June is Posttraumatic Stress Awareness Month. About 7% of the U.S. population has PTSD at any given time, according to the National Institute of Mental Health (NIMH). Living with PTSD is difficult for the person who has it and for those around him/her. Most people associate PTSD with war veterans, but anyone can experience it following a traumatic event in which actual or the potential for serious harm was present.
Some examples: victims of physical assault/violence; survivors of torture and systemic abuse; childhood abuse; rape survivors; people who have experienced natural disasters; those who have been in car accidents; and so on. What these people have in common is the experience of loss of control over their personal safety. The following highlights will give you more insight.
1. According to the DSM-5, the symptoms of PTSD include:
Intrusive thoughts, images, feelings, or behaviors related to the traumatic event.
- Repetitive intrusive thoughts.
- Flashbacks or intrusive images.
- Extreme emotional distress when reminded of the trauma.
- Physical arousal or distress when reminded of the trauma.
Avoidance or reminders of the traumatic event.
- Avoidance of trauma-related thoughts or feelings.
- Avoidance of reminders of the traumatic event.
Changes in thinking or mood related to the traumatic event.
- Inability to remember some aspects related to the traumatic event.
- Persistent negative beliefs and expectations about oneself and the world.
- Persistent distorted blame of oneself or others for the traumatic event.
- Persistent negative trauma-related emotions.
- Loss of interest in activities enjoyed before the trauma.
- Feeling alienated from others since the traumatic event.
- Inability to experience positive emotions.
Changes in arousal and reactivity related to the traumatic event.
- Irritability, agitation, or aggressive behavior.
- Self-destructive or reckless behavior.
- Hypervigilance—being “on guard” most of the time.
- Exaggerated startle response.
- Difficulty concentrating.
- Problems sleeping.
There are new subtypes of PTSD for children under age 6 and those who experience dissociation. One does not need to have all of these symptoms to meet the criteria for PTSD.
If you recognize some of these symptoms in yourself or a loved one after a traumatic event, and the symptoms do not decrease in frequency and intensity over a period of one month, it’s a good idea to discuss this with a medical or mental health provider. In fact, anyone who experiences a traumatic event would be wise to talk to a professional. There is often an immediate stress response called acute stress (ASD). ASD occurs within the first month after a trauma and places a person at risk for PTSD. However, not everyone who experiences a trauma will develop ASD or PTSD.
2. Triggering events
Triggers are situations, sensations or memories associated with the traumatic event that can cause the initial emotional and physical reactions to reoccur. These triggers may not be directly associated with the traumatic event. For example, one sexual abuse victim I worked with became physically ill and emotionally distressed when she saw hot dogs that she associated with male genitalia.
A more common situation involved a woman who had been in a car accident and became terrified to the point of panic when she had to ride in cars. One man I worked with who had been severely physically and emotionally abused as a child became triggered when he perceived anyone as threatening, as in through tone or volume of voice. A woman I worked with who had been robbed as a teller at a bank was unable to go near a bank without experiencing an acute stress reaction.
Determining what triggers precede a PTSD reaction help those who have the issue learn to identify and cope with them. This is a critical aspect of treatment.
3. Treatment for PTSD
There are two common therapies for PTSD: cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). There are several types of CBT for PTSD, primarily exposure therapy and cognitive restructuring.
- Exposure therapy entails gradually introducing reminders of the traumatic event to desensitize the person with PTSD to those triggers, and help them work through their reactions.
- Cognitive restructuring involves examining thoughts and memories, as well as one’s perceptions about the event, and then restructuring those that are problematic.
- EMDR uses bilateral stimulation, such as moving the eyes from side to side or alternately tapping each knee, while following a sequence of of treatments.
- Family therapy, medication, and self-help groups are also recommended for some people.
4. Self-help for PTSD
Support groups are one form of self-help. Support groups for people with PTSD are usually led by a professional facilitator. Other self-help strategies involve staying connected with people in your support network to decrease isolation. Service dogs and companion animals can also be helpful for people with PTSD and related issues. Just remember: none of these are a replacement for treatment by a qualified professional.
Most people who experience PTSD after a traumatic event gradually get better. It is important to understand that the process of recovery takes time and follow-through. Although there may be times when you want to isolate yourself from others, connections with supportive people are critical to your recovery. Professional treatment with a therapist and medication management, if warranted, with a knowledgeable psychiatrist or medical prescriber will provide you with the best chances of recovery. Support groups and other self-help efforts will enhance your prognosis.
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