Post-Traumatic Stress Disorder

INTRODUCTION

Although it is always kicked off by a terrifying event, PTSD may have roots in biology as much as in experience.
Exposure therapy and other psychotherapy, and medication, all have a role in treating the flashbacks, anger
outbursts, physical distress and other signs of the disorder.

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may develop after exposure to a terrifying
event or ordeal in which severe physical harm occurred or was threatened. Traumatic events that may trigger
PTSD include violent personal assaults, natural or unnatural disasters, accidents, or military combat.

Anyone who has gone through a life-threatening event can develop PTSD including military troops who served
in wars; rescue workers for catastrophes like the 2001 terrorist attacks on New York City and Washington,
D.C.; survivors of the Oklahoma City bombing; survivors of accidents, rape, physical or sexual abuse, and other
crimes; immigrants fleeing violence in their countries; survivors of earthquakes, floods, and hurricanes; and
those who witness traumatic events. Family members of victims can develop the disorder as well.

PTSD affects about 7.7 million American adults, but it can occur at any age, including childhood. Women are
more likely to develop the disorder than men, and there is some evidence that it may run in families. PTSD is
frequently accompanied by depression, substance abuse, or anxiety disorders. When other conditions are
appropriately diagnosed and treated, the likelihood of successful treatment increases.

Roughly 30 percent of Vietnam veterans developed PTSD. The disorder also has been detected in as many as
10% of Gulf War (Desert Storm) veterans, about 6% to 11% of veterans of the Afghanistan war, and about 12%
to 20% of veterans of the Iraq war.

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to
PTSD and other mental health problems. These factors include what you do in the war, the politics around the
war, where it's fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or
sexual assault that occurs while you are in the military. MST can happen to men and women and can occur
during peacetime, training, or war. Among veterans using VA health care, about 23 out of 100 women (23%)
reported sexual assault when in the military, 55 out of 100 women (55%) and 38 out of 100 men (38%) have
experienced sexual harassment when in the military.

PTSD is diagnosed when the stress symptoms following exposure have persisted for at least a month. When
symptoms develop immediately after exposure, the condition may be called acute stress disorder.
SYMPTOMS

Many people with PTSD tend to re-experience the ordeal that set the disease in motion, especially when they
are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger
symptoms. People with PTSD also experience emotional numbness, sleep disturbances, anxiety, intense guilt,
depression, irritability, or outbursts of anger. Most people with PTSD try to avoid any reminders or thoughts of
the ordeal. PTSD is diagnosed when symptoms last more than one month.

Symptoms associated with reliving the traumatic event:

● Having bad dreams about the event or something similar
● Behaving or feeling as if the event were actually happening all over again (known as flashbacks)
● Having a lot of emotional feelings when reminded of the event
● Having a lot of physical sensations when reminded of the event (heart pounds or misses a beat,
sweating, difficulty breathing, feeling faint, feeling a loss of control)

Symptoms related to avoidance of reminders of the traumatic event:

● Avoiding thoughts, conversations, or feelings about the event
● Avoiding people, activities, or places associated with the event
● Having difficulty remembering an important part of the original trauma
● Emotional "numbing," or feeling as though you don't care about anything
● Feelings of detachment
● Lack of interest in normal activities
● Less expression of moods
● Sense of having no future

Arousal Symptoms:
● Sleeping difficulties including trouble falling or staying asleep
● Irritability and outbursts of anger
● Difficulty concentrating
● Feeling easily startled
● Excess Awareness (hypervigilance)

Medical or emotional issues:

● Stomach upset, trouble eating
● Trouble sleeping & exhaustion
● Pounding heart, rapid breathing, edginess
● Severe headache if thinking of the event, sweating
● Failure to engage in exercise, diet, safe sex, regular health care
● Excess smoking, alcohol, drugs, food
● Worsening of chronic medical problems
CAUSES
The cause of PTSD is unknown, but psychological, genetic, physical, and social factors are involved. PTSD
changes the body's response to stress. It affects the stress hormones and chemicals that carry information
between the nerves (neurotransmitters). Having been exposed to trauma in the past may increase the risk of
PTSD. People who have suffered childhood abuse or other previous traumatic experiences are more likely to
develop the disorder. And people who experience emotional distancing may be more prone to PTSD.

Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person
more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some
of these risk and resilience factors are present before the trauma and others become important during and
after a traumatic event.

Risk factors include living through dangerous events and traumas, having a history of mental illness, getting
hurt, seeing people hurt or killed, feeling horror, helplessness, or extreme fear, having little or no social
support after the event and dealing with extra stress after the event, such as loss of a loved one, pain and
injury, or loss of a job or home.

Resilience factors that may reduce the risk of PTSD include seeking out support from other people, such as
friends and family, finding a support group after a traumatic event, feeling good about one's own actions in
the face of danger, having a coping strategy, or a way of getting through the bad event and learning from it
and being able to act and respond effectively despite feeling fear.

TREATMENTS
Treatment for PTSD typically begins with a detailed evaluation, and development of a treatment plan that
meets the unique needs of the survivor. The main treatments for people with PTSD are psychotherapy ("talk"
therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work
for another. It is important for anyone with PTSD to be treated by a mental health care provider who is
experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their
symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of
the problems need to be treated. PTSD-specific-treatment begins only when the survivor is safely removed
from the crisis situation. Other ongoing problems can include panic disorder, depression, substance abuse,
and feeling suicidal.
Other strategies for treatment include:
● Educating trauma survivors and their families about how persons get PTSD, how PTSD affects survivors
and their loved ones, and other problems commonly associated with PTSD symptoms. Understanding
that PTSD is a medically recognized anxiety disorder is essential for effective treatment.
● Exposure to the event via imagery allows the survivor to re-experience the event in a safe, controlled
environment. A professional can carefully examine reactions and beliefs in relation to that event.
● Examining and resolving strong feelings such as shame, anger, or guilt, which are common among
survivors of trauma.
● Teaching the survivor to cope with post-traumatic memories, reminders, reactions, and feelings
without becoming overwhelmed or emotionally numb. Trauma memories usually do not go away
entirely as a result of therapy, but new coping skills can make them more manageable.
COMPLEX PTSD

Complex PTSD,​ ​also known as disorder of extreme stress, is found among individuals who have been exposed
to prolonged traumatic circumstances, especially during childhood, such as childhood sexual abuse. Research
shows that many brain and hormonal changes may occur as a result of early, prolonged trauma, and
contribute to troubles with learning, memory, and regulating emotions.

Combined with a disruptive, abusive home environment, these brain and hormonal changes may contribute to
severe behavioral difficulties such as eating disorders, impulsivity, aggression, inappropriate sexual behavior,
alcohol or drug abuse, and other self-destructive actions, as well as emotional regulation (such as intense rage,
depression, or panic) and mental difficulties (such as scattered thoughts, dissociation, and amnesia).

As adults, these individuals often are diagnosed with depressive disorders, personality disorders, or
dissociative disorders. Treatment may progress at a much slower rate, and requires a sensitive and structured
program delivered by a trauma specialist.

SYMPTOMS OF COMPLEX PTSD

Symptoms of ​Complex PTSD​ are quite different. The first requirement for the diagnosis is that the individual
experienced a prolonged period (months to years) of total control by another. The other criteria are symptoms
that tend to result from chronic victimization. Those symptoms include alterations in emotional regulation
which may include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger, alterations in
consciousness such as forgetting traumatic events, reliving traumatic events, or having episodes in which one
feels detached from one's mental processes or body as well as changes in self-perception which may include a
sense of helplessness, shame, guilt, stigma, and a sense of being completely different than other human
beings.

Other symptoms are alterations in the perception of the perpetrator which may include attributing total
power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a
preoccupation with revenge and alterations in relations with others which may include variations in personal
relations including isolation, distrust, or a repeated search for a rescuer. Finally, changes in one's system of
meanings may include a loss of sustaining faith or a sense of hopelessness and despair.
 POST-TRAUMATIC STRESS DISORDER QUESTIONS

1. Explain Post-Traumatic Stress Disorder in your own words:

Post-traumatic stress disorder (PTSD) is a disorder that develops in
some people who have experienced a traumatic event.

2. Who can develop PTSD symptoms? Anyone can develop PTSD at any age. This includes people
_______________________________________________________
who experienced any traumatic events.

3. How many Americans are affected by this disorder?

7.7 million American adults
__________________________________________

4. Which gender is more likely to develop PTSD? Women are more likely to develop this disorder than men.
______________________________________________

5. What percent of these veterans developed PTSD?

Vietnam: 30% veterans
Desert Storm: 10% veterans
Afghanistan: 6% to 11% veterans
Iraq: 12% to 20% veterans

6. What are the ​PTSD symptoms​ related to ​reliving a traumatic event​ and ​avoidance of reminders of the
traumatic event​?
Relieving a traumatic event: Having bad dreams about the event or something similar/Having a lot of physical
sensations when reminded of the event (sweating, difficulty breathing, feeling dizzy, feeling a loss of control).
Avoidance of reminders of the event: Having difficulty remembering an important part of the original
trauma/Avoiding thoughts, conversations, or feelings about the event/Avoiding people, activities, or places associated
7. What are the ​PTSD symptoms​ related to ​arousal​ and ​medical/emotional issues​?
with the event.
Arousal: Sleeping difficulties including trouble falling or staying asleep/Irritability and outbursts of anger/Difficulty
concentrating/Feeling easily startled.
Medical/Emotional issues: Stomach upset, trouble eating/Trouble sleeping & exhaustion/Pounding heart,rapid
breathing,edginess/Severe headache if thinking of the event.
8. What are some ​treatments​ for PTSD?
The main treatments for people with PTSD are psychotherapy (talk therapy), medications, or both. Includes:
Examining and resolving strong feelings such as shame, anger, or guilt, which are common among survivors of
trauma/Teaching the survivor to cope with post-traumatic reminders, reactions, and feelings without becoming
overwhelmed.
9. What is ​Complex PTSD​?

Complex post-traumatic stress disorder (CPTSD) is a condition where you experience some symptoms
of PTSD along with some additional symptoms.

10. What are the ​symptoms of Complex PTSD​?

Those symptoms include alterations in emotional regulation which may include persistent sadness, suicidal thoughts,
explosive anger, or inhibited anger, alterations in consciousness such as forgetting traumatic events, reliving
traumatic events, or having episodes in which one feels detached from one's mental processes or body as well as
 REFLECTION QUESTIONS

1. Which of the PTSD symptoms would be the most difficult for you to deal with? Why?
The most difficult symptoms I would deal with is the changes in perception which may include sense of
being completely different than other human beings and having episodes in which one feels detached from
one's body or mental processes. I would find these specific symptoms the hardest because I would feel I
am left out and that the rest of the world is different than me which would then lead to depression and
then to suicidal thought so each symptom leads to another symptom.

2. Think of an event in history that might have caused PTSD (other than the Holocaust). Why would this
event cause PTSD? What symptoms do you think the survivors of that event might have?
An event in history that might have caused PTSD can be the Vietnam War. This event can cause
this disorder because it is a war which is classified as a traumatic event where people watch as
they lose their country's soldiers. The survivors of the war could might have witnessed the
symptoms shown: persistent sadness, explosive anger, having nightmares of the event or
something similar etc.
3. How is Complex PTSD similar to regular PTSD? How is it different?

Complex PTSD is different from PTSD because it often occurs in people who've experienced extreme
violence and stress over an extended period of time. These stressful events make the person feel trapped and
thus hopeless and they may be physically or psychologically unable to escape.

4. Do you know anyone who has suffered from PTSD? Explain.

No I do not know nay one who have experienced post traumatic stress disorder.

5. In the novel we will read next, ​A Long Way Gone,​ author Ishmael Beah shares stories of his life as a
child soldier in Sierra Leone. What events or situations might cause him to develop PTSD? How do you
think he deals with his past, now that he is an adult?

Don't understand