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Post Traumatic Stress Disorder
(PTSD)
  Post Traumatic Stress Disorder
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 It can lead to...
 Treatment recommendations
 


There is a growing awareness among healthcare providers that traumatic experiences are widespread and that it is common for people who have been traumatized to develop medical and psychological symptoms associated with the experience. Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing Post Traumatic Stress Disorder (PTSD). Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape. PTSD is associated with an extremely high rate of medical and mental health service use, and possibly the highest per-capita cost of any psychological condition.

But there is help and there is hope.

PTSD is a long-term problem for many people. Studies show that 33-47% of people being treated for PTSD were still experiencing symptoms more than a year after the traumatic event. Without treatment many people continue to have PTSD symptoms up to ten years after the traumatic event.

Incidence; Risk Factors


Conservative estimates show that 9-10% of the general population has PTSD. Among people who were victims of specific traumatic experiences (rape, child abuse, violent assaults, etc.), the rate of PTSD is 60-80%.

PTSD can affect anyone at any age who has been exposed to a traumatic event where he/she experienced terror, threat (or perceived threat) to life, limb or sanity and his/her ability to cope was overwhelmed.

Signs & Symptoms
PTSD symptoms are divided into three categories. People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. However, the diagnosis of PTSD means that someone has met very specific criteria. The symptoms for PTSD are listed below.
  • Intrusive Re-experiencing People with PTSD frequently feel as if the trauma is happening again. This is sometimes called a flashback, reliving experience or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.
  • Avoidance People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.
  • Arousal Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled, irritable and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.
Below you will find some reactions and symptoms that are often experienced by individuals who have been through a trauma. These symptoms reflect your body's way of trying to cope and adjust to what has happened.

Physical
  • Pounding heart
  • Sweating
  • Flushed
  • Shortness of Breath/Hyperventilation
  • Chest Pains
  • Nausea/Vomiting
  • Upset stomach, Diarrhea
  • Loss of appetite or craving junk food
  • Muscle tremors
  • Loss of coordination
  • Frequent headaches or migraines
  • Muscle soreness
  • Rapid uncontrolled speech
  • Difficulty sitting or relaxing
  • Dizzy or fainting
  • Dryness of mouth and throat
  • Frequent need to urinate
  • Grinding of teeth
  • Inability to shake a cold
  • Weight change (gain or loss)
  • Insomnia/difficulty sleeping, nightmares
  • Feeling of exhaustion and fatigue
  • Change in sexual functioning or desire
  • Missed menstrual cycle
Thoughts and Attitudes
  • Disbelief
  • Horror
  • Confusion
  • Poor concentration
  • Spaciness
  • Poor decision making abilities
  • Disorientation
  • Poor memory
  • Poor attention (not retaining information)
  • Preoccupied with trauma memories
  • Preoccupation with health
  • Time distortion (time slows down or speeds up)
  • Increased rigidity and closed thinking (inflexibility)
  • Feeling omnipotent (unrealistic appraisal of situation)
  • Cynicism or negativism
  • Absolute thinking (I will never; This always)
  • Negative/Critical judgements against self (I am such a failure)
  • Hindsight thinking (If only; Why didn't)
Emotions
  • Numb/Emotionally shut down
  • Shocked
  • Anxious
  • Agitated
  • Panicked or fearful (specific or general)
  • Overwhelmed
  • Anger (at self, others, God)
  • Mood swings
  • Troubling dreams
  • Sad
  • Depression
  • Helpless or inadequate feelings
  • Sense of guilt
  • Loss of sense of humor
  • Less able to cope with new or continued emotional stress
Relationships
  • Irritability
  • Easily frustrated
  • Insensitivity
  • Loss of interest in others
  • Isolating/Distancing (Avoiding fellowship)
  • Insecurity
  • Avoidance of intimacy
  • Suspicious
  • Clingy
  • Discord/Arguments
  • Critical of others
  • Scapegoating (a focal point for suppressed anger and depression)
  • Hypersensitivity (feelings easily hurt)
Avoidance behaviors
  • Use of alcohol to numb
  • Use of drugs (prescription or not) to numb
  • Abandonment of fun activities
  • Overly involved in work
  • Desire to leave field
  • Less productive
Risky/Self-destructive behaviors
  • Increased smoking
  • Excessive spending
  • Accident prone
  • Sexual immorality
  • Losing or misplacing things
  • Easily startled/Hyperalert to environment
  • Tearful
Meaning/Ministry
  • Increasingly busy with task orientation
  • Loss of sense of purpose/role
  • Less meaning in ministry
  • Disappointment with God
  • Loss of motivation
  • Questioning former beliefs
Conclusion
Each person is unique in how they respond to a trauma, so your response may not be the same as another person who has gone through the same or a similar experience.

Remember that it takes time to heal.

After you work through these reactions, you will come to a new place in your life that is characterized by deeper understanding, healthy conclusions, resilience, deeper trust, and an expanded world view. You will be one who has suffered and yet thrived.

Even after many of the memories are gone and you are feeling much better, there may still be things which "trigger" these symptoms and painful memories.

If these symptoms become very intense and persist over a long period of time, or if you are noticing impairment in your ministry or relationships, you may want to consider talking with a counselor who specializes in trauma. This does not mean that you are crazy, only that you need some help.

Diagnosis & Tests
Unfortunately, it is common for those with PTSD to avoid treatment. Also, it is common for those who do seek treatment to be misdiagnosed. Because PTSD often occurs at the same time as other physiological and mental health disorders, PTSD symptoms may be masked or difficult to identify. Examples of common co-occurring conditions are depression, substance use/dependence and bipolar disorder. Trauma survivors may also experience headaches, chest pain, digestive or gynecological problems as well. However, there is a growing number of clinicians who are skilled at recognizing PTSD and still others who are specializing in treatment of traumatic stress disorders. If you think you might have PTSD you should seek professional help for a thorough physical and mental health assessment.

Treatment & Prevention
A person who has survived a traumatic event will probably never feel as if the event didn't happen, but the disruptive, distressing effects of PTSD are completely treatable. Depending on the source of the trauma (man-made versus natural), the nature of the trauma (accidental versus purposeful), and the age of the victim at the time of the trauma, treatment strategies may vary. Treatment involves both managing symptoms and working through the traumatic event. Most experts agree that psychotherapy is an important part of recovery. Medications can help reduce some symptoms allowing psychotherapy to be more effective.





Signs, symptoms & indicators of Post Traumatic Stress Disorder (PTSD):
Symptoms - Mind - Emotional  Difficult memories
 People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Many with PTSD often feel as if the trauma is happening all over again.

  Irritability

Symptoms - Mind - General

  Jumpiness
 Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may seem constantly on guard and may find it difficult to concentrate.

  Having trouble concentrating

Symptoms - Respiratory

  (Sudden) shortness of breath

Symptoms - Sleep

  Bizarre/vivid/nightmarish dreams
 People suffering from PTSD may have intrusive mental images or hallucinations about a trauma, or recurrent nightmares.

  Unsound sleep
  (Frequent) difficulty falling asleep
  Being a light sleeper

Conditions that suggest Post Traumatic Stress Disorder (PTSD):
Addictions  Alcohol-related Problems
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Mental

  Panic Attacks
 Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

  Poor Sense of Humor

Risk factors for Post Traumatic Stress Disorder (PTSD):
Childhood  (Severe) sexual abuse during childhood
 Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

  Harsh punishment/physical abuse during childhood
 Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

Supplements and Medications

  (Past) marijuana use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) cocaine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) heroin/morphine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) LSD use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) methamphetamine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) ecstacy use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Symptoms - Mind - Emotional

  Having been raped
 Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape.

  History of panic attacks
 Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

Post Traumatic Stress Disorder (PTSD) can lead to:
Mental  Poor Sense of Humor

Recommendations and treatments for Post Traumatic Stress Disorder (PTSD):
Psychological  Counseling


KEY
Weak or unproven link
Strong or generally accepted link
Highly recommended


GLOSSARY

Bipolar Disorder (Manic Depression, Manic-Depression, Manic-Depressive)
A disorder is characterized by alternating periods of extreme moods, usually swinging from being overly elated or irritable (mania) to sad and hopeless (depression) and then back again, with periods of normal mood in between. The frequency of the swings between these two states, and the duration of the mood, varies from person to person.

Crave (Craving, Cravings)
To have a strong desire for; to feel the need for.

Diarrhea
Excessive discharge of contents of bowel.

Hallucination (Hallucinations)
A false or distorted perception of objects or events, including sensations of sight, sound, taste, smell or touch, typically accompanied by a powerful belief in their reality.

Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.

Migraine (Migraine Headache, Migraine Headaches, Migraines)
Not just a headache, but a disorder affecting the whole body, characterized by clearly defined attacks lasting from about 4 to 72 hours, separated by headache-free periods; progresses through five distinct phases. Prodrome: experienced by about 50% of migraineurs and starting up to 24 hours before the headache - changes in mood, sensory perception, food craving, excessive yawning, or speech or memory problems. Aura: experienced by about 15% and starting within an hour before the headache - disruption of vision (flashing lights, shimmering zigzag lines, blind spot) or sensation (numbness or 'pins and needles' around the lips or hand), or difficulty speaking. Headache: usually pulsating and occurring on one side of the head, it may occur on both sides of the head and alternate from side to side. Muscles in the neck and scalp may be tender; there may be nausea and the desire not to eat, move, see or hear. Resolution: the headache disappears and the body returns to normal. Resolution may occur over several hours during sleep or rest; an intense emotional experience or vomiting may also end the headache. Postdrome: After the headache stops, the sufferer feels drained, fatigued and tired. Muscles ache, emotions are volatile and thinking is slow.

Nausea
Symptoms resulting from an inclination to vomit.

Panic Attack (Panic Attacks)
A brief, irrational episode of fear that is perceived as so real that an individual may be driven to escape from the place or situation where it occurs. The attack is sudden and increases in severity until it leaves, usually within ten minutes. Panic attack symptoms are numerous and involve both mental and physical signs and symptoms. A panic attack can occur in other anxiety states such as agoraphobia and with certain activities and places. It may occur spontaneously without an apparent cause.

Post Traumatic Stress Disorder (Posttraumatic Stress Disorder, PTSD)
An anxiety disorder in which symptoms develop following a psychologically distressing event that is outside the normal range of human experiences (e.g. military combat, sexual assault, natural disasters, severe auto accidents). The essential features of PTSD include increased arousal, re-experiencing of a traumatic event, and avoidance of stimuli associated with the traumatic event. The symptoms include continued flashbacks, nightmares, and intense distress when exposed to an object or situation that is related to the traumatic event.

Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.




Last updated: Jul 12, 2008


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