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Post-traumatic Stress Disorder

PTSD

Post-traumatic stress disorder (PTSD) is a condition which develops after you have been involved in, or witnessed, a serious trauma such as a life-threatening assault. During the trauma you feel intense fear, helplessness or horror. In some people PTSD develops soon after the trauma. However, in some cases the symptoms first develop several months, or even years, after the trauma.

The strict definition of PTSD is that the trauma you had or witnessed must be severe. For example: a severe accident, rape, a life-threatening assault, torture, seeing someone killed, etc. However, symptoms similar to PTSD develop in some people after less severe traumatic events.

Some people have risk factors which make them more prone to develop PTSD when they are exposed to a traumatic event. These include:

  1. Previous mental health problems.
  2. Being female.
  3. Coming from a poor background.
  4. Lack of education.
  5. Coming from an ethnic minority.
  6. Being exposed to trauma in the past.
  7. A family history of mental illness.
What are the symptoms of post-traumatic stress disorder?

Recurring thoughts, memories, images, dreams, or flashbacks of the trauma which are distressing. You try to avoid thoughts, conversations, places, people, activities or anything which may trigger memories of the trauma, as these make you distressed or anxious. Feeling emotionally numb and feeling detached from others. Your outlook for the future is often pessimistic.

Increased arousal which you did not have before the trauma. This may include:
  1. Difficulty in getting off to sleep or staying asleep.
  2. Being irritable which may include outbursts of anger.
  3. Difficulty concentrating.
  4. Increased vigilance.
What is the treatment for post-traumatic stress disorder?

You may need no treatment if your symptoms are mild, particularly if the trauma happened less than a month ago. However, if your symptoms are prolonged and moderate or severe, treatment can help you to adjust. If you have severe symptoms 2-4 weeks after the incident, you are likely to need treatment.

You should be aware that no treatment will 'make everything absolutely alright all over again.

Cognitive behavioural therapy (CBT) may be advised. Briefly, CBT is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as PTSD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and false ideas or thoughts. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful.

Eye movement desensitisation and reprocessing (EMDR) is a treatment that seems to work quite well for PTSD. Briefly, during this treatment a therapist asks you to think of aspects of the traumatic event. Whilst you are thinking about this you follow the movement of the therapist's moving fingers with your eyes. It is not clear how this works. It seems to desensitise your thought patterns about the traumatic event.

Self-help. Joining a group where members have similar symptoms can be useful. This does not appeal to everyone, but books and leaflets on understanding PTSD and how to combat it may help.

Medication

Antidepressant medicines are often prescribed. These are commonly used to treat depression, but have been found to help reduce the main symptoms of PTSD even if you are not depressed.

Antidepressants take 2-4 weeks before their effect builds up, and can take up to three months. There are several types of antidepressants. However, selective serotonin reuptake inhibitor (SSRI) antidepressants are the ones most commonly used for PTSD. Paroxetine has been found particularly useful for general use.

A combination of treatments such as cognitive behavioural therapy and an SSRI antidepressant may work better in some cases than either treatment alone.

What is the outlook for post-traumatic stress disorder?

Statistics show that about 2 in 3 people with PTSD eventually get better without treatment, although the improvement may take several months. In about 1 in 3 three people the symptoms last longer, sometimes for many years, and can be quite severe in some people.


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