Post-Traumatic Stress Disorder
People often feel fear, anxiety, and depression after they have seen or experienced terrible events. However, sometimes these feelings do not go away even after a long time, and people keep on feeling that they are in danger; they suffer from painful memories and dreams. In such cases, it is usually considered that they suffer from post-traumatic stress disorder PTSD). Nevertheless, sometimes it is hard to understand whether a patient has the above mentioned disease or not. Thus, it is important to study its peculiarities as well as ways of treatment.
Definition and Peculiarities
Post-traumatic stress disorder is the condition, in which a person feels very strong fear, horror, or helplessness in response to injury or threat of death. Those who have experienced such events may start suffering from depression, substance abuse, anxiety disorder, panic disorder, as well as from physical illnesses, such as increased blood rate, chronic pain symptoms, and asthma (Yehuda, 2002).
PTSD has first been recognized among those who took part in the war in Vietnam. After that, the diagnosis has been applied to the people who endured a wide range of traumas in wars or civil life. Most of medical investigations of the discussed disorder have been conducted on individuals who have experienced traumatic events (Hapke, Shumann, Rumpf, John, & Meyer, 2006).
Post-traumatic stress disorder can be divided into two categories: acute and chronic. If symptoms last for less than three month, it is the acute form of illness. If symptoms persist for the longer period of time, then it is the chronic PTSD (Javidi & Yadollahie, 2012).
The effects of PTSD can be amplified by other psychological disorders and vice versa. The illness may occur as both primary and secondary disorder. Apart from that, psychiatric disorders often increase the risk of post-traumatic stress disorder in distressing situations (Hapke et al., 2006).
Although women in general get injured less often than men do, they are more easily exposed to PTSD. However, this is not defined by any peculiarities of women’s psychology or physiology, but rather by social factors (e.g. different ways of coping for men and women, the limitation of social and economic resources of women, higher exposure of women to sexual abuse, etc.). The type of traumatic event also has a great significance. Personal assaults have the higher risk of causing PTSD than less personal distressing situations (Hapke et al., 2006).
The reasons for experiencing the post-traumatic stress disorder might be different. Among the most common ones are enduring events that go beyond the range of usual human experience and which would cause stress to almost anybody: threat to one’s life; serious harm or threat to one’s children, wife or husband, parents or other close people; the situations where one suddenly loses his/her home; seeing a severely injured or killed person who has become a victim of an accident or physical violence (Peterson, Prout, & Schwarz, 1991).
Javidi and Yadollahie (2012) provide the examples of traumatizing events: physical attacks, sexual assault, war, being kidnapped or taken as a hostage, terrorist attacks, torturing, car accidents with serious outcomes, and natural disasters. For children, the following events may be the most distressing ones: unexpected death of the beloved ones, sexual abuse, seeing severe injuries, etc.
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Apart from that, it is worth mentioning that the event, which caused trauma, is constantly re-experienced by a person in at least one of the following ways:
- recurrent recollections of the event;
- constant dreaming of the event;
- sudden feeling that the distressing event is repeating (hallucinations, illusions, dissociative episodes);
- strong psychological distress when the events, the elements of which remind of the elements of the traumatic events, happen (Peterson et al., 1991).
However, it is worth mentioning that there are the factors, which make people more easily exposed to PTSD. Among them are feeling desperate, hopeless, or ashamed; divorce; violence; alcohol or drug abuse; physical symptoms; problems at work (Javidi & Yadollahie, 2012).
The biological and psychological responses to distressing events are defined by the characteristic features of both the person suffering and the event. The initial response is fear. This is a biological reaction, but it can be influenced by the subjective interpretation of the event by the person involved (Yehuda, 2002).
It is a common thing that after a traumatic event one starts feeling powerless and vulnerable. In such a case bringing comfort to a victim might help. However, if the distressing situation is not over yet (e.g. a war), an individual may keep on getting worse until he/she loses the coping resources and starts avoiding all the feelings and thoughts associated with the event. The avoidance of certain thoughts may interfere with the person’s ability to build coping strategies and his/her fragility in social, interpersonal, and occupational relations (Yehuda, 2002).
Horror, sadness, guilt, humiliation, and anger are also among other symptoms. Some people consider themselves to be guilty because they did not behave the way, which could have helped to avoid the traumatic event (Yehuda, 2002).
Extremely distressing events also have the biological influence on individuals. For instance, those who have endured post-traumatic stress disorder have the lower level of cortisol, even in more than ten years after the event, than those who have not. At the same time, the level of corticotropin-releasing hormone is increased. For comparison, people suffering from short periods of stress or depression have the increased levels of both corticotropin-releasing hormone and cortisol (Yehuda, 2002).
Both psychological and biologic aspects of the illness show that PTSD develops because of the failure to hold back the biologic stress response in the course of the traumatic event. This results in constant recollecting of the traumatic event and hyperarousal. Apart from that, patients suffering from PTSD also have the increased heart rate. All of these findings indicate that those with PTSD have more activated sympathetic system than those who do not have the disorder (Yehuda, 2002).
Ways of Treatment
First of all, it is important to make a patient understand that he/she has a health issue. The doctors should explain the patients the peculiarities of their condition and treatment as well as persuade them that the way they feel is not just a weakness but a serious illness. Apart from that, the patients should not be additionally stressed in the course of taking treatment, so it is important that the doctors help them feel they are not alone (Yehuda, 2002).
However, people suffering very rarely turn to the doctors who major in mental health. This is due to the fact that they do not realize how serious their symptoms are. Sometimes the patients are also afraid that others will start perceiving them as emotionally unstable. Some are even afraid that they may lose their job. Nevertheless, this problem can be solved by persuading people that using the services of mental health practitioners is not worse than turning to a physician, for example (Yehuda, 2002).
When a patient with PTSD turns to a doctor, the treatment strategy should be elaborated and followed. First of all, it is necessary to reduce the feeling of stress. At this stage, the techniques, such as anxiety management, exposure therapy (helping the patients cope with the memories and feelings associated with the traumatic event), interpersonal therapy (helping those who suffer understand, in which way their condition affects different aspects of their life, including relationships with other people), and cognitive therapy (teaching patients how to evaluate their own thoughts and beliefs). It is also worth mentioning that applying the therapies to the groups of people rather than to separate individuals is more helpful, since in such a case the patients do not feel isolated (Yehuda, 2002).
Another way of treatment is prescribing medications. The medications can be advised by a physician. The medical practice has shown that tricyclic antidepressants, serotonin reuptake inhibitors, and monoamine oxidase inhibitors are the most effective for the discussed condition. Serotonin reuptake inhibitors are the most often prescribed medications, since they are the safest ones. The patients are under constant observation of doctors in the course of taking medication. If the medication prescribed does not help the patient after eight weeks, the doctor advices something different, such as nefazone or venlafaxine. If there is a partial result, then the patient should take additional medicines, for instance, divalproex, which is a mood stabilizer (Yehuda, 2002).
The decision on what type of treatment should be taken, medicines or psychological therapy, or whether they should be combined, must be taken on the basis of the general clinical picture (Yehuda, 2002).
Advances in the Field
Nowadays scholars focus their work on finding out more about the origin of PTSD so that the illness can be avoided. The big part of researches is dedicated to the role of genes in creating the memories. Finding out how memories of fear appear can help to create new ways of reducing the negative effects of PTSD (Post-Traumatic Stress Disorder). The studies have resulted in identifying that there are the genes, which produce:
- Stathmin, the protein, which plays the major role in creating fear memories.
- GRP, which is the chemical that sends signals to the brain. It is released during emotional events (Post-Traumatic Stress Disorder).
There are also many other genes, which have minor effects on the development of PTSD (Post-Traumatic Stress Disorder).
Apart from studying genes, the scholars also study what happens to the brain during traumatic events and the development of PTSD. They believe that the part of the brain that takes the biggest part in suffering from post-traumatic stress disorder is amygdala. It plays one of the major roles in learning, memory, and emotion. The amygdala becomes activated in learning how to fear something (e.g. touching hot objects), as well as in learning how not to fear. The scholars also assume that the prefrontal cortex is responsible for keeping the extinguishing memories and dampening fear responses (Post-Traumatic Stress Disorder).
Nevertheless, it is worth emphasizing that peculiarities of genes or brain areas cannot become the cause for PTSD. They are only the basis for the development of the illness, which is triggered by environmental factors (traumatic events) (Post-Traumatic Stress Disorder).
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It is important to mention that a big progress has been made during the last decade. For instance, the researches funded by NIMH are working on medications that are believed to target the causes of post-traumatic stress disorder with the purpose of preventing the illness. Another group of scholars tries to increase personality, social, and cognitive protective factors to reduce the risk of fast development of PTSD to a minimum. There is yet another research dedicated to the study of why some patients with PTSD respond well to one type of treatment, and others to the different one. Its main purpose is to develop more efficient treatment, which would be good for different individuals (Post-Traumatic Stress Disorder).
Post-traumatic stress disorder is the mental disorder, which occurs after a person has experienced a dangerous or extremely distressing event. Even long after the event has passed, an individual may feel uncomfortable and it begins to interfere with his/her normal life. There are different types of treatment offered by modern medicine, but researchers work hard on elaborating the new methods of fighting the problem.