PTSD (POST TRAUMATIC STRESS DISORDER)

By Chris Clayton

WHAT IS PTSD?

PTSD, or Post Traumatic Stress Disorder, is a psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood. Most survivors of trauma return to normal given a little time. However, some people will have stress reactions that do not go away on their own, or may even get worse over time. These individuals may develop PTSD. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the persons daily life. People with PTSD experience three different kinds of symptoms. The first set of symptoms involves reliving the trauma in some way such as becoming upset when confronted with a traumatic reminder or thinking about the trauma when you are trying to do something else. The second set of symptoms involves either staying away from places or people that remind you of the trauma, isolating from other people, or feeling numb. The third set of symptoms includes things such as feeling on guard, irritable, or startling easily. PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that people with PTSD often may develop additional disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the persons ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting. PTSD can be treated with psychotherapy (talk therapy) and medicines such as antidepressants. Early treatment is important and may help reduce long-term symptoms. Unfortunately, many people do not know that they have PTSD or do not seek treatment. This fact sheet will help you to better understand PTSD and the how it can be treated.

HOW COMMON IS PTSD?

An estimated 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse. About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced clinically serious stress reaction symptoms. PTSD has also been detected among veterans of other wars. Estimates of PTSD from the Gulf War are as high as 10%. Estimates from the war in Afghanistan are between 6 and 11%. Current estimates of PTSD in military personnel who served in Iraq range from 12% to 20%.

DIAGNOSIS/SYMPTOMS

There are three main kinds of symptoms that clinicians look for when diagnosing posttraumatic stress disorder (PTSD). These include re-experiencing symptoms, avoidant symptoms and symptoms of increased arousal. Re-experiencing symptoms include ways in which the person persistently re-experiences the traumatic event. These symptoms may include the following: Intrusive memories of the traumatic event Recurrent, distressing dreams about the traumatic event Acting or feeling as if the traumatic event is reoccurring Mental and physical discomfort when reminded of the traumatic event (e.g., on the anniversary of the traumatic event) Avoidant symptoms are ways in which the person tries to avoid anything associated with the traumatic event. These symptoms may also include a numbing effect, where the persons general response to people and events is deadened. Avoidant symptoms include the following: Avoiding thoughts or feelings, people or situations (anything that could stir up memories) associated with the traumatic event Not being able to recall an important aspect of the traumatic event Reduced interest or participation in significant activities Feeling disconnected from others Showing a limited range of emotion Having a sense of a shortened future (e.g., not expecting to have a normal life span, marriage or career) Symptoms of increased arousal may be similar to symptoms of anxiety or panic attacks. Increased arousal symptoms include the following: Difficulty concentrating Exaggerated watchfulness and wariness Irritability or outbursts of anger Difficulty falling or staying asleep Being easily startled

CAUSE AND EFFECTS FROM PTSD SYMPTOMS

CAUSES OF PTSD?

Living through or seeing something that's upsetting and dangerous can cause PTSD. This can include: Being a victim of or seeing violence The death or serious illness of a loved one War or combat Car accidents and plane crashes Hurricanes, tornadoes, and fires Violent crimes, like a robbery or shooting.

PTSD VICTIMS

FACTS AND STATISTICS

An estimated 70% of adults in the United States have experienced a traumatic event at least once in their lives, and up to 20% of these people go on to develop Posttraumatic Stress Disorder, or PTSD. An estimated 5% of Americans more than 13 million people have PTSD at any given time. Approximately 8% of all adults one of 13 people in this country will develop PTSD during their lifetime. An estimated one out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD. This may be due to the fact that women tend to experience interpersonal violence (such as domestic violence, rape or abuse) more often than men. Almost 17% of men and 13% of women have experienced more than three traumatic events in their lives. The estimated risk for developing PTSD for people who have experienced the following traumatic events is:

Rape (49 %) -Severe beating or physical assault (31.9 %) -Other sexual assault (23.7 %) -Serious accident or injury; for example, car or train accident (16.8 %) -Shooting or stabbing (15.4 %) -Sudden, unexpected death of family member or friend (14.3 %) -Childs life-threatening illness (10.4 %) -Witness to killing or serious injury (7.3 %) -Natural disaster (3.8 %)

PTSD STATISTICS CHART

MEDICATION AND TREATMENTS

Some medications have shown benefit in preventing PTSD or reducing its incidence, when given in close proximity to a traumatic event. These medications include: Alpha-adrenergic agonists. Anecdotal report of success in using clonidine ("Catapres") to reduce traumatic stress symptoms[105] suggests that it may have benefit in preventing PTSD. Beta blockers. Propranolol ("Inderal"), similarly to clonidine, may be useful if there are significant symptoms of "over-arousal". These may inhibit the formation of traumatic memories by blocking adrenaline's effects on the amygdala.[106] Glucocorticoids. There is some evidence suggesting that administering glucocorticoids immediately after a traumatic experience may help prevent PTSD. Several studies have shown that individuals who receive high doses of hydrocortisone for treatment of septic shock, or following surgery, have a lower incidence and fewer symptoms of PTSD.[107][108][109] Psychobiological treatments have also found success, especially with cortisol.[97] Psychobiological treatments target biological changes that occur after a traumatic event. They also attempt to chemically alter learning or memory formation. Cortisol treatments after a traumatic event have found success in mitigating later diagnosis of PTSD. As discussed earlier, cortisol is often lower in individuals who are at risk of PTSD after a traumatic event than their counterparts. By increasing cortisol levels to normal levels this has been shown to reduce arousal post event as well prevent GR upregulation. Ecstasy may be used to help Post-Traumatic Stress Disorder (PTSD) patients. Researchers in South Carolina found that the purer form of Ecstasy, MDMA, can help treat the mental illness if it is coupled with psychotherapy but further research is needed.

PREVENTION

Modest benefits have been seen from early access to cognitive behavioral therapy, as well as from some medications such as propranolol.[97] Critical incident stress management has been suggested as a means of preventing PTSD, but subsequent studies suggest the likelihood of its producing iatrogenic outcomes.[98][99] A review "...did not find any evidence to support the use of an intervention offered to everyone", and that "...multiple session interventions may result in worse outcome than no intervention for some individuals.[100] The World Health Organization recommends against the use of benzodiazepines and antidepressants in those who have experienced trauma.[101]

DISCOVERIES/EFFECTS
Emotional stress caused by last year's tsunami caused a part of some survivors' brains to shrink, according to scientists in Japan who grasped a unique chance to study the neurological effects of trauma. On a quest to better understand post-traumatic stress disorder (PTSD), the researchers compared brain scans they had taken of 42 healthy adolescents in other studies in the two years before the killer wave, with new images taken three to four months thereafter.

Previous studies had already suggested that PTSD patients undergo changes to the brain, but this is the first to pinpoint which part of the organ is altered by trauma.
The full implications of these findings are so far unclear, but there could be an early benefit for doctors and patients. Telltale changes in brain volume may help easier diagnoses of PTSD and timely treatment with psychotherapy. The researchers also found that people with a smaller anterior cingulate cortex before a traumatic event were more prone to develop PTSD thereafter

WANT TO KNOW MORE ABOUT PTSD?

Aug 18, 2009 Dr. Barbara Rothbaum, is the Director of the Trauma and Anxiety Recovery Program at Emory University School ... Video: Understanding PTSD | Watch This Emotional Life Online ...
http://video.pbs.org/video/1218601697/

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