Symptoms Post Traumatic Stress Disorder (PTSD) and Effective Ways of Treating Post Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows a traumatic event. The symptoms of post traumatic stress disorder are numerous and often people with PTSD have persistent frightening thoughts and memories of their experience and feel emotionally numb.

PTSD, once referred to as shell shock, was first brought to public attention by war veterans, but it can result from any number of traumatic incidents. These include kidnapping, serious accidents such as car or train wrecks, industrial/ work accidents, natural disasters such as floods or earthquakes, and violent attacks such as a mugging, rape. The traumatic event may be something that threatened the person's life or the life of someone close to him or her. For men, the most common events associated with the development of PTSD are combat exposure and witnessing of violent events, and for women, rape and sexual assault.

PTSD is quite a common condition. It has been estimated that approximately 6% of men and 11% of women will experience PTSD sometime in their life.

Symptoms Post traumatic Stress Disorder

For a diagnosis of PTSD to be made, the person must have experienced or witnessed or was confronted with an unusually traumatic event that has both of these elements:

1.  The event involved actual or threatened death or serious physical injury to the person or to others, AND

2. The person felt intense fear, horror or helplessness

Symptoms post traumatic stress disorder includes the following (symptoms required for post traumatic stress disorder diagnosis):

1.      The person repeatedly relives the event in at least 1 of these ways:

• Intrusive, distressing recollections - thoughts, images.

• Repeated, distressing dreams.

• Through flashbacks, hallucinations or illusions, acts or feels as if the event were
  recurring.

• Marked mental distress in reaction to internal or external cues that symbolize or
  resemble the event.

• Physiological reactivity - such as rapid heart beat, elevated blood pressure in response to these cues.

2. The person repeatedly avoids the trauma-related stimuli and experiencing a general 'numbing' as shown by the following:

• Tries to avoid thoughts, feelings or conversations concerned with the event.

• Tries to avoid activities, people or places that recall the event.

• Cannot recall an important feature of the event.

• Marked loss of interest or participation in activities important to the patient.

• Feels detached or isolated from other people.

• Restriction in ability to love or feel other strong emotions.

• Feels life will be brief or unfulfilled (lack of marriage, job, children).

3. The person experiences some of the following symptoms of hyperarousal which were not present before the traumatic event:

• Insomnia (initial or interval)

• Irritability

• Poor concentration

• Hypervigilance

• Increased startle response

The symptoms must last longer than a month after the event and are severe enough to cause impair work, social or personal functioning.

Symptoms Post traumatic Stress Disorder in Children

Children with PTSD may present with a combination of problems and many signs and symptoms of PTSD in children can look very similar to other psychiatric problems such attention deficit hyperactivity disorder (ADHD), separation anxiety, oppositional behaviour and major depression. This makes diagnosis difficult, resulting in regular misdiagnosis.

Common signs and symptoms of PTSD in children include impulsivity, distractibility and attention problems (due to hypervigilance), dysphoria, emotional numbing, social avoidance, dissociation, sleep problems, aggressive play (often re-enactment), school failure and regressed or delayed development.

Studies show that between 15 to 90 % of children exposed to a traumatic event will develop PTSD. The percentage varies depending upon the nature of the event but generally the rates of children developing PTSD following traumatic events is higher than those reported for adults.

Treating Post traumatic Stress Disorder

The therapeutic options with the strongest scientific support for the treatment of PTSD include cognitive behavior therapy (CBT), exposure therapy, eye movement desensitization and reprocessing (EMDR), and many combinations of these procedures.

Of all these treatments, EMDR or trauma-specific cognitive behavioral therapy has been recommended as the first-line treatments for trauma victims.

Cognitive behavioral therapy (CBT) - Cognitive behavioral therapy (CBT) is aims to change the patterns of thinking and/or behavior that are responsible for a trauma victim's negative emotions and, in doing so, change the way they feel and act. In CBT, individuals learn to identify thoughts that make them feel afraid or upset, and replace them with less distressing thoughts. The goal is to understand how certain thoughts about trauma cause stress and make symptoms worse.

Eye movement desensitization and reprocessing - EMDR is effective in treating PTSD and is also increasingly used to treat panic disorder, phobias, performance anxiety, self-esteem issues and other anxiety-related disorders. Through a series of eye movements while recalling aspects of the trauma, it seems to have a direct effect on the way that the brain processes information. With successful EMDR treatment, information processing is normalised allowing a person recall the event without associated intense feelings. EMDR can result in rapid improvement for many PTSD sufferers.

Exposure therapy - Exposure therapy involves confronting distressing trauma-related memories and reminders in order to facilitate the emotional processing of the trauma memory. Exposure therapy is primarily undertaken through imagery although can also involve real-life exposure to trauma reminders. Exposure therapy is often used in cognitive behaviour therapy and is also a component of EMDR.

Medication - Medication can have some benefit in reducing PTSD symptoms, but there is no clear drug treatment for PTSD. Standard medications used in PTSD include antidepressants such as SSRIs (selective serotonin reuptake inhibitors) and TCAs (tricyclic antidepressants).  

Post traumatic stress disorder is a serious condition that greatly affects a person well being and overall functioning. Because of the many symptoms post traumatic stress disorder it can also be very distressing for loved ones and effective treatment is often necessary. If you or a loved one is suffering from many of the symptoms described, do seek professional support.

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