Post-Traumatic Stress Disorder
“The human nervous system learns well, sometimes too well. A life-threatening experience, just once, can teach your brain to be cautious about anything even remotely resembling that experience, for years.” This, says psychiatrist Jim Phelps, appears to be central in the development of post-traumatic stress disorder.
What is PTSD?
Post-traumatic stress disorder (PTSD) can develop after a person experiences a traumatic event that harmed or threatened them or a loved one, or they witness such an event. Examples include: violent assault, the death of a child, natural or manmade disasters, military combat, and automobile accidents.
“After I watched my brother get shot, I felt afraid all the time. Although he recovered, I just couldn’t seem to get over it. I had awful nightmares and memories; I’d cry and shake. Medication and therapy really helped and I am starting to feel like myself again.”
Fear, an emotion that evolved to protect us from danger, causes an automatic protective response of hormones and neurotransmitters. But for people with PTSD, that response continues to occur long after the danger has passed.
PTSD is often accompanied by depression, substance abuse or an anxiety disorder. Symptoms can start within about three months of the event or not until years later. Some people get better within months, while others may have the illness for much longer.
What are the symptoms of PTSD?
If you have PTSD, you often have nightmares or frightening thoughts about the experience you went through. You may try to avoid anything that reminds you of your experience.
You may experience symptoms like these for a month or longer:
- feeling emotionally numb,
- feeling unable to trust or care about other people,
- having sleeping difficulties,
- losing interest in things you used to enjoy,
- feeling guilty,
- become angry or more aggressive,
- having trouble doing everyday things,
- having difficulty remembering important aspects of the event,
- having difficulty concentrating.
Physical symptoms such as headaches, gastrointestinal distress, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common in people with PTSD. Often, doctors treat these symptoms without being aware that they stem from an anxiety disorder.
How is it treated?
Certain medications and certain kinds of psychotherapy have proven successful in treating the symptoms of PTSD. Choose a doctor who has special training and experience in treating people with PTSD.
Three kinds of psychotherapy have been shown to be effective in the treatment of PTSD:
Anxiety management teaches coping skills, including relaxation techniques, assertiveness training and positive self-talk.
Cognitive therapy helps patients learn to recognize the distorted thoughts and beliefs that cause pain and replace them with those that help them feel and function better.
In exposure therapy, patients relive their traumatic experience, in a safe way, and gradually confront situations that trigger their unrealistic anxiety.
For patients with severe symptoms, medications may be used. These include antidepressants, usually SSRIs; antianxiety medications; and when necessary, antipsychotic medications, anticonvulsants and benzodiazepines. It may take a few weeks for the medicine to work.
These steps can help speed up the healing process:
- Learn about the disorder
- Talk to others about what you’re experiencing
- Use aerobic exercise for its calming effect
- Avoid caffeine which can make symptoms worse
- Don’t use alcohol or drugs to mask your pain
- Ask family members for their support
- Remember that it’s not your fault