Post Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is an equal opportunity psychiatric diagnosis. It afflicts young and old, men and women, and any race. Its victims are frequently ashamed and embarrassed about getting help or even about merely admitting to themselves what is going on. The sufferers commonly have had no previous difficulty in handling and controlling their emotions during their lives. Suddenly they feel of emotionally out of control. That causes an additional amount of anxiety and fear.
PTSD is an anxiety disorder which in my clinical experience can develop in virtually anyone, if the traumatic event they experienced is horrifying enough. Different people experience the same kind of traumatic situation differently. Thus the intensity of the gruesome event is determined by the unique perspective of any given person. What may be horrifying for one person, may only be somewhat disturbing to another. Another aspect of causation to consider is that multiple horrifying events can gradually break down a person’s psychological defenses. After repeated trauma, some last traumatic event can suddenly cause much more severe and enduring symptoms of PTSD.
The symptoms of PTSD include severe nightmares, flashbacks, intrusive memories, insomnia, irritability, hypervigilance, avoidance of reminders of the trauma, and avoidance behavior. The avoidance behavior actually causes the most severe disability. For example it's impossible to live a normal life when you can't drive on freeways, enter grocery stores, enter shopping malls, read the news, or be around any people who remind you of the person who assaulted you.
Treatment has to be individualized. Currently there is a widespread therapeutic modality called "critical incident debriefing". More recent scientific research has questioned whether or not this procedure is actually useful for everyone.. Many people find it helpful to be able to talk to someone who understands their symptoms and who can convince them that their emotional reactions are quite common after trauma. Many people also seem to benefit from at least some participation in a group with other patients suffering from PTSD. Being around others with the same symptoms helps many people stop blaming themselves or feeling crazy. However, other people actually find talking repeatedly about what happened to them to be unhelpful or even retraumatizing.
Psychiatric medications are usually helpful when patients have severe symptoms. Although they do not cure the basic biological abnormalities of PTSD, they usually provide a lot of symptomatic relief. The serotonin reuptake inhibitor type antidepressants are frequently beneficial. It may be necessary to use additional drugs to treat insomnia. Recurrent nightmares frequently respond to Prazosin.
Secondary psychiatric diagnoses can develop. Many PTSD victims become alcoholics or addicted to other dangerous drugs. Some of these people are unskillfully trying to self medicate. Because of the irritability and rage reactions of PTSD victims, marriages suffer or break up. PTSD patients sometimes socially isolate which can worsen their symptoms because of a negative vicious circle. Another common secondary diagnosis is major depression. By using an individualized approach virtually everyone can improve, based upon my clinical experience. Unfortunately some people will never totally recover, but they can usually have very satisfying lives by accepting and learning to work around some of their persistent symptoms.
As for any other psychological problem, when you choose a doctor or therapist, it's important that you find one who you trust and with whom you feel comfortable. You have to be able to open up enough to tell your doctor or therapist what's really going on with you. Be patient, because this may take a little time.
There's another situation in which post-traumatic stress disorder symptoms can develop I'm referring to the fact that children who experience physical, sexual, and/or emotional abuse or neglect, commonly develop PTSD. The trauma can be obvious or subtle. It can consist of so-called "cumulative micro-trauma", as opposed to one major traumatic event. This makes sense when you consider the fact that children are very emotionally sensitive. Moreover, they are being betrayed or abused by the very people that they should be able to trust. Being raised in these difficult, abusive childhood circumstances causes one's very personality and character to be warped and distorted by ongoing PTSD symptoms. Again there is hope, and patients can definitely improve significantly. Improvement may be gradual and the treatment may be challenging, but continuing to live with distressing symptoms is also painful.
So if you see yourself in any of this, I would encourage you to put any skepticism aside and try discussing things with your doctor or with a mental-health provider, so that you can learn how to suffer less, and experience more enjoyment in your life.