What is PTSD?
The information in this post was adapted from the above 50 & Better Health Fair presentation given by Brenna Ryan, D.O.’24 in November 2021.
Post-traumatic stress disorder, or PTSD, is a mental health condition that’s triggered by a terrifying or traumatic event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. People with PTSD often have severe depression and problems functioning in their daily lives. They may be more likely to commit suicide, abuse drugs or alcohol or get into trouble with the law. Previously known as shell shock, PTSD is no longer just restricted to service members; in fact, it occurs in 15 million US adults each year.
Despite this, it’s important to know that PTSD is a treatable psychiatric disorder. The trauma that can induce PTSD comes in a variety of forms, including things like natural disasters, being involved in war and combat or being taken hostage, being a victim of terrorist actions, being a victim of sexual or domestic abuse, or becoming a prisoner of war. Trauma associated with PTSD can be acute or chronic. If it is a relatively short duration, it is characterized as acute PTSD; If someone experiences prolonged amounts of trauma, trauma over a long period of time or repeated exposures to traumatic events, this can eventually develop into a complex form of PTSD that often has a more severe presentation of symptoms and can sometimes be more challenging, although not impossible to treat.
What factors contribute to PTSD?
There are various factors that can predispose someone to be more likely to develop PTSD. Some internal factors include identifying as female, having an attitude of self-blame, and having prior emotional or behavioral challenges. External factors that can contribute to this predisposition include encountering childhood adversity, having prior exposure to trauma, either in childhood adolescence or adulthood, and most importantly, having a lack of a social support system.
How do I know if I have PTSD?
PTSD is diagnosed through a series of criteria: First, there must be exposure to a trauma of some sort, either through witnessing a traumatic event, experiencing a traumatic event, or learning about the trauma faced by a close friend or family member.
Secondly, we must see some sort of intrusion of this trauma into a person’s daily life. This can come through the form of dreams, intrusive memories, or even flashbacks. What we also see is persistent avoidance of anything that can set off these intrusive thoughts. A particular situation, sound, person, or experience might cause these traumatic memories to consistently appear.
How is PTSD diagnosed?
Patients with PTSD often experience alterations in their mood and thinking, which can manifest as an inability to remember details, or distort the details of their traumatic event. Mood can be impacted by not enjoying activities that the person used to love, not emotionally connecting with people, or not being able to experience as many positive feelings.
With changes to arousal and reactivity, we see that people become hyper-vigilant, have stronger reactions to surprises, and can even have more overt anger and outbursts. In terms of arousal, the person may be experiencing a lot of sleep disturbance. Any presentation of one or multiple of these symptoms for longer than one month is highly indicative of PTSD.
What types of PTSD treatment are there?
There are two primary treatment methods for PTSD: psychotherapy and pharmacology.
Within psychotherapy there are many approaches to treatment, including prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing. The goal of these different psychotherapies is ultimately to reduce anxiety, confront the trauma, and reshape the distortions that have occurred as a result of this.
In anxiety reduction, we see techniques such as meditation and breathing exercises to help the patient control their thoughts. With confrontation, we placed the patient in a scenario where the trauma is reproduced, but in a more therapeutic way with the presence of a therapist or other guiding factors. This practice allows the patient to have more control over the traumatic environment and ultimately allows them to accomplish the final step of reshaping their distortions.
By working with a therapist in a safe environment, it’s possible to remove the link that has formed between the traumatic stimulus and the fear that the patient encounters. One example of how confrontation can be used is a small 2019 study in which 20 veterans of various ages and genders were exposed to war-themed video games in order to confront their previous traumas in a safe and controlled environment.
In addition to individualized therapy, we also see success in group therapy with PTSD treatment, as this allows for not only the confrontation of trauma, but also the use of social support systems to show patients that they are not alone in their struggle.
Medications to help treat PTSD
Medications that are used to help treat PTSD include selective serotonin receptor inhibitors (SSRIs) and Prazosin. SSRIs are used to improve mood by leaving the molecule serotonin in a receptor synapse for a longer period of time; Prazosin is an anti-hypertensive agent which can help reduce the prevalence of nightmares.
PTSD Treatment Outcomes
With proper treatment, PTSD has good outcomes, especially if patients avoid substance abuse, prevent additional trauma within their ability and maintain good social support throughout the treatment process. It should also be noted that since PTSD can occur simply through learning about the trauma that others have experienced, family and friends of those with current or prior PTSD should also consider seeking therapy to improve their quality of life.
If you or someone you know is struggling with post-traumatic stress disorder, our providers at the DMU Behavioral Health Clinic are here to help you return to living life to the fullest. To schedule an appointment, visit the DMU Clinic website or call 515-271-1716.