Post Traumatic Stress Disorder Treatment
Disaster and Trauma
Goals for Mental Wellness
Learn More About PTSD
When put in a dangerous situation – whether as a witness or as a victim – the natural response is fear and anxiety. These emotions trigger changes in the brain and body designed to protect the person from the perceived danger. Called the “fight or flight” response, this reaction is healthy and normal, but in those who are living with post-traumatic stress disorder (PTSD), this response is damaged. In many cases, PTSD patients live in an almost constant state of “fight or flight,” perceiving normal situations as potentially dangerous and continuing to feel threatened long after the danger has passed.
According to the National Institute of Mental Health, PTSD is classified as an anxiety disorder that strikes some people who live through a traumatic event. No one knows why it develops in some survivors of trauma and not others, but those who do end up struggling with the disorder will require treatment in order to regain balance in their lives.
The National Institutes of Health estimates that 3.5 percent of the American population has PTSD due to sexual trauma, violence or natural disaster, and that about 36 percent of those cases are classified as severe. Unfortunately, only about half of those with the disorder get the help they need to heal.
If you or someone you care about is in need of post-traumatic stress disorder treatment, don’t wait to get the help you need. If your reaction to a traumatic event is severe and disrupting your life, there is pharmacological and psychotherapeutic treatments that can help you heal.
The diagnosis for post-traumatic stress disorder is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the manual used by physicians and psychiatrists to determine what types of treatment will be most effective for patients based upon their symptoms and experience.
According to the National Center for PTSD, a diagnosis for PTSD is given when a patient has been exposed to a traumatic event defined by specific characteristics and is experiencing symptoms from each of three symptom types, including intrusive memories, avoidance or numbing symptoms, and symptoms of arousal. If the patient has been living with these issues for a long period of time and they are disrupting his or her life, then a diagnosis is given – and treatment can begin.
The DSM-IV PTSD criteria includes the following:
- Stressor. The event that triggers the issues with PTSD can happen directly to the patient or they can witness the event. In either case, if the person’s response was intense fear, horror or helplessness, then the stressor qualifies as a PTSD criterion.
- Intrusive memories. In PTSD, memories of the traumatic event come back repeatedly and in such a way that the patient feels as if he or she is re-experiencing it. Flashbacks, vivid dreams, extreme responses to any cue that signifies the event, and physiological reactions to reminders of the traumatic incident are all criteria for PTSD.
- Avoidance and numbing. Patients with PTSD often go out of their way to avoid anything that reminds them of the trauma and emotionally shut down in an effort to stop the pain that comes with re-living the experience. Some will block out certain portions of the event; avoid any conversation, person or activity that reminds them of the trauma; feel detached from those with whom they were formerly close; and experience a lack of interest in anything. Many even believe that they don’t have much of a future in terms of family, careers or long-term health, and therefore don’t make plans or work toward goals.
- Arousal. An inability to stay asleep or fall asleep, angry outbursts or irritation, a hard time concentrating, being overly vigilant against danger, and an exaggerated response to unexpected or loud noises are all symptoms of arousal that can indicate PTSD.
- Duration. In order for PTSD to be an issue, symptoms must remain for more than a month. Symptoms that last less than three months are classified as acute while those that last longer than three months are chronic.
- Functional ability. When the above symptoms intrude on the patient’s ability to function at work, in social interactions and at home, then PTSD is likely the cause.
Why can one person go to war and return without experiencing symptoms of PTSD while another cannot? Why can one patient live through a natural disaster or experience a violent or sexual attack and still be able to function while others can’t? The answers to these questions are unknown, but according to PubMed Health, when certain people of any age experience anything from rape or a terrorist attack to a stay in prison or domestic abuse, post-traumatic stress disorder can result.
It is likely that psychological, genetic and social factors may play a part in the development – or not – of PTSD. When the right combination of influences is involved, the patient will experience a change in stress hormones and neurotransmitters after a traumatic event and the symptoms described above will occur. One thing that is known is that those who have a history of trauma will be more likely to develop PTSD after experiencing a new traumatic event.
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Disaster and Trauma
Anything from a human-caused event, like a terrorist attack, to a natural disaster, like a tsunami or hurricane, can qualify as a disaster that sparks PTSD in certain patients. Those who live through the events may ultimately develop symptoms of PTSD but those who are witness to the event on television may also experience issues as well.
According to the United States Department of Veteran Affairs, there are three phases that people go through when they develop PTSD after a disaster or public trauma. These include:
- Impact phase. Most people will respond in an effort to protect themselves and their loved ones during a disaster. Some, however, shut down and are unable to function – or even move – while the event is happening. This inability to recognize and process the danger while it is happening and respond effectively may indicate a cognitive issue or a degree of dissociation and can be the initial phase of PTSD. When stressors – like loss of a loved one, injury, threat to life, torture or bearing witness to any of these happening to someone else – occur, it can make the ordeal even more traumatic.
- Immediate post-disaster phase. Patients with PTSD will show the initial symptoms during this period, often being completely stunned or demonstrating a great deal of anxiety. Nightmares, anger, depression, helplessness, fear, denial and numbness are all common.
- Recovery phase. Re-adjusting and learning how to live normally after a trauma is the focus of this period. It will take different amounts of time and be characterized by various symptoms depending upon the patient. When treatment is attempted during this time, it can be a much quicker, safer experience for all involved.
The National Center for PTSD reports that as many as 13 percent of women have experienced a sexual attack or trauma during their lives. Childhood sexual abuse is even higher, with 27 percent of women reporting the experience. Though not all of these women will develop PTSD as a result, some will experience problems for years. According to the National Institute of Mental Health (NIMH) some possible issues include:
- Physical problems. Diabetes, asthma, back pain, headaches, obesity, digestive issues, hypertension and other ailments may be more common.
- Psychological issues. PTSD is the most common psychological issue reported by women who have experienced sexual trauma, but depression, anxiety and eating disorders are also common. One study reported that about 45 percent of women and 65 percent of men who experienced a rape ultimately developed PTSD.
- Interpersonal issues. The ability to trust in a new relationship is often difficult for those who have experienced sexual trauma. In long-term relationships, recurring issues based on the trauma can have a negative impact on the couple’s ability to function.
There are a number of different types of violence and each type can have a significant impact upon the survivor or witnesses to the attack. Some of the most common types of violence that can trigger a problem with post-traumatic stress disorder include:
- Community violence. Drive-by shootings, riots and terrorist attacks all fall into the category of community violence and can have a huge impact on those who are victim to the incidents, those who lose someone in the events, and those who witness the events and feel threatened.
- War. It is estimated that about 38.8 percent of men who experience combat will develop an issue with PTSD when they return home. The horrors of war are unspeakable and the constant threat of death can take its toll on the human psyche in a very brief period of time.
- Domestic violence. A child who is witness to domestic violence can have just as serious issues with PTSD as the adult who experiences the attack. Both will certainly need counseling, but patients who experience symptoms of PTSD will need more comprehensive mental health care.
- Personal attack. A robbery, car jacking, mugging – these are just a few of the types of one-on-one attacks that can trigger PTSD.
Moving Forward: Goals for Mental Wellness After Trauma
When a patient experiences a multitude of symptoms that disrupt their lives and make it difficult or impossible for them to experience functional relationships in the world, PTSD treatment is the only answer. The goals of treatment will vary depending upon the individual and his or her experience and needs, but in general, treatment will include:
- Learning how to trust individuals again. Issues of power and victimization often come up when a patient has fallen victim to a trauma in the past. Addressing those issues and learning how to cope on an interpersonal level is crucial.
- Learning how to trust situations and take risks. Leaving the house, getting into an empty car, walking into a dark room or down an isolated path – many who have lived through an attack may panic at these situations.
- Finding meaning and value in day-to-day life. Losing sight of what’s important and lacking enjoyment in life are common consequences of PTSD. It’s important that patients learn how to live their lives and find a focus for themselves other than revenge or over-zealous preparation for another attack.
- Dealing with emotions. Guilt, shame, depression, powerlessness – these emotions can be gripping when PTSD is an issue and too overwhelming to handle alone.
- Realistic protections. Ensuring that the trauma doesn’t repeat itself is impossible, but patients can do things like take self-defense classes, store up on supplies in the event of a natural disaster, and create safety plans that will help them feel better able to protect themselves in an emergency.
Comprehensive PTSD Treatment
In most cases, the best way to treat symptoms of post-traumatic stress disorder is to provide the patient with both medication and psychotherapy, according to the US National Library of Medicine. A number of studies have explored the effects of different drugs and types of therapy, and multiple psychotherapeutic and medical organizations have developed guidelines for treatment that have been proven effective. Comprehensive PTSD treatment may include all or some of the following:
- Medication. The US Food and Drug Administration (FDA) has approved Zoloft (or sertraline) and Paxil (or paroxetine) for the treatment of post-traumatic stress disorder. Both are antidepressants, which can help patients deal with the numb feeling as well as the depression and anger that may characterize their struggle with the disorder. Alone, medication is not an effective treatment but it can set the stage for more effective care in psychotherapy.
- Exposure-based treatments. According to the Overview of Psychotherapy for PTSD, putting patients in the position to safely re-experience the traumatic event can help them to drain the triggering incident of its power. There are a number of different types of exposure treatments that have been proven effective but Prolonged Exposure (PE) has garnered the most attention. In PE, imaginal and in vivo exposure to situations that have formerly triggered fear, because they remind the patient of their trauma, has helped patients to build confidence.
- Cognitive treatments. The most widely researched form of psychotherapeutic treatment for PTSD, according to the VA/DoD Clinical Practice Guidelines, cognitive treatments help patients to confront maladaptive perspectives based on their traumatic experience and deal with acute issues of fear that they experience in day-to-day life as well as ongoing beliefs that maintain the construct that life is meaningless or without value.
- EMDR. Eye movement desensitization and reprocessing (EMDR) was developed specifically to treat patients struggling with PTSD and works in combination with cognitive therapy and medication to help patients heal. Bilateral stimulation (such as eye movements, tapping, etc.) are performed by the patient as he or she is exposed to images that trigger reminders of their trauma. This eight-stage approach to treatment can be extremely effective in combination with other therapies.
Learn More About PTSD Today
If you or someone you care about is living with flashbacks, nightmares, rage outbursts or an inability to function normally in everyday life due to a traumatic event, treatment is available that can help. Change the trajectory of your life today and rediscover your link to the future you deserve. Call now.