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Post-Traumatic Stress Disorder (PTSD)

Overview

Post-Traumatic Stress Disorder (PTSD) is a debilitating anxiety disorder that fills people with fear and recurring terror. It typically stems from a horrifying event or series of threatening or violent incidents that happened to them in the past. According to The National Institute of Mental Health (NIMH), PTSD affects just over five million Americans. Women are twice as prone to developing the disorder as men. The onset of PTSD may be caused by a physically or emotionally violent act, or a life-threatening event, to the individual or their family members. Children may also develop PTSD if they are witness to or survivors of violence and abuse. People with PTSD may also develop one or more other anxiety disorders, suffer from depression, or abuse alcohol and drugs. In severe cases, the person may have trouble working, socializing, or visiting places where the trauma originally occurred or places that remind the individual of the experience.

Many people experience anxiety in remembering traumatic events in their lives. But people with PTSD repeatedly experience the event as a real-time incident that invades their daily activities or occurs in persistent nightmares. Ordinary work or social interactions with people can spark flashbacks or violent emotional reactions in individuals with PTSD. Fortunately, PTSD can be treated and managed with medications and therapy from professionals who specialize in the disorder. Some individuals experience recovery in six months, while others may remain on medication indefinitely to treat other underlying disorders such as depression or phobia.

Symptoms

Not everyone who experiences a profoundly disturbing physical or emotional event develops PTSD. The disorder was originally brought to the attention of the mental health community by military veterans who experienced life-threatening battles, saw or participated in killing, or whose lives were under constant peril. Today, PTSD diagnosis can be vital in treating survivors of violent crimes such as kidnapping, rape, or mugging. Other people with PTSD are among the survivors of natural disasters, or involved in horrific car, train or airplane accidents. Adolescents or adults who have experienced a long history of child abuse may also develop the disorder.

A person with PTSD may appear numb to people who were once dear to them. They may seem to have flattened human emotions in everyday interactions. On the other hand, an episode may flare out of nowhere and their moods will shift abruptly to irritability or explosive anger. If especially frightened by the association of a present event to their past, the person may become violent. They may be particularly vulnerable on the anniversary date of the original trauma. The individual may also experience long bouts of symptoms normally attributed to depression: sleeplessness, loss of interest in affection and sexuality, and loss of appetite. In children, PTSD may express itself through continuing emotional outbursts or acts of aggression. As the disorder progresses, the person may withdraw completely from work, school, friends and family.

Following the initial trauma, symptoms usually begin within three months. However, the illness has been known to develop years after the event. According to the NIMH, PTSD is diagnosed only if the symptoms last longer than a month. If you or a person in your life is experiencing these symptoms, an evaluation by a mental health professional is recommended to determine if there is a possibility of PTSD, or whether other anxiety or mood disorders are involved.

Causes, Genetic Factors and Cultural Influences

PTSD can occur in people of any age, including in children. Scientists have not discovered a genetic predisposition to PTSD. However, some anxiety disorders have genetic ties, and researchers continue to study whether children of adults with PTSD may be susceptible to the disorder. Other illnesses with genetic predispositions, including clinical depression or substance abuse, may accompany PTSD.

Current research has not found definite cultural factors in PTSD.

Risks

Occasionally adults as well as children may react aggressively to threats that do not appear to people around them.

Individuals with PTSD may have a chronic addiction to alcohol and drugs. They may display behavior that is confused, violent and unpredictable while under the influence of these substances.

People who have PTSD may also suffer from serious depression which may result in self-destructive or suicidal thoughts and behavior. If a person exhibits signs of suicide, they should be taken seriously. Do not hesitate to contact 911 emergency services in a crisis.

Treatment

No magic drug has been found to cure PTSD, and symptoms seldom go away completely. But PTSD can be effectively treated, managed, and minimized through the combined use of medication and intensive therapy. People with PTSD may find it helpful to attend PTSD support group meetings and share their concerns and feelings with others with similar experiences. A relatively new therapy called Eye Movement Desensitization and Reprocessing (EMDR) has been used with trauma survivors. With EMDR, the therapist leads the survivor through a range of physical eye exercises that can train the brain to react differently to memories.

A physician may initially prescribe anti-anxiety benzodiazepines like clonazepam (Klonopin®), lorazepram (Ativan®), and alprazolam(Xanax®) to temporarily regulate anxiety and sleeplessness. The FDA has cleared new medications called paroxetine (Paxil®), and sertraline (Zoloft®) for the direct treatment of PTSD. To treat underlying depression, the physician will prescribe selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), fluvoxamine (Luvox®), paroxetine (Paxil®), and citalopram (Celexa®). SSRIs have proven to be more effective in the treatment of women with PTSD than in men. Doctors may try combinations of drugs to find the most-effective regimen.

Cognitive-behavior therapy is helpful in assisting the individual to cope with anxiety, manage their anger, and deal with stress. Often therapists will use imagery and other experiential techniques to allow the person with PTSD to fully remember and react to their trauma in a safe environment. People with PTSD learn relaxation techniques for use when old memories flood in from triggering events. By combining newly learned techniques, the person with PTSD is better prepared to return to an active life of everyday stress.

How You Can Help

If you think a friend or family member needs help, the National Institute of Mental Health (NIMH) recommends that you encourage the individual to get an evaluation from a mental health professional. Family members and friends can help an individual recognize that they have an illness that can be treated if they are willing. It is important to understand that diagnosing serious mental illness is not simple or straightforward. Your doctor may need to revise the initial diagnosis, treatment and drug therapies one or more times over a period of weeks or months to find the best treatment regimen.

Sometimes, family members and friends need to intervene if a loved one with serious mental illness refuses to obtain treatment. This can be a very difficult situation for both the individual with the illness and the family members and friends. It is important to obtain assistance from a mental health professional to guide you through the medical and legal issues involved in an intervention.

Family members and friends of a person with serious mental illness can help by offering their support and affection to the extent possible. It is important to understand that people with serious mental illness cannot simply “pull themselves together” and get better. The support of family members and friends over the long term can be invaluable to an individual with a serious mental illness. Support groups can also be invaluable. Consumer groups offer individuals with mental illness an opportunity to share their needs, concerns and struggles with others in the same situation. Consumer support groups are available in many communities.

Family members and friends need to become educated about serious mental illness. They also need to take care of their own emotional needs. Support groups can also help family members and friends cope with their loved one’s illness. Family support groups provide a place for family members to share their experiences and obtain current information and education about their loved one’s mental illness.

NAMI Mt. San Jacinto maintains a list of  community resources and support to individuals and families needing help with serious mental illness. The list includes information, contact persons, crisis numbers, telephone listings, and email contacts.

Family physicians, mental health professionals, religious counselors, community mental health centers, social service agencies, state and private hospitals are also available to provide help and support as needed. Ask us for a current list mental health professionals (psychiatrists, psychologists, care homes, etc.) that provide support for serious mental illness in your community.

NAMI Mt. San Jacinto also offers the “Family-to-Family” program to educate and support families who have members afflicted with a serious mental illness.

Finally, and most importantly, do not hesitate to get help from your local 911 emergency service or suicide hotline in a crisis.

For additional information, visit these web sites

Anxiety Disorders Association of America

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