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#10930 - 03/30/11 11:19 AM PTSD - What is it?
Dianne E. Offline

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What is PTSD?

It is common for people to feel that no matter what they’ve faced or lived with, no matter how extreme, they should be able to carry on. But sometimes people face situations that are so traumatic that they may become unable to cope and function in their daily lives. Some people become so distressed by memories of the trauma – memories that won’t go away – that they begin to live their lives trying to avoid any reminders of what happened to them.

A person who feels this way months after a traumatic experience has passed may be suffering from Posttraumatic Stress Disorder, or PTSD, a serious and common health condition. For these people, getting beyond the trauma and overcoming PTSD requires the help of a professional.

PTSD may develop following exposure to extreme trauma.

Extreme trauma is a terrifying event or ordeal that a person has experienced, witnessed or learned about, especially one that is life-threatening or causes physical harm. It can be a single event or repeated experience.

The experience causes that person to feel intense fear, horror or a sense of helplessness.

The stress caused by trauma can affect all aspects of a person’s life, including mental, emotional and physical well-being.

Research suggests that prolonged trauma may disrupt and alter brain chemistry. For some people, this may lead to the development of PTSD.

Posttraumatic stress disorder (PTSD)—once called shell shock—affects hundreds of thousands of people who have survived earthquakes, airplane crashes, terrorist bombings, inner-city violence, domestic abuse, rape, war, genocide, and other disasters, both natural and human made.

The Facts
Posttraumatic stress disorder (PTSD) has been called shell shock or battle fatigue syndrome. It has often been misunderstood or misdiagnosed, even though the disorder has very specific symptoms.

Ten percent of the population has been affected at some point by clinically diagnosable PTSD. Still more show some symptoms of the disorder. Although it was once thought to be mostly a disorder of war veterans who had been involved in heavy combat, researchers now know that PTSD also affects both female and male civilians, and that it strikes more females than males.

In some cases the symptoms of PTSD disappear with time, whereas in others they persist for many years. PTSD often occurs with—or leads to—other psychiatric illnesses, such as depression.

Everyone who experiences trauma does not require treatment; some recover with the help of family, friends, or clergy. But many do need professional treatment to recover from the psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic event.

Symptoms
PTSD usually appears within 3 months of the trauma, but sometimes the disorder appears later. PTSD’s symptoms fall into three categories:

  • Intrusion
  • Avoidance
  • Hyperarousal
Intrusion
In people with PTSD, memories of the trauma reoccur unexpectedly, and episodes called "flashbacks" intrude into their current lives. This happens in sudden, vivid memories that are accompanied by painful emotions that take over the victim’s attention. This reexperience, or "flashback," of the trauma is a recollection. It may be so strong that individuals almost feel like they are actually experiencing the trauma again or seeing it unfold before their eyes and in nightmares.

Avoidance
Avoidance symptoms affect relationships with others: The person often avoids close emotional ties with family, colleagues, and friends. At first, the person feels numb, has diminished emotions, and can complete only routine, mechanical activities. Later, when reexperiencing the event, the individual may alternate between the flood of emotions caused by reexperiencing and the inability to feel or express emotions at all. The person with PTSD avoids situations or activities that are reminders of the original traumatic event because such exposure may cause symptoms to worsen.

The inability of people with PTSD to work out grief and anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it. Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others—particularly friends or family—did not.

Hyperarousal
PTSD can cause those who have it to act as if they are constantly threatened by the trauma that caused their illness. They can become suddenly irritable or explosive, even when they are not provoked. They may have trouble concentrating or remembering current information, and, because of their terrifying nightmares, they may develop insomnia. This constant feeling that danger is near causes exaggerated startle reactions.

Finally, many people with PTSD also attempt to rid themselves of their painful re-experiences, loneliness, and panic attacks by abusing alcohol or other drugs as a "selfmedication" that helps them to blunt their pain and forget the trauma temporarily. A person with PTSD may show poor control over his or her impulses


Source: APA

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#10932 - 03/30/11 01:38 PM Re: PTSD [Re: Dianne E.]
Dianne E. Offline

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Through years of research, 17 PTSD symptoms have been identified. These are symptoms that can develop following the experience of a traumatic event and are listed in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (or DSM-IV). These 17 symptoms are divided into three separate clusters. The three PTSD symptom clusters, and the specific symptoms that make up these clusters, are described below.

Re-Experiencing Symptoms

•Frequently having upsetting thoughts or memories about a traumatic event.
•Having recurrent nightmares.
•Acting or feeling as though the traumatic event were happening again, sometimes called a "flashback."
•Having strong feelings of distress when reminded of the traumatic event.
•Being physically responsive, such as experiencing a surge in your heart rate or sweating, to reminders of the traumatic event

Avoidance Symptoms

•Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
•Making an effort to avoid places or people that remind you of the traumatic event.
•Having a difficult time remembering important parts of the traumatic event.
•A loss of interest in important, once positive, activities.
•Feeling distant from others.
•Experiencing difficulties having positive feelings, such as happiness or love.
•Feeling as though your life may be cut short.

Hyperarousal Symptoms

•Having a difficult time falling or staying asleep.
•Feeling more irritable or having outbursts of anger.
•Having difficulty concentrating.
•Feeling constantly "on guard" or like danger is lurking around every corner.
•Being "jumpy" or easily startled.

Many of these symptoms are an extreme version of our body's natural response to stress. Understanding our body's natural response to threat and danger (the fight or flight response) can help us better understand the symptoms of PTSD.

Do You Need All of These Symptoms for a Diagnosis of PTSD?

To be diagnosed with PTSD, a person does not need to have all these symptoms. In fact, rarely does a person with PTSD would experience all the symptoms listed above. To receive a diagnosis of PTSD, you only need a certain number of symptoms from each cluster. Additional requirements for the diagnosis also need to be assessed, such as how the person initially responded to the traumatic event, how long the symptoms have been experienced, and the extent with which those symptoms interfere with a person's life.

The symptoms of PTSD can have a major impact on many areas of a person's life. Fortunately, you can do some things to cope with the symptoms of PTSD.

Coping with Symptoms of PTSD
The symptoms of PTSD can be difficult to cope with, and as a result, many people with PTSD develop unhealthy coping strategies, such as alcohol or drug abuse or deliberate self-harm. Therefore, it is important to develop a number of healthy coping strategies to manage your PTSD symptoms:

  • Healthy Ways to Manage Your Emotions
  • Ways of Coping with Unpleasant Thoughts and Memories
  • How to Identify and Cope with PTSD Triggers
  • Coping with Sleep Problems
  • Managing Flashbacks and Dissociation

A number of psychological treatments have been found to be effective in helping people cope with the symptoms of PTSD.

Cognitive-Behavioral Treatments for PTSD
Cognitive-Behavioral Treatments (or CBT) for PTSD focus on changing the way in which people evaluate and respond to situations, thoughts, and feelings, as well as unhealthy behaviors that stem from thoughts and feelings.

Exposure Therapy for PTSD
Exposure therapy is a behavioral treatment for PTSD that aims to reduce a person's fear, anxiety, and avoidance behavior by having a person fully confront (or be exposed to) thoughts, feelings, or situations that are feared.

Acceptance and Commitment Therapy
Acceptance and Commitment Therapy is a behavioral treatment that is based in the idea that our suffering comes not from the experience of emotional pain, but from our attempted avoidance of that pain. Its overarching goal is to help people be open to and willing to have their inner experiences while focusing attention not on trying to escape or avoid pain (because this is impossible to do) but instead, on living a meaningful life.

Treatments for the Co-Occurrence of PTSD and Substance Abuse
PTSD and substance abuse frequently co-occur, and therefore, several treatments have been developed that specifically target this co-occurrence. Seeking Safety is one such treatment.

Psychodynamic Psychotherapy for PTSD
Psychodynamic psychotherapy focuses on numerous factors that may influence or cause a person's symptoms, such as early childhood experiences, current relationships and the things people do to protect themselves from upsetting thoughts and feelings. Unlike CBT, psychodynamic psychotherapy emphasizes the role of the unconscious mind in our behaviors.

If you are experiencing symptoms of PTSD, it is important that you get the help you need. Many people have recovered from PTSD through treatment. However, unaddressed symptoms of PTSD can get worse over time and may contribute to the development of other psychological disorders, such as major depression, substance use disorders, eating disorders, or anxiety disorders. You can find PTSD treatment providers in your area through UCompare HealthCare from About.com, as well as the Anxiety Disorder Association of America. Source.........




PTSD CheckList – Civilian Version (PCL-C)

APA Clinical Tools to improve the care of patients with PTSD


PTSD Revisions Proposed for DSM-5


Neural Network Relationships differ in patients with PTSD



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#11067 - 05/03/11 02:43 PM PTSD What are the consequences associated [Re: Dianne E.]
Dianne E. Offline

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What are the consequences associated with PTSD?

PTSD is associated with a number of distinctive neurobiological and physiological changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The amygdala has also been found to be involved in coordinating the body's fear response.

Psychophysiological alterations associated with PTSD include hyper-arousal of the sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities.

People with PTSD tend to have abnormal levels of key hormones involved in the body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in individuals who have both PTSD and depression.

PTSD is associated with the increased likelihood of co-occurring psychiatric disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence (27.9 percent).

PTSD also significantly impacts psychosocial functioning, independent of comorbid conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system.

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD.

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#11872 - 09/22/11 02:32 PM Re: PTSD What are the consequences associated [Re: Dianne E.]
Dianne E. Offline

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Excerpts from WebMD

September 13, 2011 — Reduced serotonin type 1B receptor activity, especially in the brain's caudate area, is strongly associated with trauma exposure and may represent a biomarker for the development of posttraumatic stress disorder (PTSD), new research suggests.

In a study of 96 participants who underwent positron emission tomography scans, those with PTSD had significantly lower serotonin 1B levels than did those without the disorder. Interestingly, the levels were also lower in those who experienced severe trauma, including childhood abuse, domestic violence, and military violence, but did not have a PTSD diagnosis compared with their nontraumatized peers.

"Lower serotonin 1B levels were also strongly associated with age at first trauma. The earlier the trauma exposure, the greater the brain alterations and the greater the severity of PTSD symptoms, and the greater the risk of developing comorbidities," senior author Alexander Neumeister, MD, associate professor of psychiatry at Mount Sinai School of Medicine in New York City, told Medscape Medical News.

"These findings establish that trauma at a young age causes long-lasting neurobiological and psychological effects in survivors with PTSD. In other words, early-life trauma can interfere with normal brain development," he said.

The investigators add that this study is "the first evidence of a potential drug target" for this disorder.

"Currently the only medication treatment options for the nearly 8 million American adults with PTSD are antidepressants and anti-anxiety medications, which show little benefit in improving the mental health of these patients," added Dr. Neumeister in a release.

"Our research sets the stage for the development of therapies that target serotonin 1B receptors."

The study appears in the September issue of the Archives of General Psychiatry.

Traumatic Stress Mechanisms

The investigators write that "relatively little is known regarding the human neurobiological mechanisms that underlie adaptive or pathologic responses to traumatic stress."

Although the medications currently approved by the US Food and Drug Administration for the treatment of PTSD target the serotonin system, defining the system's specific role in treating this disorder "has been challenging in the face of a wide and complex diversity of receptor subtypes and their functions," the researchers explain.

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