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Let's
Talk Facts About...
POSTTRAUMATIC
STRESS DISORDER
Posttraumatic
stress disorder (PTSD)—once called shell shock—affects
hundreds of thousands of people who have survived earthquakes,
airplane crashes, terrorist bombings, inner-city violence,
domestic abuse, rape, war, genocide, and other disasters,
both natural and human made.
The
Facts
Posttraumatic
stress disorder (PTSD) has been called shell shock or
battle fatigue syndrome. It has often been misunderstood
or misdiagnosed, even though the disorder has very specific
symptoms.
Ten
percent of the population has been affected at some
point by clinically diagnosable PTSD. Still more show
some symptoms of the disorder. Although it was once
thought to be mostly a disorder of war veterans who
had been involved in heavy combat, researchers now know
that PTSD also affects both female and male civilians,
and that it strikes more females than males.
In
some cases the symptoms of PTSD disappear with time,
whereas in others they persist for many years. PTSD
often occurs with—or leads to—other psychiatric
illnesses, such as depression.
Everyone
who experiences trauma does not require treatment; some
recover with the help of family, friends, or clergy.
But many do need professional treatment to recover from
the psychological damage that can result from experiencing,
witnessing, or participating in an overwhelmingly traumatic
event.
Symptoms
PTSD
usually appears within 3 months of the trauma, but sometimes
the disorder appears later. PTSD’s symptoms fall
into three categories:
- Avoidance
- Hyperarousal
- Intrusion
In
people with PTSD, memories of the trauma reoccur unexpectedly,
and episodes called "flashbacks" intrude into
their current lives. This happens in sudden, vivid memories
that are accompanied by painful emotions that take over
the victim’s attention. This reexperience, or "flashback,"
of the trauma is a recollection. It may be so strong
that individuals almost feel like they are actually
experiencing the trauma again or seeing it unfold before
their eyes and in nightmares.
Avoidance
Avoidance
symptoms affect relationships with others: The person
often avoids close emotional ties with family, colleagues,
and friends. At first, the person feels numb, has diminished
emotions, and can complete only routine, mechanical
activities. Later, when reexperiencing the event, the
individual may alternate between the flood of emotions
caused by reexperiencing and the inability to feel or
express emotions at all. The person with PTSD avoids
situations or activities that are reminders of the original
traumatic event because such exposure may cause symptoms
to worsen.
The
inability of people with PTSD to work out grief and
anger over injury or loss during the traumatic event
means the trauma can continue to affect their behavior
without their being aware of it. Depression is a common
product of this inability to resolve painful feelings.
Some people also feel guilty because they survived a
disaster while others—particularly friends or family—did
not.
Hyperarousal
PTSD
can cause those who have it to act as if they are constantly
threatened by the trauma that caused their illness.
They can become suddenly irritable or explosive, even
when they are not provoked. They may have trouble concentrating
or remembering current information, and, because of
their terrifying nightmares, they may develop insomnia.
This constant feeling that danger is near causes exaggerated
startle reactions.
Finally,
many people with PTSD also attempt to rid themselves
of their painful re-experiences, loneliness, and panic
attacks by abusing alcohol or other drugs as a "selfmedication"
that helps them to blunt their pain and forget the trauma
temporarily. A person with PTSD may show poor control
over his or her impulses and may be at risk for suicide.
Treatment
Today,
psychiatrists and other mental health professionals
have good success in treating the very real and painful
effects of PTSD. These professionals use a variety of
treatment methods to help people with PTSD to work through
their trauma and pain.
Behavior
therapy focuses on correcting the painful and intrusive
patterns of behavior and thought by teaching people
with PTSD relaxation techniques and examining (and challenging)
the mental processes that are causing the problem.
Psychodynamic
psychotherapy focuses on helping the individual examine
personal values and how behavior and experience during
the traumatic event affected them.
Family
therapy may also be recommended because the behavior
of spouse and children may result from and affect the
individual with PTSD.
Discussion
groups or peer-counseling groups encourage survivors
of similar traumatic events to share their experiences
and reactions to them. Group members help one another
realize that many people would have done the same thing
and felt the same emotions.
Medication
can help to control the symptoms of PTSD. The symptom
relief that medication provides allows most patients
to participate more effectively in psychotherapy when
their condition may otherwise prohibit it. Antidepressant
medications may be particularly helpful in treating
the core symptoms of PTSD—especially intrusive
symptoms.
Other
Sources of Information
American
Psychiatric Association
1400 K Street, N.W.
Washington, DC 20005
202-682-6000
www.psych.org
Anxiety
Disorders Association of America, Inc.
11900 Parklawn Drive, Suite 100
Rockville, MD 20852-2624
301-231-9350
www.adaa.org
International
Society for Traumatic Stress Studies
60 Revere Drive, Suite 500
Northbrook, IL 60062
847-480-9028
www.istss.org
National
Center for PTSD
VA Medical Center (116D)
White River Junction, VT 05009
802-296-5132
www.dartmouth.edu/dms/ptsd
National
Institute of Mental Health Public Inquiries
6001 Executive Blvd., Room 8184 MSC 9663
Bethesda, MD 20892-9663
301-443-4513
FACTS ON DEMAND: 301-443-5158
www.nimh.nih.gov
U.S.
Veterans Administration
Mental Health and Behavioral Sciences Services
810 Vermont Avenue, N.W., Room 990
Washington, DC 20410
202-273-8431
©
Copyright 1999 American Psychiatric Association
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