Post Traumatic Stress Disorder

Post Traumatic Stress Disorder

What is Post Traumatic Stress Disorder?

Post Traumatic Stress disorder (PTSD) develops after a significant trauma occurs that was either experienced or witnessed by the young person. It involves the development of psychological reactions related to the experience such as recurrent, intrusive and distressing recollections of the event. These may be in the form of nightmares, flashbacks and/or hallucinations.

Recent widening of diagnostic criteria has included repeated or extreme indirect exposure in the performance of professional duties. This is not the same as watching tragic events on the television. It is essential not to confuse normal negative emotions with PTSD. Feeling upset about a stressful event is not PTSD. Feeling upset when remembering a stressful time or event is not PTSD.

The word trauma and the phrase “traumatic experience” should be reserved for severe, substantive and significant (often life-threatening) events. They should not be used to describe stress-provoking and difficult, unusual or common challenges of life.

What does PTSD look like?

The symptoms of PTSD develop are found 6-8 weeks following the traumatic event and are organized into three categories:

  • Intrusion Symptoms – recurrent, intrusive, distressing recollections or memories of the event in the form of memories, dreams, or flashbacks in which the individual perceives himself/herself to be re-living the event as though it was actually happening again in the present.
  • Avoidance Symptoms – avoidance of things – people, places, topics of conversation, food, drink, weather conditions, clothing, activities, situations, thoughts, feelings – that are associated with or are reminders of the traumatic event. In addition the person may experience a general sadness, numbing of emotions, a loss of interest in previously enjoyed activities, detachment from family and friends, and a sense of hopelessness about the future.
  •  Hyper arousal Symptoms – sleep problems (difficulties falling asleep or staying asleep), irritability, aggression, angry outbursts, hyper vigilance, self-destructive behavior, exaggerated startle response, and difficulty concentrating.
  •  Negative Moral Symptoms – Unable to recall key aspects, persistent and disturbed negative feelings, self-blaming, guilt, shame, and detachment.

1. The person has been exposed to a traumatic event in which both of the following were present:

The person felt their life was in danger or witnessed someone else’s life put in danger.

The person experienced extreme fear, helplessness or horror

2. The traumatic event is re-experienced, including one or more of:

Recurrent intrusive memories, dreams or nightmares reliving the event which causes psychological distress.

3. Avoidance of things associated with the event including 3 or more of:

Avoiding thoughts, feelings or conversations, avoiding activities, places or people, inability to recall aspect of the trauma, decreased interest or participation in activities, feeling detached or estranged from others, restricted range of affect, sense of foreshortened future.

4. Persistent symptoms of increased arousal including 2 or more of:

Difficulty falling or staying asleep, irritability, difficulty concentrating, hyper vigilance, exaggerated startle response short time accompanied by a lack of control over the eating during the episode) and by frequent and 5. Duration of symptoms greater than 1 month:

Severity of symptoms causes marked distress and impairment in daily functioning. How does PTSD differ from Acute Stress Disorder or normal grieving? It is normal to remember traumatic events and to fill distress or discomfort when doing so. This is not PTSD. PTSD must be distinguished from normal responses (such as grief, acute stress response) to such situations and from Acute Stress Disorder (ASD). ASD has similar symptoms to PTSD but ends or is diminished greatly sometimes without formal treatment within about four weeks of the traumatic event. Psychotherapies or SSRImedication may be used to treat ASD.

Duration and severity of PTSD symptoms may vary over time with recovery occurring within half a year (or less) in about half of cases.

What can I do if it is PTSD?

The first thing is to identify the young person with PTSD and help them find a knowledgeable helper who can provide education to them about what the problem is and how it can be treated.

It is important not to confuse PTSD with normal responses to traumatic events (often called an acute stress response) or with ASD. Do not create pathology where it does not exist! For people with PTSD, supportive counselling using cognitive therapy methods may be of help.

If the disorder is causing significant distress and impairment, referral to a specialist health care provider is indicated, as medication or specific types of psychotherapeutic treatments may be needed.