Sunday, January 31, 2016

Mental Health Series - PTSD (Post Traumatic Stress Disorder)

Post-Traumatic Stress Disorder (PTSD) 

Recently I went through a PTSD crisis. It occurred because of a trigger that happened several weeks ago. A couple of days after that trigger, another trigger occurred. Then, a couple of days later, another trigger occurred. They weren't monumental triggers like having the same traumatic event happen. They were triggers of telling the event in various ways and talking about it to fill out some disability paperwork. Then the next trigger was a personal lesson during bible study. The third trigger was just a discussion on forgiveness.  Just a simple word and a simple non-related discussion.

However, each event built upon the other causing very serious symptoms in me. I became anxious, increasingly emotional, flashbacks, nightmares, insomnia, loss of desire to be with others, lack of ability to concentrate on activities, and eventually a series of panic attacks that escalated throughout the two weeks I attempted to cope with it on my own, until I ended up in the psychiatric ward of the hospital for intense, immediate and safe treatment. Especially, because I started having suicidal thoughts.

I'm out of the hospital now, but I'm not "cured." I'm not over the PTSD crisis. It's still there. But, I'm better able to cope because of the skills I learned while hospitalized, the addition of a mood stabilizer, and a medication to help me sleep. All of these combined, still do not make the PTSD crisis go away. I still need to work with my psychiatrist and my therapist to develop a treatment plan. Hopefully, this plan will include EMDR therapy. I've had EMDR therapy before, but it was nearly six years ago. Because the of the intensity of the triggers, I believe another session is required. 

When someone is feeling threatened, a “flight or fight” response is triggered that protects them from harm. However, in someone with PTSD, the “flight or fight” response is changed or damaged in some way. Someone with PTSD can feel stressed or frightened even when there is no threat of danger.

How does PTSD develop? 
PTSD usually develops after a terrifying, horrific ordeal that either involved physical harm or the threat of physical harm. Usually the person who develops PTSD may have been the one to be harmed, or the harm could have happened to a loved one, or the person who develops PTSD could have witnessed a harmful event that happened to a loved one or even to strangers. These result in the person developing Fear Memories.

Even though PTSD was first brought to the public’s attention by war veterans, PTSD can result from a variety of traumatic events: assault, muggings, rape, torture, kidnapped, held captive, child abuse (physical/sexual), childhood neglect, sudden death of a loved one, car accidents, train wrecks, plane crashes, terrorist attacks, bombings, or some kind of natural disaster such as flood or earthquake.

The person involved in the event can develop PTSD or other people can be affected who have to pick up the pieces of the tragic event afterwards such as: emergency workers, law enforcement officers, friends, and/ or family.

PTSD development varies from person to person. Symptoms can occur within hours or days of an event, it can sometimes take weeks, months, or even years before the symptoms actually appear.

How are Fear Memories created? 
Scientists are currently working on studying genes that play a role in creating fear memories. Like other mental disorders, it is likely many genes with small effects are at work in PTSD: (Stathmin, GRP, 5-HTTLPR)

What are the causes of PTSD? 
While scientists study the brain and fear and stress to determine the causes of PTSD, environmental factors are also considered: childhood trauma, head injury, or a history or mental illness.

How common is PTSD?
Although it’s been said that any of us can suffer from PTSD given the right circumstances, it’s estimated that approximately 5% of men and 10% of women suffer from PTSD at some point in their lives.

What are the signs or symptoms of PTSD?
PTSD can cause many symptoms. These symptoms are grouped in three categories: 

1. Re-experiencing Symptoms
2. Avoidance and Numbing Symptoms
3. Increased Anxiety and Emotional Arousal Symptoms

What symptoms do the three categories have? 
1. Re-Experiencing the Traumatic Event

  • Intrusive, upsetting memories of the event 
  • Flashbacks, (acting or feeling like the event is happening again) 
  • Nightmares (either of the event or of other frightening things) 
  • Feelings of intense distress when reminded of the event 
  • Intense physical reactions to reminders of the event (such as: pounding heart, rapid breathing, nausea, muscle tension, sweating) 

 2. Avoidance and Numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma 
  • Inability to remember important aspects of the trauma 
  • Loss of interest in activities and life in general 
  • Feeling detached from others and emotionally numb 
  • Sense of limited future (you don’t expect to live a normal life span, get married, have a career) 

 3. Increased Anxiety and Emotional Arousal

  • Difficulty falling or staying asleep 
  • Irritability or outbursts of anger 
  • Difficulty concentrating 
  • Hyper-vigilance (on constant “red alert”) 
  • Feeling jumpy and easily startled 

 Other common symptoms of PTSD include: anger and irritability, guilt, shame, or self-shame, substance abuse, feelings of mistrust and betrayal, depression and hopelessness, suicidal thoughts and feelings, feeling alienated and alone, and physical aches and pains.

Who is at risk for PTSD?
Although it’s impossible to predict who will develop PTSD in response to any trauma in their life, there are certain risk factors that can increase your vulnerability.

  • Previous traumatic experiences, especially in early life 
  • Family history of PTSD or depression 
  • History of physical or sexual abuse 
  • History of substance abuse 
  • History of depression, anxiety, or another mental illness 
  • High level of stress in every day life 
  • Lack of support after the trauma 
  • Lack of coping skills 

What are the treatments for PTSD? 
Education plays a big part of treating others for Post-Traumatic Stress Disorder (PTSD). It helps to provide information about the illness to help the person manage their symptoms. Psychological and medical help is also given to those with PTSD. When receiving education about PTSD, the person who suffers from PTSD will learn about others, their traumas, and that it is caused by stress rather than weakness in the person involved.

Cognitive Behavioral Therapy is an important part of using therapy to help those with PTSD. This many even be combined with group therapy. It helps people who suffer from PTSD to recognize and adjust their trauma-related thoughts.

Eye-Movement Desensitization and Reprocessing (EMDR), a form of cognitive therapy, has been found to be extremely successful in helping those with PTSD. It works by the person with PTSD talking about the trauma they suffered and the negative feelings they associate with the event, while focusing on a rapidly moving object or a tone while wearing headphones.

Medications are also helpful. They help the various environmental and/or physical symptoms demonstrated by the person with PTSD, such as serotonergic antidepressants. Other medications such as mood stabilizers and antipsychotics have also been found to be helpful.

Those with PTSD who maintain their medical regime are less likely to experience a relapse of their illness if the antidepressant treatment is continued for at least a year.

When should someone who suspects PTSD see a doctor? 
If symptoms occur for more than a month, it may mean the person is suffering from PTSD. It doesn’t necessarily mean you have PTSD if you’ve experienced a traumatic event and suffered some occasional fear and anxiety, lack of concentration, sadness or changes in sleeping or eating habits, or even bouts of crying. However, if the symptoms are severe enough to impede the person’s ability to get back to a normal life he / she should see a medical professional. If the symptoms are so strong that someone in the person’s life such as a friend or family member feel that they may harm themselves, seek medical attention immediately.

I should have let my psychiatrist and therapist know immediately how severely affected I was due to the PTSD triggers. It's possible, the right treatment could have been started immediately, thus, avoiding an Emergency trip to the hospital resulting in hospitalization.

I beg you. If you or someone you know experiences anything like what I've described here in this article, please seek professional help immediately. Don't wait. It only makes the situation worse.

 Image Copyright: unkreatives / 123RF Stock Photo

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