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PTSD. Recollection of Facts

Introduction. PTSD summary of facts

Facts PTSD. Picture shows British soldiers in the tranches of WW I. The soldiers stand in a trench next to a canon. One soldier is running with his guns into attack. The air is covered by dust
British soldiers in the trenches of WW I

In the below article we present a summary about Post-Traumatic Stress Disorder (PTSD) and related facts.

Post-Traumatic Stress Disorder may occur in people, who were exposed to traumatic events. Since WW I the war trauma has been described in military terms. During WW I it has been called “shell shock”; during World War II “battle fatigue”. During WW I and WW II psychiatrists called the disorder “war neurosis”.

Today PTSD diagnosis is used not only for the veterans of wars but also for civilians developing the above-mentioned symptoms after being affected by suddenly occurring traumatic event. A fact is that after the exposure to trauma person suffers from intense, disturbing thoughts and/or feelings that last long after the exposure.

What is PTSD?

PTSD (Post-Traumatic Stress Disorder) is a mental health problem developed after being exposed to a life-threatening event. For some people, the symptoms might occur directly after the trauma exposure, or they may come and go over time.

How can I recognize that I have PTSD?

After a trauma people might develop upsetting memories, called “flash backs” and feel easily irritable. It is a fact that other symptoms typical for PTSD are insomnia, anxiety, and depression. PTSD affects your social and professional activities like going to work, being effective at work, seeing friends and enjoying the social interactions. Some people develop PTSD symptoms immediately after the trauma. By others, the symptoms may come over time. If the symptoms and thoughts related to the trauma persist over months upsetting you causing problems in your life, it’s likely that you have PTSD.

Who can develop PTSD?

PTSD recollection of facts. Picture with flames in the shape of the letters PTSD
PTSD occurs not only in soldier but also in ordinary people, who were exposed to traumatic events

Another PTSD fact is that anyone can develop PTSD at any age. Several factors make people more likely to get PTSD, most of which are beyond the person’s control. For example, an intense or prolonged traumatic event makes a person more likely to develop PTSD. It is a fact that PTSD is common after certain types of traumata, such as combat trauma or sexual assault. Also, personal factors such as previous traumatic experiences, age, and gender can influence the risk for PTSD.

PTSD in Veterans

Researchers noted that prior to being accepted as an official medical diagnosis in the 1980s statistics on PTSD in veterans of past wars are not available.  Most of the veteran’s PTSD data currently available are from recent wars involving Iraq and Afghanistan. The military PTSD statistics show that in fact an estimated 20% of veterans of these wars developed PTSD.

What Are the Symptoms of PTSD?

PTSD symptoms usually begin shortly after the traumatic event but can appear months or years later. They can also come and go over the years. Typical for PTSD is when the symptoms persist for more than 4 weeks, causing great distress and interfering with people’s personal life.

PTSD-Symptoms clusters

Re-experiencing symptoms

Memories of the event appearing repeatedly. This can be nightmares, trauma memories (“flash backs”) related to the event. Particulate situations called triggers such as smell, sound or news reliving the trauma, can trigger overshooting stressful reaction.

Avoidance

The person avoids things reminding him of the trauma. They can avoid places or people related to the event, or even suppressing talking and thinking of such event. For example, avoiding narrow or open spaces, crowded places, or other situations usually connected thematically with the event.

Negative feelings and thoughts

After the event, the person experiences negativistic thinking. He might feel numb and unable to express emotions, even towards the love-ones. Frequently the feelings of guilt or shame are present, especially by those who witnessed the death of friends or relatives, called “survivor guilt”.

Hyperarousal

The hyperarousal is frequently associated with insomnia, lack of focus, and unhealthy lifestyle such as overeating, excessive smoking, abusing alcohol or drugs. The person feels “on edge”, is easily irritable, anxious or might act aggressively.

PTSD and Trauma

Picture of ruined building after the Earthquake in Sicily 1990
Ruins after 1990 earthquake in Sicily

Scientists linked over 60 years the combat trauma and PTSD together. Most of the scientists thought that military combat was the primary cause of PTSD. An important fact is that over the past thirty years the criteria of PTSD has evolved. It currently is linking to PTSD also other traumatic events such car accidents, plane crashes, natural disasters, such es earthquakes and hurricanes, being taken hostages, domestic violence, and sexual abuse.

PTSD and Depression

Depression is a common mental health problem. In the industrialized countries depression (mild, moderate, or severe) affects around one of ten individuals per year. The pre-existent depression adds to the risk of developing PTSD and in reverse, PTSD can trigger depression in previously healthy individuals. It is a fact that people with PTSD are three to five times more likely to be affected. In summary, sufferers of PTSD are four time more likely to develop depression. Mental health professionals are aware that PTSD significantly increases the risk of suicide.

PTSD and Anxiety

The American Psychiatric Association (APA) in the past classified PTSD as an anxiety disorder. Such association was understandable because PTSD and anxiety disorders might crate the same symptoms. The most frequent symptoms occurring in PTSD and in the anxiety, disorders are fluctuating anxiety, panic attacks, insomnia as well as disturbances of several important biological functions. On the other hand, the pre-existent anxiety increases the risk of PTSD after trauma exposure.

PTSD and Substance Abuse

Mental healthcare providers noted that PTSD and substance abuse often coexist. A summary of several studies has shown that around half patients suffering of PTSD fulfil the criteria for a substance abuse disorders. PTSD and alcohol dependence in traumatized individuals often occur at the same time. The reason for alcohol over drug abuse, it because of alcohol’s legal status and its availability.

Treatments for PTSD

Researchers in the field of psychiatry and psychology have proven the fact that trauma-focused psychotherapy and pharmacotherapy, used separately or together, are most effective in treating PTSD.

Trauma-Focused Psychotherapy

Psychologists have shown that trauma-focused psychotherapy is the most effective evidence-based treatment for PTSD. “Trauma-focused” means that treatment focuses on the memory of the traumatic event and their associations. The three most effective forms of trauma-focused psychotherapy are:

Medications for PTSD

Medication for PTSD
Medication for PTSD

Certain medications are effective in treating PTSD symptoms. Some specific SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors) used in depression also work in PTSD.

PTSD-Prognosis

A PTSD summary shows us that the prognosis of this disorder has improved in recent years as researchers and medical professionals have discovered increasingly effective treatments. The long-term prognosis for PTSD is good, and symptoms often disappear or lessen with treatment. Such positive therapeutic effects can be achieved with treatment initiated soon after trauma and with healthy social support. The prognosis is good especially in high-functioning individuals without pre-traumatic psychiatric disorders.

Dr. Gregor Kowal - The Best Psychiatrist in Dubai | CHMC

DR. GREGOR KOWAL

Senior Consultant in Psychiatry, Psychotherapy And Family Medicine (German Board)
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