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Posttraumatic stress disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening. Anyone who has gone through a life-threatening event can develop PTSD. These events can include: Combat or military exposure Child sexual or physical abuse Terrorist attacks Sexual or physical assault Serious accidents, such as a car wreck. Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake. After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.
How does PTSD develop?
All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD. Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include: How intense the trauma was or how long it lasted If you lost someone you were close to or were hurt How close you were to the event How strong your reaction was How much you felt in control of events How much help and support you got after the event Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.
What are the symptoms of PTSD?
Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day. PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.
Feeling keyed up (also called hyperarousal): You may be jittery. or always alert and on the lookout for danger. or despair Employment problems Relationships problems including divorce and violence Physical symptoms . You may feel the same fear and horror you did when the event took place. This is known as hyperarousal. These include: Drinking or drug problems Feelings of hopelessness. which may bring back memories of assault for a woman who was raped Avoiding situations that remind you of the event: You may try to avoid situations or people that trigger memories of the traumatic event. You may have nightmares. numbing. It can cause you to: Suddenly become angry or irritable Have a hard time sleeping Have trouble concentrating Fear for your safety and always feel on guard Be very startled when someone surprises you What are other common problems? People with PTSD may also have other problems. Feeling numb: You may find it hard to express your feelings. Reliving the event (also called re-experiencing symptoms): Bad memories of the traumatic event can come back at any time. This is called a flashback. 1. This is another way to avoid memories.There are four types of symptoms: reliving the event. shame. 3. This keeps them from having to think or talk about the event. Triggers might include: Hearing a car backfire. which can bring back memories of gunfire and war for a combat veteran Seeing a car accident. You even may feel like you're going through the event again. and feeling keyed up. 2. You may not have positive or loving feelings toward other people and may stay away from relationships You may not be interested in activities you used to enjoy You may forget about parts of the traumatic event or not be able to talk about them. which can remind a crash survivor of his or her own accident Seeing a news report of a sexual assault. 4. A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants Some people may keep very busy or avoid seeking help. You may even avoid talking or thinking about the event. avoidance. Sometimes there is a trigger: a sound or sight that causes you to relive the event.
fear. drug intoxication or . a physical condition. dealing with the past can be hard. you may keep your feelings bottled up. which is also used for depression. test. The doctor's initial task is to see if your anxiety is caused by a medical condition. nervous. It is noteworthy that teenagers are particularly susceptible to having irritability as a symptom of a number of emotional problems. You may have upset stomach. andgastrointestinal systems. infection. They also may develop fears and anxiety that don't seem to be caused by the traumatic event. As children get older their symptoms are more like those of adults. A type of drug known as a selective serotonin reuptake inhibitor (SSRI). is also used for PTSD. They may have the symptoms described above or other symptoms depending on how old they are. these symptoms are related to the heart. the effects of drugs. or from a combination of these.emedicinehealth. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. www. asthma attack. or stories. Medications can be effective too. lungs. including anxiety. There are good treatments available for PTSD.com Anxiety Overview Anxiety is a feeling of nervousness. They may complain of physical problems or become more irritable or aggressive.Can children have PTSD? Children can have PTSD too. or worry. is effective for PTSD. such as worry about a loved one or in anticipation of taking a quiz. apprehension. Problem anxiety interferes with the sufferer's ability to sleep or otherwise function. diarrhea. Instead of telling others how you feel. But treatment can help you get better. Most commonly. have trouble sleeping. • Anxiety can be accompanied by a variety of physical symptoms. Young children may become upset if their parents are not close by. feel as if you may faint or are having a heart attack. Conditions as varied as anemia. Anxiety may occur without a cause. troublebreathing. or suddenly have trouble with toilet training or going to the bathroom Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play. A similar kind of therapy called EMDR. Cognitive-behavioral therapy (CBT) is one type of counseling. Severe anxiety can have a serious impact on daily life. What treatments are available? When you have PTSD. or it may occur based on a real situation but may be out of proportion to what would normally be expected. It appears to be the most effective type of counseling for PTSD. Some fears and worries are justified. drawings. or other examination. or eye movement desensitization and reprocessing. Anxiety Causes Problem anxiety may be caused by a mental condition.
an overactivethyroid. In order to qualify for the diagnosis of panic disorder. for example. o Separation anxiety disorder: Considered a disorder of children. o Obsessive compulsive disorder: Individuals with this condition either suffer from intrusive and distressing thoughts (obsessions) or engage in irresistible. or a number of heart conditions are just a few examples of medical problems that can be associated with anxiety. dizziness. in that they feel as if they are looking at themselves from outside of themselves. and shortness of breath. • Common types of anxiety include these mental conditions: o Panic disorder: In addition to attacks of anxiety. air travel. Examples of phobias include fears of spiders. open spaces. insects in general. or avoiding touching doorknobs. o • o o o o Stress disorders These common external factors can cause anxiety: Stress at work Stress from school Stress in a personal relationship such as marriage or friendships Financial stress . closed-in spaces. These same symptoms also can be caused bycaffeine consumption. the individual would experience repeated panic attacks rather than just one episode. amphetamines ("speed" is the street slang for amphetamines when they are not prescribed by a doctor). often repetitive behaviors (compulsions). palpitations (feeling your heart beat). o Generalized anxiety disorder: Those who endure this condition experience numerous worries that are more often on the mind of the sufferer than not. The panic attack sufferer may experience their mind going blank or that they somehow do not feel real. o Phobic disorders: People with phobias experience irrational fear that may rise to the level of panic attacks in response to a specific thing or situation. Examples of compulsions include counting items or activities. called panic attacks. separation anxiety disorder can be diagnosed when a child becomes extremely anxious in response to anticipating or being separated from one or more caregiving adults (usually a parent). Examples of obsessions include worries about germs or having items in a particular order. The separation may come with the child's going to school each day or going to bed each evening.withdrawal. and social anxiety. common symptoms of panic disorders are stomach upset. avoiding walking on cracks. and other heart abnormalities (such as mitral valve prolapse). abnormal heart rhythms. heights. Those worries interfere with the person's ability to sleep or otherwise function.
a natural disaster. in a study of people with chest pain that could be heart disease but turned out not to be heart related. victimization by crime. For example.emphysema. such as cocaine or amphetamines o Withdrawal from an illicit drug. worry about having an attack. or changing the way one behaves because of the panic attacks for at least a month. acute stress disorder or post traumatic stress disorder) o o Stress from a serious medical illness Side effects of medication o Intoxication (being "high" on) with an illicit drug. Panic attacks are separate and intense periods of fear or feelings of doom developing over a very short time frame-10 minutes-and they're associated with at least four of the following: o o o o o o o o o Palpitations Sweating Trembling Shortness of breath Sense of choking Chest pain Nausea or other stomach upset Dizziness A feeling of being detached from the world (derealization) . physical abuse or sexual abuse (for example. about what it means. benzodiazepines. or pulmonary embolism (a blood clot with the vessels of the lung) • The doctor has the often difficult task of determining which symptoms come from which causes.o Stress from an emotional trauma such as the death of a loved one. heroin) or from prescription drugs like Vicodin. or barbituates o Symptoms of a medical illness o Lack of oxygen: In circumstances as diverse as high altitude sickness. 43% were found to have a panic disorder-a common form of anxiety. Anxiety Symptoms • Panic disorder: recurrent episodes of panic attacks. such as opiates (for example.
persistent. • Stress disorders: anxiety (also known as post-traumatic stress disorder) caused by the exposure to either death or near-death circumstances such as fires. doom and gloom with diminished emotions such as loving feelings or aspirations for the future . The traumatic event is re-experienced in thoughts and dreams. Examples of such trauma include victimization through physical or sexual abuse. or public places). Common behaviors include the following: o Re-experiencing the trauma. spiders. or wars. These exposures may trigger a panic attack. earthquakes. exposure of children to pornographic images or acts). or blood) or situations (such as heights. either when awake (flashbacks) or when asleep (nightmares) o o o o Avoiding activities. and recurring fear of certain objects (such as snakes. feeling as if the mind has gone blank Fear of dying Numbness or tingling Chills or hot flashes • Generalized anxiety disorder: excessive. shootings. for example. places. witnessing the abuse of another or over-xposure to inappropriate material (for example. floods. automobile accidents. speaking in front of a group. Other traumatic events may not have had the threat of death or near-death but resulted in the severe injury or threat thereof. It's associated with three of the following: o o o o o o Restlessness Easily tired Trouble concentrating Irritability Muscle tension Sleep problems • Phobic disorders: intense. and difficult to control worry over a period of at least six months. unrealistic. or people associated with the triggering event Difficulty concentrating Difficulty sleeping Being hypervigilant (you closely watch your surroundings) o Feeling a general sense of depression. irritability.o o o o Being unable to think.
• • If the symptoms are so severe that you believe medication may be needed If the symptoms are interfering with your personal. Even though this meeting is seven days away. his stomach turns raw with anxiety and fear floods over him again. Just the thought of speaking in front of coworkers raises his anxiety.. the boss is going to be there. or professional life • If you have chest pain. He has seven miserable days of anxiety ahead of him -.. quickly. shortness of breath. dizziness.. When to Seek Medical Care Call your doctor when the signs and symptoms of anxiety are not easily. they can never fully relax when other people are . The socially anxious person can't relax. he won't remember what to say. the meeting is over. and weakness generally should not be attributed to anxiety and require evaluation by a doctor. palpitations. ruminate over it.to think about it.again and again and again. But when the signs and symptoms are severe and come on suddenly. At next week's meeting. people with social anxiety feel that everyone is watching. A man hates to go to work because a meeting is scheduled the next day. "take it easy". dizziness. and clearly diagnosed and treated. He knows that in front of the boss he'll stammer. worry about it. and everyone will witness his embarrassment and humiliation.. A big wave of relief spills over him as he begins to relax.. staring. In public places.... fainting spells. social. and enjoy themselves in public.. In fact. they may represent a serious medical illness that needs immediate evaluation and treatment in a hospital's emergency department. hesitate. palpitations. headaches. over-exaggerate it in his mind. Finally. Sometimes he can't sleep the night before because of the anticipatory anxiety that builds up.. He knows that these meetings always involve co-workers talking with each other about their current projects. you may be able to make an appointment with your doctor for evaluation. and judging them (even though rationally they know this isn't true). But the memory of the meeting is still uppermost in his mind. or shopping. He is convinced he made a fool of himself and that everyone in the room saw how afraid he was when he spoke. meetings. or unexplained weakness • If you are depressed and feel suicidal or homicidal When the signs and symptoms suggest that anxiety may have been present for a prolonged period (more than a few days) and appear to be stable (not getting worse rapidly). and how stupid he acted in their presence.fainting.• Symptoms such as chest pain. such as work. shortness of breath. his face will turn red.
. People with social phobia come to our anxiety clinic labeled as "schizophrenic". without some kind of education. they must keep quiet about them. The feelings I described to you at the beginning of the article are those of people with social anxiety disorder..you have it every day for the rest of your life. ANALYSIS BY SHRINK Social anxiety is the third largest psychological problem in the United States today. It always feels like others are evaluating them.. Because the anxiety is so very painful.. Making the situation more difficult is that social anxiety does not come and go like some other physical and psychological problems. Because few socially-anxious people have heard of their own problem. psychiatrists. therapists.around. and "personality disordered". and focus on anything else except the anxiety and fear. psychologists. Then what would people think about them? Unfortunately. everyone with social anxiety has slightly different secondary symptoms. such as the television talk shows. people with social anxiety are misdiagnosed almost 90% of the time.. Therefore. social anxiety is not well understood by the general public or by medical and mental health care professionals.. the chances that they can find it are very. when a person with social anxiety finally gets up the nerve to seek help. Some people. This type of anxiety affects 15 million Americans in any given year. being critical of them. such as doctors. That is. Still others have severe anxiety about eating or drinking in the presence of other people. "clinically depressed". knowledge. or "judging" them in some way. "manicdepressive". social phobia/social anxiety continues to wreak havoc throughout their lives. cannot write in public because they fear people are watching and their hand will shake.. their symptoms apply to most social events and functions in almost every area of life. among other damaging misdiagnoses. relax. and counselors. In fact.. they think they are the only ones in the whole world who have these terrible symptoms. Adding to the dilemma. The person with social anxiety knows that people don't do this openly. of course.. "panic disordered". Others experience a muscle spasm (usually around the neck and shoulders) and it becomes the center of their focus ---"it's so embarrassing that if someone sees it I will be humiliated forever!" . Some people with social anxiety feel that a certain part of their body (such as the face or neck) are particularly "strange looking" and vulnerable to being stared at. social workers.) As with all problems. for example. very slim. If you have social anxiety one day. and have never seen it discussed on any media. I suffered from social anxiety myself for twenty years before I ever saw the term or read about its symptoms in a book. it's much easier just to stay away from social situations and avoid other people altogether. It's sometimes impossible to let go. and appropriate treatment. It would be awful if everyone realized how much anxiety they experienced in daily life. Unlike some other psychological problems. but they still feel the self-consciousness and judgment while they are in the other person's presence. (The first book that specifically dealt with social phobia was not published until the 1990's. Others are very introverted and they find it too difficult to hold down a job.
You can too. Many of us have been through the crippling fears and constant anxiety that social phobia produces -. In fact. then cognitive-behavioral treatment provides the methods. You can't be "counseled" out of social phobia. How can social anxiety be treated? Many therapeutic methods have been studied. its bark is worse than its bite. Ph.and have come out healthier and happier on the other side. They are the ones who give up. the people who are unsuccessful are the ones who are not persistent in their practice and who won't stick with simple methods and techniques at home. In fact. (Shudder. despite this rational knowledge. Add to this that current research is clear that cognitive-behavioral therapy is highly successful in the treatment of social anxiety. Here comes the good part. Psychologist . social anxiety is a torturous and horrible emotional problem. and strategies that come together to lessen the anxiety and make the world a much more enjoyable place. with treatment. That is. Richards. They realize that their thoughts and feelings are somewhat exaggerated and irrational. It is a catch-22 situation: there is no way out without the appropriate therapy. which just reinforces the fact that "I will never get better". Without treatment. I have seen significant progress in just twelve individual sessions. techniques.One thing that all socially anxious people share is the knowledge that their thoughts and fears are basicallyirrational. they still continue to feel differently. Usually these anxious feelings are tied to thoughts that are entwined in a vicious cycle of negative expectations and negative appraisals. Social anxiety responds to relatively short-term therapy.. In fact.D.this statement does NOT have to be true. which in turn leads to depression. They understand that people are not trying to embarrass or humiliate them.) THERE IS A BETTER LIFE FOR ALL PEOPLE WITH SOCIAL ANXIETY. What socially anxious people do not need is years and years of therapy or counseling. If a person is motivated to end the years and years of crippling anxiety. ---Thomas A. socially anxious people who are taught to "analyze" and "ruminate" over their problems usually make their social anxiety and fears much worse. treatment of social anxiety through cognitive-behavioral methods has the capacity to produce long-lasting. people with social anxiety know that others are really not critically judging or evaluating them all the time. although most people respond better with sixteen to twenty-four meetings. depending on the severity of the condition. but cognitive-behavioral therapy is the only modality that has been shown to work effectively. Yet.. permanent relief from the anxiety-laden world of social anxiety. It is these automatic "feelings" and thoughts that occur around social situations that must be met and conquered in therapy. completion of a behavioral therapy group is also essential (when people feel ready for this and not before). To overcome social anxiety.