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Line 1: − '''Post-Traumatic Stress Disorder''' is an [[anxiety disorder]] that can occur after experiencing or witnessing a traumatic event. Some examples of a traumatic events are: [[military combat]], [[natural disasters]], [[terrorist attacks]], car accidents, physical and sexual assault. It can also affect rescue workers that respond to the traumatic incident. During [[World War I]], Post-Traumatic Stress Disorder was called "Shell Shock". It was then changed to "Battle Fatigue" during [[World War II]] and then its name was changed again to "Operational Exhaustion" during the [[Korean War]]. PTSD got its current name during the [[Vietnam War]].+ + + + + + + + + + + + + + − People exposed to a traumatic incident will most likely develop some of the symptoms of PTSD. These symptoms can be very long lasting and severe. Why PTSD develops is currently being studied. Biological, psychological and social factors affect the development of PTSD. PTSD is not diagnosed unless the symptoms last for 1 month or longer.+ − There are four types of symptoms associated with PTSD:+ − * Re-experiencing − ** Examples of re-experiencing include, but are not limited to, flashbacks, nightmares, or persistent unwanted recollections of the traumatic event. − * Emotional numbing − ** Examples of numbing include, but are not limited to, feeling detached, a flattened affect (a decrease in the strength of emotions felt or range of different emotions felt), or loss of enjoyment in previously enjoyed activities. − * Avoidance − ** Examples of avoidance include, but are not limited to, avoiding a street on which an assault or accident took place, avoiding people associated with the trauma (even if they had no causal role), or avoiding anything that may be similar or reminders of the traumatic event. − * Increased arousal − ** Examples of increased arousal include, but are not limited to, increased startle response (such as jumping at loud noises or seeing something appear unexpectedly), difficulty sleeping, irritability, trouble concentrating, or hypervigilance. + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Post-Traumatic Stress Disorder (view source)
Revision as of 23:59, April 26, 2008
, 23:59, April 26, 2008Complete re-write of article.
In our everyday lives, any of us can have an experience that is overwhelming, frightening, and beyond our control. We could find ourselves in a car crash, the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences as they often have to deal with horrifying scenes. Soldiers may be shot or blown up, and see friends killed or injured. Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years. This is called Post-Traumatic Stress Disorder (PTSD).
==How does PTSD start?==
PTSD can start after any traumatic event. A traumatic event is one where a person can see that they are in danger, their life is threatened, or where an individual sees other people dying or being injured. Some typical traumatic events would be:
*Serious road accidents
*Military combat
*Violent personal assault (sexual assault, physical attack, abuse, robbery, mugging)
*Being taken hostage
*Terrorist attack
*Being a prisoner-of-war
*Natural or man-made disasters
*Being diagnosed with a life-threatening illness.
Even hearing about an the unexpected injury or violent death of a family member or close friend can start PTSD. The symptoms of PTSD can start after a delay of weeks, or even months. They usually appear within 6 months of a traumatic event.
==Symptoms of PTSD==
Many people feel grief-stricken, depressed, anxious, guilty and angry after a traumatic experience. As well as these understandable emotional reactions, there are three main types of symptoms produced by such an experience:
'''1. Flashbacks & Nightmares'''
The sufferer finds themselves re-living the event, again and again. This can happen both as a "flashback" in the day, and as nightmares when asleep. These can be so realistic that it feels as though the person is living through the experience all over again. The person can see it in their mind, but may also feel the emotions and physical sensations of what happened - fear, sweating, smells, sounds, pain. Ordinary things can trigger off flashbacks. For instance, if the sufferer had a car crash in the rain, a rainy day might start a flashback.
'''2. Avoidance & Numbing'''
It can be just too upsetting to re-live your experience over and over again. So the sufferer distracts his or her self. The person will keep their mind busy by losing themselves in a hobby, working very hard, or spending time absorbed in crossword or jigsaw puzzles. They avoid places and people that remind them of the trauma, and try not to talk about it. They may deal with the pain of their feelings by trying to feel nothing at all - by becoming emotionally numb. The person communicate less with other people, who then find it hard to live or work with the sufferer.
'''3. Being "On Guard"'''
The sufferer finds that they stay alert all the time, as if they are looking out for danger. They can't relax. This is called "hypervigilance" and the sufferer feel anxious and find it hard to sleep. Other people will notice that they are jumpy and irritable.
===Other Symptoms===
Emotional reactions to stress are often accompanied by:
*Muscle aches and pains
*Diarrhoea
*Irregular heartbeats
*Headaches
*Feelings of panic and fear
*[[Depression ]]
*Drinking too much alcohol
*Using drugs (including painkillers).
==Why are traumatic events so shocking?==
They undermine our sense that life is fair, reasonably safe, and that we are secure. A traumatic experience makes it very clear that we can die at any time. The symptoms of PTSD are part of a normal reaction to narrowly avoided death. Not everyone gets PTSD after a traumatic event, but nearly everyone will have the symptoms of post traumatic stress for the first month or so. This is because they help to keep you going, and help you to understand the experience you have been through. This is an "acute stress reaction". Over a few weeks, most people slowly come to terms with what has happened, and their stress symptoms start to disappear. Not everyone is so lucky. About 1 in 3 people will find that their symptoms just carry on and that they can't come to terms with what has happened; it is as though the process has got stuck. The symptoms of post traumatic stress, although normal in themselves, become a problem - or Post Traumatic Stress Disorder - when they go on for too long.
===What makes PTSD worse?===
The more disturbing the experience, the more likely individuals are to develop PTSD. The most traumatic events:
*Are sudden and unexpected
*Go on for a long time
*Trap the individual, who is unable to get away
*Are man-made
*Cause many deaths
*Cause mutilation and loss of arms or legs
*Involve children.
===Ordinary "stress"===
Everybody feels stressed from time to time. Unfortunately, the word "stress" is used to mean two rather different things: our inner sense of worry, feeling tense or feeling burdened or the problems in our life that are giving us these feelings. This could be work, relationships, maybe just trying to get by without much money. Unlike PTSD, these things are with us, day in and day out. They are part of normal, everyday life, but can produce anxiety, depression, tiredness, and headaches. They can also make some physical problems worse, such as stomach ulcers and skin problems. These are certainly troublesome, but they are not the same as PTSD.
==Psychopathology of PTSD==
There are a several possible explanations for why PTSD occurs.
===Psychological===
When humans are frightened, they remember things very clearly. Although it can be distressing to remember these things, it can help to understand what happened and, in the long run, help us to survive. The flashbacks, or replays, force the sufferer to think about what has happened. The individual can decide what to do if it happens again. After a while, he or she learns to think about it without becoming upset. It is tiring and distressing to remember a trauma. Avoidance and numbing keep the number of replays down to a manageable level. Being "on guard" means that the sufferer can react quickly if another crisis happens. It can also give individuals the energy for the work that's needed after an accident or crisis. But the sufferer doesn't want to spend the rest of their life going over it. They only want to think about it when they have to, such as if the sufferer finds themselves in a similar situation.
===Physical===
Adrenaline is a hormone our bodies produce when we are under stress. When the stress disappears, the level of adrenaline should go back to normal. In PTSD, it may be that the vivid memories of the trauma keep the levels of adrenaline high. This will make a person tense, irritable, and unable to relax or sleep well. The hippocampus is a part of the brain that processes memories. High levels of adrenaline can stop it from working properly. This means that flashbacks and nightmares continue because the memories of the trauma can't be processed. If the stress goes away and the adrenaline levels get back to normal, the brain is able to repair the damage itself, like other natural healing processes in the body. The disturbing memories can then be processed and the flashbacks and nightmares will slowly disappear.
==Evidence of recovery from a traumatic experience==
Individuals can recognise that they have overcome PTSD when they:
*Think about it without becoming distressed
*Don't feel constantly under threat
*Don't think about it at inappropriate times.
===Why is PTSD often not recognised?===
The sufferer may not want to admit to having symptoms, because he or she doesn't want to be thought of as weak or mentally unstable. Doctors and other professionals may feel uncomfortable if the sufferer tries to talk about gruesome or horrifying events. People with PTSD often find it easier to talk about the other problems that go along with it - headache, sleep problems, irritability, [[depression]], tension, substance abuse, family or work-related problems.
==Children and PTSD==
PTSD can develop at any age. Younger children may have upsetting dreams of the actual trauma, which then change into nightmares of monsters. They often re-live the trauma in their play. For example, a child involved in a serious road traffic accident might re-enact the crash with toy cars, over and over again. They may lose interest in things they used to enjoy. They may find it hard to believe that they will live long enough to grow up. They often complain of stomach aches and headaches.
[[category:Mental health]]
[[category:Psychiatry]]
[[category:Psychiatric Disorders]]
[[category:psychology]]
[[category:psychology]]