Understanding Post-traumatic Stress Disorder (PTSD)
A mental health condition triggered by an extremely stressful event, post-traumatic stress disorder (PTSD) affects over 5.2 million Americans each year, and almost 8 million will experience it at some point over their lifetimes. PTSD is a serious mental disorder that can develop at any age and last for years. Once known as “shell shock” because so many soldiers in combat developed the disorder, PTSD is commonly associated with war veterans. However, a variety of triggering events can lead to the onset of this disorder, which can affect anyone.
Causes and Risk Factors
PTSD can be triggered by experiencing any sort of physical or psychological trauma, or even by seeing or learning about such an event. Feelings of helplessness and intense fear bring on later symptoms. Examples of traumas can include physical or sexual assault, life-threatening experiences such as combat or accidents, natural disasters, or the death of a loved one. First responders to emergencies, such as EMTs and other rescue workers, can develop the disorder due to exposure to others’ trauma.
Many people face terrifying or extremely stressful experiences in their lives, but not everyone goes on to develop PTSD. What triggers the disorder in some individuals but not others? It appears that the following factors may affect an individual’s relative resiliency when exposed to extreme stress:
- Genetic factors, including inherited mental health risks;
- Severity and amount of previous trauma, particularly in childhood;
- An individual’s temperament;
- How one’s brain regulates hormones and chemicals released during episodes of stress;
- Presence of lack of a strong support system of friends and family;
- Intensity and duration of the traumatic experience;
- One’s gender – women develop PTSD more frequently than men, partially due to the fact their increased vulnerability to domestic violence, rape, and other forms of abuse;
- Presence of existing mental health problems such as depression or anxiety.
Symptoms of PTSD
In order to be classified at having PTSD, an individual must have symptoms occurring for at least one month and affecting overall functioning. Most individuals develop symptoms within three months of the traumatic event, but symptoms may not emerge until years later.
People who go through a traumatic event can have reactions that include anxiety, anger, shock, and guilt. These are common responses that fade away over time. For an individual with PTSD, these feelings don’t fade but actually increase.
Mental health experts classify post-traumatic stress disorder symptoms in three categories:
- Reliving. Flashbacks, hallucinations, and nightmares are common ways in which individuals relive their traumatic ordeals.
- Avoidance. Individuals often avoid places, people, or situations that remind them of the trauma. This behavior can lead to social isolation, emotional numbing, and loss of interest in activities.
- Increased arousal. Individuals may experience volatile emotions, such as anger outbursts, and feel agitated or easily startled. Concentration is often poor. Associated physical symptoms include increased heart rate or blood pressure, rapid breathing, and muscle tension.
The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer.
Treatment of PTSD
While PTSD can be disabling, it is treatable – usually through a combination of medication and psychotherapy.
Medications are often used to control extreme symptoms of the disorder, including anxiety, nightmares, and sleep disturbance. Antidepressants or anti-anxiety medications may be prescribed to manage anxiety and depression and improve sleep. On a short-term basis, antipsychotics may be given to control emotional outbursts and severe sleeping disturbance.
Other medications may be used to treat specific physical or psychological symptoms. For example, Prazosin, a drug normally prescribed for hypertension, may also manage insomnia and recurring nightmares.
Professionals also recommend psychotherapy or “talk therapy” to help individuals learn to manage symptoms and cope better with memories and feelings. Common treatment approaches include individual, family, or group therapy. Cognitive behavioral therapies are particularly effective, as they help patients deal with negative thought patterns that trigger stress.
Two strategies often associated with PTSD treatment are exposure therapy and eye movement desensitization and reprocessing (EMDR). The former is a type of cognitive behavioral therapy in which patients relive traumatic experiences in a controlled and supportive environment. This technique allows patients to confront their fears and become more comfortable in anxiety-provoking situations. EMDR helps patients deal with traumatic memories by teaching a group of guided eye movements that assist in processing these memories.
A word about prevention: there is evidence that seeking treatment as soon as possible after a traumatic event can be highly beneficial. Immediate support can often help an individual recover from trauma without developing full-blown PTSD. Whether a mental health counselor, minister, or other helping professional, a trained, caring individual can provide invaluable support at a critical time.
Co-Occurring Disorders Complex But Treatable
Diagnosing specific mental health problems and disorders is not always easy. The human mind is very complex. Even highly-trained and vastly experienced mental health professionals may occasionally experience some difficulties in pinning down a definitive diagnosis.
This is especially true in regard to co-occurring disorders. Also referred to as “dual disorders” or a “dual diagnosis,” a co-occurring disorder exists when a mental health condition is accompanied by at least one other disorder.
Co-occurring disorders are relatively common. It is often the case where the symptoms of one condition will present themselves while other conditions lie beneath the surface. This is the challenge for psychiatric professionals; to determine whether there are underlying issues that may be affecting or exacerbating what appears to be a particular mental illness.
For example, it is not uncommon for ADHD to be accompanied by anxiety or mood disorders; or Post Traumatic Stress Disorder (PTSD) to coexist with depression. The symptoms of these illnesses can play into each other, overlap or display themselves as a result of the other.
Such is the case with addictive disorders that are well-known for existing with other conditions. Many who struggle with depression or mood and anxiety disorders turn to substance abuse to relieve their symptoms.
Treating Co-occurring Disorders
To effectively treat co-occurring disorders, each condition must be isolated and addressed. Every patient has their own unique background and set of circumstances. Therefore a treatment plan must be tailored to meet the needs of each individual.
After initial evaluation and assessment, an “integrated” approach to counseling and psychotherapy is usually preferred when treating co-occurring disorders. This is where substance abuse counselors, psychotherapists and anyone else involved in the treatment process will coordinate efforts and share information regarding the patient’s condition, care and progress.
An integrated program for those with co-occurring disorders is usually administered in stages. Various avenues of treatment are incorporated into a comprehensive strategy that includes helping the patient understand their condition, establishing goals and guiding the patient toward the development of healthier behavior patterns. Group therapy and aftercare can also play an important role in an overall plan to help a co-occurring disorder sufferer heal.
Chronic Stress Can Take a Toll on One’s Mental Well-Being
Stress is a normal reaction to situations and frustrations that we occasionally experience during the course of our lives. Career concerns, deadlines, financial troubles and kid-related issues can all cause us moments of worry and degrees of anxiety. Normal stress can also be beneficial to us in some ways. For instance, it heightens our awareness in dangerous situations and boosts our ability to perform in an athletic endeavor.
But when feelings of apprehension and distress become perpetual, and there aren’t many moments in a day when we’re not feeling stressed or anxious, it can eventually wear us down and have a negative impact on our health. Stress can affect us both physically and mentally. Some of the physical manifestations of stress are tension, an elevated heartbeat, sweatiness and an upset stomach. Continuous stress can also lead to high blood pressure and heart problems.
The Effects of Chronic Stress on Mental Health
Post-Traumatic Stress Disorder (PTSD) is a well-known condition in which a traumatic event or the circumstances surrounding that event can cause recurring bouts of extreme stress. But constant, long-term stress can also have devastating consequences if not properly addressed.
Many people with chronic stress are unaware that the almost ceaseless worry and anxiety in their everyday lives may be turning into a deeper issue. They may feel that stress is just a part of their daily existence, and that the irritability, forgetfulness, trouble sleeping and fatigue, among other symptoms that can accompany chronic stress, simply come along with it.
However, “nervous breakdowns” or the development of anxiety disorders, eating disorders, sleep disorders, panic attacks and clinical depression that can result from persistent, long-term stress are serious conditions which require proper mental health treatment. This may consist of learning techniques to better manage and alleviate stress, or, depending on the severity of the situation, may involve psychotherapy and medication.
If there are indications that an individual may be experiencing chronic stress and they are beginning to show signs that there may be worse problems on the horizon, it’s time for them to get help. They shouldn’t hesitate to consult with a professional at one of their local mental health centers and begin to learn how to achieve some peace in their lives and get themselves back on track.
9/11 Responders Struggle with Post Traumatic Stress Disorder
On the 10th anniversary of 9/11, Americans took the time to reflect upon the events of that horrific day. Observances and ceremonies were conducted throughout the country to pay respect to the victims and to memorialize the heroes that emerged from that devastating day. Nearly 3,000 people lost their lives in New York, Washington and Pennsylvania, but many more continue to acutely feel its after-effects.
Ten years later, many 9/11 first responders and those that followed them to “ground zero” to address the aftermath are not only experiencing severe physical ailments, but are suffering with serious mental health issues as well. The lives of these individuals have been forever changed as they continue to deal with the repercussions of that fateful day.
A Traumatic Impact
As millions around the world watched the terrifying and almost surreal scene unfold in the middle of New York City on Sept. 11, 2001, the impact was intensely magnified for those in close proximity to ground zero. After having been directly involved with such a traumatic event, thousands of responding firefighters, police personnel, doctors, nurses and even construction and utility workers developed Post Traumatic Stress Disorder (PTSD), anxiety problems and depression in its wake.
Attempting to Heal
In January 2011, the James Zadroga 9/11 Health and Compensation Act was federally approved. This bill offers assistance to ground zero workers suffering from a physical or mental illness as a result of 9/11. It also establishes medical and mental health centers dedicated in part to the treatment of those affected by the travesty.
The Zadroga Act has greatly benefited workers and their families experiencing mental health issues. Those who might lack the financial means to receive treatment for depression , PTSD and treatment for other mental health issues associated with the traumatic events of 9/11 are now able to get the help they need.
Understanding Anxiety Disorders
Everyone experiences some level of worry or anxiety from time to time. But when that worry or anxiousness becomes overwhelming or subsists for long periods of time, there may be a deeper issue at hand.
In a given year, anxiety disorders affect roughly 18 percent of Americans over the age of 18, according to the National Institute of Mental Health (NIMH). Following are descriptions of some of the more prominent anxiety disorders:
Panic Disorder: A panic attack is a brief period of intense uneasiness, fear or distress. The duration of these attacks can range anywhere from minutes to a few hours. While the cause is not completely clear, it is thought that the tendency toward panic attacks could be genetic or linked to a traumatic occurrence in an individual’s life. Those suffering from panic disorders display an inability to properly process stressful situations and therefore react to them with a heightened sense of fear and apprehensiveness.
Obsessive-Compulsive Disorder (OCD): Those suffering with OCD are bombarded with persistent thoughts and fears usually focusing on one area. They develop repetitive behaviors in an attempt to “control” the things causing their fears, and end up becoming obsessed with their rituals.
Post-Traumatic Stress Disorder (PTSD): PTSD is the result of a terrifying or traumatic event in one’s life where they will re-experience the event and react with intense fear, anger, anxiety or even numbness. These episodes are usually brought about by exposure to a situation, thought or image reminding them of the original experience.
A combination of psychotherapy, behavior modification and medications are used for OCD treatment, PTSD treatment and the treatment of most other anxiety disorders. Mental health professionals continue to gain a better understanding of anxiety-related disorders, which has resulted in more effective methods of therapy.