TRAUMA AND POST-TRAUMATIC STRESS DISORDER
Post-traumatic stress disorder (PTSD) is a disorder which is triggered by either experiencing or witnessing a terrifying event.
Most people experience a “fight or flight” response to typical traumatic event, and with time get better. This is a reaction to prevent a person from harm. However, some people continue to experience these reactions which can lead to PTSD.
Signs and Symptoms
Symptoms usually begin early, within 3 months of the traumatic incident, or may not begin until years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic. Symptoms may include:
- Recurrent, unwanted distressing memories of the traumatic event
- Reliving the traumatic event as if it were happening again (flashbacks)
- Upsetting dreams or nightmares about the traumatic event
- Severe emotional distress or physical reactions to something that reminds you of the traumatic event
- Trying to avoid thinking or talking about the traumatic event
- Avoiding places, activities or people that remind you of the traumatic event
- Hopelessness about the future
- Memory problems, including not remembering important aspects of the traumatic event
- Lack of interest in activities you once enjoyed
- Feeling emotionally numb
- Being easily startled or frightened
- Always being on guard for danger
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble sleeping
- Trouble concentrating
- Irritability, angry outbursts or aggressive behavior
- Overwhelming guilt or shame
Co-existing/Co-morbid Disorders
PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders, eating disorders, suicidal thoughts and actions.
Risk Factors
Risk Factors include war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or other serious events. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others. The sudden, unexpected death of a loved one can also lead to PTSD.
Some factors that increase risk for PTSD include:
- Living through dangerous events and traumas- combat exposure, torture,
- Getting hurt
- Seeing another person hurt, or seeing a dead body
- Childhood physical abuse
- Being threatened with a weapon
- Feeling horror, helplessness, or extreme fear
- Having little or no social support after the event
- Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
- Having a history of mental illness or substance abuse
- Exposure to fire, natural disaster, plane crash, terrorist attacks
Some factors that may promote recovery after trauma include:
- Seeking out support from other people, such as friends and family
- Finding a support group after a traumatic event
- Learning to feel good about one’s own actions in the face of danger
- Having a positive coping strategy, or a way of getting through the bad event and learning from it
- Being able to act and respond effectively despite feeling fear
Treatment and Therapies
Treatment is for the symptoms control.
Depression and anxiety are managed by using Antidepressants. Antidepressants usually take higher dose and longer duration (8-12 weeks) to work. Once you start feeling better, usually after a course of 6 to 12 months, you may be able to gradually taper off the antidepressants. Stopping them abruptly can cause withdrawal symptoms.
Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding please let us know prior to starting the medicines.
Psychotherapies
Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.
Holistic approach
- Getting regular exercise such as brisk walk, swimming, jogging etc. helps with anxiety and depression and promote sleep in addition to the physical benefits of work out
- Yoga and anaerobic exercise have also shown beneficial effects on mental health.
- Keep a mood log
- Be mindful of your triggers and warning signs
- Eat healthy and nutritious diet
- Maintain regular follow ups with your care providers
- Take all medicines as prescribed, consult your doctor before making any medicine changes
- Avoid misuse of alcohol or other drugs
- Adopt good sleep habits
- Mindful breathing