David Godot, Psy.D.

PTSD is an anxiety disorder A person can develop PTSD:

After being exposed to any event involving the threat of death or serious injury Which they respond to with intense fear, helplessness, or horror

Intense fear causes hyperarousal of the amygdala, which overrides hippocampal functioning Consequently, the formation of sequential memory is disrupted even as powerful emotional memories are being formed. So the sufferer is unable to process the feelings of terror which they have experienced. The feelings become dissociated from the event, and generalized.

This leads to four types of symptoms:

1. Re-experiencing 2. Avoidance
Recurrent memories, nightmares, flashbacks Of stimuli which trigger re-experiencing Feeling numb Unable to express feelings about the traumatic event Unable to remember certain parts of the event Irritability and anger Increased startle response, hypervigilance Psychomotor agitation, poor sleep

3. Detachment

4. Hyper-arousal (autonomic activation)

PTSD often co-occurs with depression

You might see a patient withdrawing from social contact in general, feeling weak and hopeless Watch for increased suicide risk!

Many PTSD sufferers attempt to self-medicate with alcohol, drugs, or medication overuse PTSD is more likely to occur in people with disrupted attachment functioning
This means that people with pre-existing psychological concerns are more likely to develop PTSD

Increased autonomic activation means the veteran is under chronic stress This can cause/exacerbate:
Insomnia GI disruption Immune disruption Headaches Chronic Pain

PTSD is very treatable! Psychotherapy is the most effective treatment

Refer for treatment as soon as possible after exposure to trauma Medications

SSRIs can be effective in reducing symptoms Benzodiazapenes are contraindicated

Cognitive Processing Therapy (CPT) Prolonged Exposure (PE) Eye Movement Desensitization and Reprocessing (EMDR) Clinical Hypnosis

PTSD symptoms may be mitigated by early intervention