Post Traumatic Stress for Dummies.

I’ve put together this crib sheet for Post-Traumatic Stress Disorder. Hopefully it’s useful, and it’s sure cheaper than the books. A summary never really hurts but let’s all be kind and remember that CK is not a health professional so she does not claim this is a definitive or complete guide to PTSD.

The Basics of Post Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder with a wide range of severity.

PTSD is not a form of psychosis, though some people who experience severe PTSD may experience psychotic symptoms at times.

Having PTSD doesn’t mean you’re any more likely to be violent, offensive or out of control than anybody else.

PTSD does not make you weak, lesser than anybody else or a burden (I’m just saying).

It is an illness that just about anyone can develop given the ‘right’ environmental circumstances though it is more likely in certain genetically predisposed individuals.

There is technically no cure but people with PTSD typically do have long periods of total, or near total remission of symptoms.

Equally, people with PTSD can have periods in which symptoms re-occur, particularly after further exposure to trauma, increased stress or following major life changes such as the birth of a child, marriage/divorce or the death of a loved one.

PTSD occurs after exposure to extreme psychological trauma, which can take many forms. This brings about an equally extreme and ongoing emotional reaction in the individual. So whilst people who have PTSD often have been exposed to physical trauma as well that in itself is not the cause.

It is possible to develop PTSD well after the psychological trauma occurred, sometimes even years later.

PTSD does cause specific biochemical changes in the brain and body. These are not yet all that well understood.

PTSD runs in families but genetic studies are complicated because there is always a very strong enviromental factor implicated in the development of the disorder.

PTSD is commonly treated with a combination of psychotherapy and medications.

Medications commonly used to treat PTSD include:

Antidepressants: Typically SSRI’s, SNRI’s or NaSSS’s.

If antidepressants don’t do the trick medications such as Atypical Antipsychotics, Anticonvulsants, Beta Blockers and/or Benzodiazepines are trialled. Their success varies pretty widely.

Individuals who suffer from PTSD alternate between periods of re-experiencing the trauma (in the form of flashbacks or nightmares) and periods of numbing/dissociation. This often makes treatment complicated, and is why psychotherapy sometimes takes longer than people expect.

People with PTSD cannot just “get over” the trauma. In individuals with PTSD the traumatic event still needs to be fully processed by the fear centers of the brain, and until that happens the trauma is repeatedly re-experienced in its full intensity in response to current environmental cues that are associated with it.

PTSD interferes with a person’s ability to sleep, may make them more prone to anger/irritability and makes them almost constantly alert for danger (hypervigilant).

One of the hallmarks of PTSD is an unusually strong startle response – for example, to loud or unexpected noises.

Anything in the current environment which is reminiscent of the emotional reaction experienced by the individual at the time of the original trauma can act as a ‘trigger’. That is, things in the here and now can put someone with PTSD back into the memory of the trauma but it is not experienced with the normal distance of an ordinary memory.

Someone with PTSD may see, hear, feel, taste or smell parts or all of the memory of the traumatic event as if it was happening again, including the same sense of fear/helplessness and terror that occurred at the time. However, the person’s reality testing capacity essentially remains intact so that they do know that the event is not really happening in the present – it ‘just’ feels like it is.

PTSD is more common in people who suffer from chronic migraine headaches.

Recent research suggests that individuals with PTSD are at higher risk for coronary heart disease.

In most cases the symptoms of PTSD will dissipate in time, though that depends on a number of variables, including:-

• Initial severity of the condition;
• Intensity of the original trauma;
• Whether the individual received appropriate treatment within an adequate time frame;
• Response to medication and/or psychotherapy;
• Incidence of co-morbid mental illness or substance abuse issues;
• Number of traumatic events experienced;
• Age at which the trauma took place;
• Whether the sufferer has a reliable support system;
• Whether the trauma was repeated and/or how long it lasted; and
• Individual predisposition to a more acute stress reaction.