also treat your pre-existing mental health problems like depression, anxiety, misuse of alcohol or drugs which are related to traumatic experiences.

* You don't have to try to handle the burden of PTSD on your own.

Psychotherapy - Several types of psychotherapies are also called as talk therapy, may be used to treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include the following :

1) Cognitive Therapy - This type of talk therapy helps to recognize or explore new ways of thinking or cognitive patterns that are keeping you stuck, for example, negative beliefs and thoughts about yourself and the risk of traumatic actions or events happening again. For PTSD, cognitive therapy is often used along with exposure therapy.

2) Exposure Therapy - This behavioural therapy helps you face both situations and memories that you think are frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful in the cases related to flashbacks and nightmares. You can approach through the use of virtual reality programmes that you allows you to re-enter the setting in which you experienced trauma.

3) Eye movement desensitization and reprocessing (EMDR) - EMDR uses the combination of exposure therapy with a series of guided eye movements that help you to process painful and traumatic memories and change how you react to them in a discretionary manner.

* Mental health expert is the best one that can help you to develop good stress management skills to help you to better handle stressful situations and cope with your stress in your life.
All these techniques will help you to gain control of lasting fear after a traumatic event. You and your mental health expert can discuss what type of therapy or combination of therapies will be best according to your needs.
You may try individual therapy, group therapy or both. Group therapy comes with an additional benefit of community support and it offers a way to connect with others going through similar experiences.

Medications of PTSD are as follows : Several types of medications can help improve your symptoms of PTSD -

Anti-depressants - These medications can help symptoms of anxiety and depression. They can also improve your sleeping problems and concentration. The Selective Serotonin Reuptake Inhibitor (SSRI) medications, Sertraline (Zoloft) and Paroextine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.

Anti- anxiety medications - These drugs can be helpful in relieving severe anxiety and depression related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short period of time.

Prazosin - If symptoms include insomnia with recurrent nightmares, a drug called Prazosin (minipress) can be helpful. Although, not specifically FDA approved for PTSD treatment, Prazosin may reduce or suppress nightmares in many people with PTSD.

* You and your doctor or mental health expert can work together to figure out the best possible medication medication with the fewest side effects for your symptoms and situations. You may experience an improvement in your mood and other symptoms within a few weeks.
 *Always tell your doctor or mental health expert about any side effects or problems that you are facing with medications. You need to try more than one or a combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for you.
  
Coping and Support - If stress and other problems caused by a traumatic event or incident affect your life, see you doctor or mental health expert. You can also take these actions as you continue with treatment for post-traumatic stress order.

Follow your medication and treatment plan - Although it may take a while to feel benefits from therapy or medications, treatment can be effective and most people do recover early and properly. Remind yourself that it takes time. Following your treatment plan and routinely communicating with your mental health expert will help move you forward.

Learning and knowing about PTSD - The knowledge and learning can help you understand and what you are feeling and then you can develop coping strategies to help you respond effectively.

Take care of yourself - Get enough rest and sleep, eat a healthy and nutritious diet, do exercise regularly and take time to relax in between when you are doing work at your job site. Try to avoid or reduce the use of caffeine and nicotine which can worsen anxiety.

Never self medicate - Turning to alcohol or drugs to numb your feelings isn't healthy, even though it may be tempting way to cope with problems. It can make the problems more severe or lead to more new problems down the road, interfere with effective treatments and prevent healing.

Break the cycle - Whenever you feel anxious, take a brisk walk or jump into a hobby to re-focus on the treatment.

Stay connected - Spend time with supportive and caring people such family, friends, faith leaders, or others. You don't have to talk about what you are feeling about the PTSD. Just share time with your close and loved ones, they can offer healing and comfort.

Consider a support group - Ask your mental health expert for help in finding a support group or contact senior or veteran's organizations. You can also take help from local support groups.

When someone you love has PTSD - The person you love may seem like a different person than you knew before the trauma, angry and irritable, for example, withdrawn and depressed. PTSD can significantly strain the emotional and mental health of loved ones and friends. Hearing about the trauma that led your loved one's PTSD may be painful and stressful for you and even cause you to relive difficult events. You may find yourself avoiding his or her attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty or offended that you are unable to do something to fix your loved one or hurry up the process of healing.

Remember that you can't change someone. However, you can do following things :

1) Learn about PTSD - This can help you understand what your loved one is going through and proper information and knowledge can give you some strength to support your loved one.

2) Recognize that avoidance and withdrawal are part of the PTSD - If your loved one resists your help, then never get irritated or angered about them. Allow some space and let your loved one know that you are always available when he or she is ready to accept your help.

3) Offer to attend medical appointments - If your loved one is accepting you and willing to take your participation in attending appointments can help you and you will provide great assistance with treatment.

4) Be willing to listen - Let your loved one know that you are ready and willing to listen, but you have to understand one thing very clear if he or she doesn't want to talk, never force them to talk.

5) Encourage participation - Plan opportunities for activities with family and friends. Celebrate good events such as birthdays, marriage anniversaries try to engage and encourage them to participate in the events.

6) Make your own health a priority - Take care yourself by eating healthy food, being physically active and getting enough rest. Take time alone or with friends, doing activities that help you recharge. Always remember that your strength will give strength to your loved one to fight with PTSD.

7) Seek help if you need it - If you have difficulty in coping, talk to with your doctor. He or she may refer you to a therapist who can help you work through your stress.

8) Stay Safe - Plan a safe place for yourself and your children because whenever your loved one becomes abusive or violent, he or she may hurt you or himself or herself unintentionally.

Preparations for the appointment - If you think that you may have post-traumatic stress disorder, make an appointment with your doctor or a mental health expert. Here is some information to help you prepare for your appointment and what to expect.
Take a trusted family member or friend along, if it is possible. Sometimes it can be difficult to remember all the information provided to you.

What you can do ? Before your appointment always make a list of the following :

1) Any symptoms you have been experiencing - Duration, frequency and intensity of symptoms are important ones.

2) Key personal information - Important information especially such as events or experiences, even in your distant past that have made you felt intense fear, helplessness or horror. It will help your doctor or mental health expert to know if there are memories you can't directly access without feeling an overwhelming need to push them out of your mind.

3) Things you have stopped doing or are avoiding - Because of the stress what activities or things you were doing, please tell the doctor.

4) Your medical information - Medical information means including all physical or mental health conditions with which you have been diagnosed. It also include any medications or supplements that you are taking and their dosages.

5) Questions to ask from doctor - You can ask certain questions with the doctor during your appointment. Some basic questions to ask your doctor or mental health expert may include written below :

I) What do you believe is causing my symptoms ?

II) Are there any other possible causes ?

III) How will you determine my diagnosis ?

IV) Is my condition likely short term or long term ?

V) What treatments do you recommend for this disorder ?

VI) I have other health problems . How best I can manage these together with PTSD ?

VII) How soon do you expect my symptoms to improve ?

VIII) Does PTSD increase my risk of other mental health problems ?

IX) Do you recommend any changes at home, work or school to encourage recovery ?

X) Would it help my recovery to tell my teachers or co-workers or other colleagues about my diagnosis ?

XI) Are there any printed materials on PTSD that I can have ? What websites do you recommend ?  

Do not hesitate to ask any other questions during your appointment.

What to expect from your doctor or mental health expert ? Your doctor or mental health expert is likely to ask you certain number of questions. Be always ready to answer them to reserve time to go over any points you want to focus on. Your doctor or mental health expert may ask the following questions :

1) What symptoms are concerning you or your loved one ?

2) When did you or your loved one first notice your symptoms ?

3) Have you ever experienced or witnessed a traumatic incident ?

4) Do you have disturbing memories, nightmares or thoughts of the trauma you witnessed ?

5) Do you avoid certain people, places or situations that remind you of the traumatic experience ?

6) Have you been having any problems at school, college work place or in your personal relationships ?

7) Have you ever thought about hurting or harming about yourself or others ?

8) Do you think that you will be harm or hurt by someone ?

9) Do you drink alcohol or take recreational drugs ? How often ?

10) Have you been treated for other psychiatric symptoms or mental illness in the past ? If yes, what type of therapy was most helpful ?

Source :
www.mayoclinic.org

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