More on The Challenges of PTSD

Yesterday, we tried to pin down a clear definition of post traumatic stress disorder (PTSD), an anxiety disorder that sometimes occurs following a traumatic, life-threatening event.   As with so many other such complex conditions, PTSD is very hard to describe definitively: there are many signs and symptoms, but they can come and go, and sometimes take years to develop.  Recovery is possible, even likely with good treatment,  but it is also ragged and uneven and frustrating for everyone involved.

There are four main sets or types of PTSD symptoms:

1.  Reliving the event (re-experiencing the symptoms)

In this situation, terrible memories of the traumatic event keep coming back – at any time.  The person very often feels the exact same fear and terror they felt when the event was actually taking place.  There are flashbacks, nightmares, dark images that pop into the head without warning.  Sometimes there are triggers: a loud bang, a silhouette against the sun, something that sets the re-enactment off.  Typical triggers include:

  • Seeing a car crash or other accident, which reminds a wreck survivor of his or her own accident.
  • Hearing a car or truck backfire, ushering in a flood of memories of gunfire and war for a combat veteran.
  • Seeing a news story or crime drama about a sexual assault, bringing back memories of the assault for a woman who was raped.

2.  Avoiding situations that remind one of the event

Here, the trauma sufferer tries very hard to avoid any situations or people who trigger memories of the event.  He or she tries to avoid talking about it, even thinking about it.  For example:

  • Some people find ways to keep themselves very, very busy – too busy.  They avoid seeking help as this keeps them from having to talk about it, think about it, share it, re-live it.
  • A person who was in an earthquake or other violent natural disaster may stop watching television or any movies or videos in which such disasters are featured.
  • A person robbed at gunpoint while ordering some take-out tacos thereafter avoids fast-food restaurants.  Or someone robbed at an ATM never uses one again.

3.  Feeling numb

The trauma victim finds it harder and harder to express his or her feelings.  Again, this is a way to avoid difficult memories.

  • He or she may not have any positive or loving feelings towards others.  They stay away from friends.  They may stay away from all relationships.
  • He or she loses interest in activities they used to enjoy.
  • He or she may not be able to talk about any part of the trauma; they may not even remember parts of it.

4.  Feeling keyed up all the time (hyperarousal)

The victim may be jittery, hyper-alert, restless, distracted, always on the lookout for danger.  This may cause him or her to:
  • Have a great deal of trouble sleeping
  • Have trouble concentrating
  • Suddenly become enraged or irritable
  • Fear constantly for their safety
  • Always be on guard
  • Be extremely startled when surprised

Some of the other problems faced by those with PTSD include:

  • Feelings of hopelessness, shame and despair
  • Drinking and drug problems
  • Employment troubles
  • Relationship problems, including violence and divorce
  • Physical ailments

And children, too, can have PTSD

Children may or may not have the symptoms outlined above, depending on their age.  As they get older, their symptoms become more like those of adults.  Some examples of signs of PTSD in children include:
  • Panic or unusual upset when separated from their parents
  • Trouble sleeping
  • Trouble with toilet training or going to the bathroom
  • Acting out the trauma through play, drawings and stories, especially ages 6-9.  
  • Complaints of physical problems
  • Irritability or aggression
  • Development of anxieties and fears that do not seem related to the traumatic event.

Good treatments are available for PTSD

  • Cognitive behavioral therapy (CBT) would appear to be the most effective counseling for PTSD sufferers.  There are different types, including cognitive therapy and exposure therapy.  Ongoing studies and trials also support and inform the development of more  effective and specific therapies as the PTSD rate continues to climb among our military population.
  • Another similar approach, called EMDR, eye movement desensitization and reprocessing, is also used for PTSD.
  • Medications are helpful, too.  They are often readjusted as the therapy progresses.  One kind of drug, known as a selective serotonin reuptake inhibitor (SSRI), also used to treat depression, is generally effective for PTSD.
Thanks US Department of Veterans Affairs.


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