Posttraumatic Stress Disorder (PTSD)
Sorry for the infrequency of my posts but due to personal and professional issues, I’ve been taking some time off from writing. This post is to signify that I am back and working to make posts more regularly. I apologize for any inconvenience regarding the readily available mental health information that I try to provide.
For today’s post I wanted to touch on the disorder of PTSD. Often in the media we have heard that many Americans and humans across the world may experience some form of PTSD due to the COVID-19 pandemic. Due to the overwhelming stress and uncertainty around the disease, many people may have underlying stress issues relating to disease for years to come. Due to this frame of thinking as purported by the media, I have decided I wanted to make an informed post on what PTSD is and how it presents under “normal” circumstances.
PTSD, or Posttraumatic Stress Disorder, is a form of stress disorder that is normally diagnosed in adults, adolescents, and children above the age of 6. It is a debilitating stress response to traumatic events that may have happened to or around the individual being diagnosed with it. Let’s start with what needs to occur for a person to be diagnosed with this disorder. Like any disorder in the DSM 5, there are certain criteria that needs to be hit for a person to qualify for the identified disorder. For PTSD there are 8 criteria that needs to be met.
Criterion A
The individual must have experienced death or have been threatened with death, serious injury or sexual violence. They must have directly experienced it, have witnessed it happening to another person or have heard that it happened to a close family member or friend. We normally hear it happen to those that have gone into the military or victims of domestic violence. The traumatic experience happening to them or witnessed by them was traumatic enough to warrant a stress response.
Criterion B
The individual must have one or more intrusion symptoms. An intrusion symptom is basically something that is out of the control of the individual that intrudes into their everyday life. For this criterion the 5 intrusion symptoms are
- Recurrent intrusive distressing memories of the traumatic events
- Recurrent distressing dreams related to the traumatic event
- Dissociative reactions where the individual feels or acts like the traumatic events were recurring
o Such as flashbacks
- Intense/prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
o Such as a negative response by a war veteran to fireworks and loud noises
- Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event
o Increased heart rate, shortness of breath, etc.
Criterion C
The individual must be persistently avoiding stimuli related to the traumatic event in at least one of two ways;
- Avoidance of or trying to avoid distressing memories, thoughts or feelings around the traumatic event
o Not sleeping is a good indicator of this
- Avoidance of or trying to avoid external reminders that may induce distressing memories, thoughts, or feelings around the traumatic event
o Avoiding gatherings or certain people in general
Criterion D
The individual would have negative alterations in mood and cognitions (thought processes) associated with the traumatic events. There are 7 different possibilities that this could present in the individual and to be accurately diagnosed with PTSD, they would have to be shown in at least 2 of the ways. They are as follows:
- Inability to remember an important aspect of the traumatic event, not evidenced by any use of alcohol, drugs or injury to the head
o Might be due to selective amnesia in order to better cope with the trauma
- Persistent and exaggerated negative beliefs about oneself or the world
- Persistent, distorted cognitions about the cause or consequences of the the traumatic events
o May blame themselves or others for the event
- Persistent negative emotional state
- Marked diminished interest or participation in significant activities
- Feelings of detachment from others
- Persistent inability to experience positive emotions
Criterion E
The individual would have alterations in arousal and reactivity associated with the traumatic events. For this criterion there are 6 different possibilities and for an accurate diagnosis they would have to be shown in at least 2 of the ways. They are as follows:
- Irritable behavior or angry outbursts expressed verbally or physically toward people or objects
o No provocation is normally involved in this case
- Reckless or self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Problems with concentration
- Sleep disturbance
o Difficulty falling or staying asleep
Criterion F
In relation to Criterions B-E, they are present for at least one month.
Criterion G
The disturbance causes significant distress in social, occupational or other important areas of functioning
Criterion H
The disturbance is not explained by substance use or a medical condition
Once the each of the criteria are met a therapist would normally add a specifier, however I will touch on specifiers in a later post.
Even though I stated earlier that PTSD is normally diagnosed in individuals 6 years and older however there are criteria for children under the age of 6 to be diagnosed with PTSD. However, in order to not bore you with more technical information, I’ll save that for another post as well. Anyone that experiences high levels of stress that they deem traumatic would possibly be diagnosed with PTSD. When you think of high stress situations, think of the situations where you assume would be highly traumatic. Active military and veterans or victims of abuse (sexual, physical, etc.) are the ones we normally hear about however as I’ve stated, high traumatic situations can lead to a diagnosis of PTSD.
TREATMENT
As for treatment for PTSD there are a couple of treatments and medications that are suggested in order to help with managing this disorder. I’ll do brief explanations of the accepted treatments with the plan on going more in depth with later posts as well.
1. Prolonged Exposure Therapy – This type of therapy helps the individual create coping mechanisms to deal with situations they’ve avoided due to their PTSD. With the new coping systems and a list of each thing that has been avoided, the individual learns how to better deal with these situations on their own.
2. Cognitive Processing Therapy – This type of therapy is self-explanatory. It helps the individual change their mindset around the trauma so that they can better explain it and deal with it.
3. Eye Movement Desensitization and Reprocessing (EMDR) – In this type of treatment the individual would be asked to focus on the traumatic event while the therapist is doing something to cause you to focus on them as well. Normally using hand movements or flashing lights.
Depending on the nature of the individual’s PTSD, would determine the best treatment that they could possibly benefit from. It is suggested that a combination of therapy and medications would best help manage the symptoms of this disorder.
Information for this post was found using the DSM 5, WebMD and the US Department of Veteran Affairs.