PTSD

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Dr. Bhushan Ambadkar
Psychiatrist

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Post-traumatic stress disorder or PTSD is a severe disorder that was first noticed as early as the 19th century in soldiers and called by various names, including battle fatigue; this term was formally recognised in 1980. PTSD affects people who have suffered some sort of traumatic events such as a near-death experience, sexual abuse or serious injury. It is a serious mental condition that can be debilitating on many levels. Initial symptoms are called acute stress disorder; only if symptoms continue for more than a month is the condition considered to be PTSD. There are a standard set of psychological tests to diagnose PTSD, which includes disturbing flashbacks, avoiding the memories of the event or high anxiety levels. Women possibly suffer from PTSD more because they are likelier to be at the end of sexual abuse. Moreover, soldiers, rape victims and people who have grown up in abusive families have a tendency to suffer from PTSD. PTSD affects mental and physical health, relationships and even job performance. The most common symptom of PTSD is flashbacks of the event in question.

The various treatment options depend on the nature of events. Some common ones include individual therapy, group therapy, medication, hypnosis, and eye movement desensitisation and reprocessing (EMDR), a type of psychotherapeutic process.

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Types

PTSD has not been classified into types; however, depending on the symptoms, it may be classified into simple and complex.

Symptoms

PTSD affects both mental and physical health, relationships and even job performance. This arises as a delayed and/or protracted response to stressful even the most common symptom of the condition is occurring against persisting background of emotional numbness and blunting. They are extremely debilitating and make the individual feel like they have travelled back in time and their tormentor (or the event that tormented them) is still there. What people require to understand is that when that happens, it is not like your feet are in the here-and-now but your head is somewhere else. Rather, it feels like your entire being is back in time, thus reliving the trauma and experience of the event. Moreover, a person can be triggered by even the smallest reminders. For example, let us say a woman was raped by her boyfriend; for her, walking past a perfume store and suddenly smelling the cologne he used to wear could act as a trigger for PTSD. Similarly, walking down the street and seeing a man who is wearing the same type of cap her boyfriend wore or going on a date with a man and him taking her hand might act as a trigger. Years can pass by; however, a person with PTSD can still experience flashbacks that make it feel like the event is happening all over again.

Everyone differently experiences PTSD; you may be able to recognise some, all or no symptoms mentioned below; they include:

Remembering aspects of previously happened scenarios:

Flashbacks that are intense


  1. Disturbing images and thoughts of the past

  2. Nightmares

  3. Feeling distressed about traumatic experiences

  4. Experiencing symptoms such as sweating, nausea or trembling


Feeling of alertness or being on edge:

  1. Getting angry or upset quickly

  2. Lack of sleep

  3. Experiencing panic when thoughts of the trauma occur

  4. Being quickly startled

  5. Difficulty in concentrating

  6. Symptoms related to anxiety


Thought of avoiding feelings and memories

  1. Trying to keep yourself constantly busy

  2. Having trouble remembering things

  3. Feeling emotionally detached and cut off

  4. Inability to express any affection

  5. Doing self-damaging things


Difficult in trusting or believing:

  1. Feeling unsafe everywhere

  2. Feeling nobody can understand you

  3. Blaming yourself for things

  4. Overwhelming feelings of sadness, guilt or anger

Causes And Risk Factors

Causes


Any situation that is extremely threatening or catastrophic in nature might cause a traumatic impact on a person and can result in PTSD. These experiences include:

  1. Road accident that leaves a severe effect on someone after the incident

  2. Experiencing assault, robbery or mugging

  3. Long-standing health problems

  4. Post childbirth in new mothers


PTSD immediately occurs or can even surface after months, years or weeks later. It affects almost one in three people who experience such things.

Risk Factors


Women are far likelier to suffer from PTSD because they are likelier to be at the end of sexual abuse. Moreover, soldiers, rape victims and people who have grown up in abusive families have a tendency to suffer from PTSD. There is an interesting evolutionary explanation of PTSD, which says that it is caused by events that our ancestors were not exposed to in everyday life. Therefore, people who have survived fires do not seem to suffer from PTSD as much as war victims perhaps because modern warfare is relatively new compared to forest fires, which have been around for ages. Moreover, studies demonstrated that children under the age of 10 are less likely to show symptoms than adults.

Prevention

A traumatic event cannot be prevented; however, you can attempt to prevent the occurrence of PTSD by -


  1. Asking for help and support

  2. Managing your emotions

  3. Focus on positivity

  4. Try to stay in contact with the important people in your life

  5. Vent out your feelings

  6. Consider yourself as a survivor and not a victim

Diagnosis

The initial symptoms are called acute stress disorder and only if they continue for more than a month is the condition considered PTSD. Not all people who go through a traumatic event develop PTSD; however, all those who had PTSD have been through a traumatic event. There are a standard set of psychological tests to diagnose the condition that includes disturbing flashbacks and avoiding the memories of the event or high anxiety levels.

Treatment

The different treatment options depend on the nature of events. Some common ones include individual therapy, group therapy, medication, hypnosis, eye movement desensitisation and reprocessing (EMDR) , a type of psycho-therapeutic process). For some people, religion and spirituality works. For some, getting involved in community events/advocacy relating to their trauma can serve as an avenue of healing that enables them to transform their experience into one that has a positive impact on the world. Pharmacotherapy could be used when and where required.

There are multiple activists in their respective causes who have shared that they were motivated to get involved because they went through a trauma and wanted to channel their energy into something productive. Ashley Judd, an American actress and daughter of famous American country singer Winona Judd, is an activist and has shared that she is a three-time rape survivor.

Lifestyle/management

You can strengthen your mental health by following a few tips like:

Do not feel helpless-

Recovering from PTSD is a slow long term process. You can help yourself by:


  1. Learning about what PTSD is.

  2. Joining a support group that includes people like you.

  3. Practising yoga and other relaxation techniques.

  4. Try to exercise.

  5. Vent your feelings out to a trustable family member or friend.

  6. Spend time with people that help you think positive.

  7. Try to avoid drinking alcohol or smoking.

  8. Go for walks and treks, try to enjoy nature and its calmness.


Move on:

Exercise helps to release endorphins and improve your mood. You can try:

  1. Exercises such as walking, dancing, swimming engages both your arms and legs and help to focus on a rhythm that can give you a sense of calmness.

  2. Rock climbing, boxing, and martial arts help you focus on body movements.

  3. Relaxation techniques like being out in nature and doing outdoor activities such as hiking and trekking help.


Try to keep up with a healthy lifestyle:

  1. Take time to relax by meditating, breathing, and massaging.

  2. Avoiding drugs and substance abuse.

  3. Eating nutritious food and incorporating foods rich in

  4. Omega-3 such as flaxseeds, walnuts, and fish, help to control mood fluctuations.

  5. Getting enough sleep of >7–9 h can help you keep a stable mood throughout the day. Try to keep your bedroom as pleasant as possible to experience a soothing environment.

Prognosis And Complications

Prognosis


If you detect PTSD soon and take the appropriate treatment, it will improve over the course of time. Treatment helps even if you faced the trauma many years ago. Continuous treatment helps with coping with PTSD-like symptoms.

Complications


If PTSD is not treated in time, it affects the suffering person and their family. Conditions normally caused by untreated PTSD are listed below:

  1. Mood disorder

  2. Panic disorder

  3. Anxiety disorder

  4. Substance abuse

  5. Dementia

References


  1. Mind. Post-Traumatic Stress Disorder - Symptoms. [Internet] [Updated on: January 2021 ] Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/symptoms/. Accessed on: 28 March 2021. (https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/symptoms/)

  2. National Health System. Post-Traumatic Stress Disorder. [ Internet] [Updated on: September 2018] Available at: https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/ Accessed on: 28 March, 2021 (https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/)

  3. Cleveland Clinic. Post-Traumatic Stress Disorder. [Internet] [ Updated on 20 January 2021] Available at: https://my.clevelandclinic.org/health/diseases/9545-post-traumatic-stress-disorder-ptsd Accessed on: 28 March, 2021 (https://my.clevelandclinic.org/health/diseases/9545-post-traumatic-stress-disorder-ptsd)

  4. Helpguide. Self-help for PTSD. [Internet] [Updated on November 2020] Available at: https://www.helpguide.org/articles/ptsd-trauma/ptsd-symptoms-self-help-treatment.htm Accessed on: 28 March, 2021. (https://www.helpguide.org/articles/ptsd-trauma/ptsd-symptoms-self-help-treatment.htm)

  5. NCBI. Article number- NBK559129. PTSD. [Journal] [Updated on: February 2021] Available at: https://www.ncbi.nlm.nih.gov/books/NBK559129/ Accessed on: 28 March, 2021. (https://www.ncbi.nlm.nih.gov/books/NBK559129/)

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