Post-traumatic stress
disorder can happen to a person after experiencing a traumatic event that has
caused them to feel fearful, shocked, or helpless. It can have long-term
effects, including flashbacks, difficulty sleeping, and anxiety.
Examples of events that can trigger post-traumatic stress disorder
(PTSD) include wars, crimes, fires, accidents, death of a loved one, or abuse
of some form. Thoughts and memories recur even though the danger has passed.
It is thought to affect between 7 and 8 percent of
the population, and women are more likely to be affected than men.
Instead of feeling better as time goes on, the individual
may become more anxious and fearful. PTSD can disrupt a person’s life for
years, but treatment can help them recover.
Symptoms and diagnosis
For a person to receive a diagnosis of PTSD, they must
meet criteria that are set out by the American Psychological Association’s
(APA) Diagnostic and Statistical Manual Fifth Edition (DSM-5).
According to these guidelines, the
person must:
1. Have been exposed to death or threatened death, serious
injury or sexual violence whether directly, through witnessing it, by it
happening to a loved one, or during professional duties
2. Experience the following for more than one month:
- one or more intrusion symptoms
- one or more avoidance symptoms
- two or more symptoms that affect
mood and thinking
- two or more arousal and
reactivity symptoms that began after the trauma
Here are some examples of these four types of symptom:
Intrusion
symptoms:
- nightmares
- flashbacks and a sensation that
the event is happening again
- fearful thoughts
Avoidance
symptoms:
- refusing to discuss the event
- avoiding situations that remind
the person of the event
Arousal
and reactivity symptoms:
- difficulty sleeping
- irritability and angry outbursts
- hypersensitivity to possible
dangers
- feeling tense and anxious
Symptoms
that affect mood and thinking:
- inability to remember some
aspects of the event
- feelings of guilt and blame
- feeling detached and estranged
from others and emotionally and mentally numbed
- having a reduced interest in
life
- difficulty concentrating
- mental
health problems, such as depression, phobias,
and anxiety
In addition, the symptoms must lead to distress or
difficulty coping with work or relationships, and they must not be due to the
use of medication or other substances, or another health condition.
Physical symptoms
There may also be physical symptoms, but these are not
included in the DSM-5 criteria:
- physical effects include
sweating, shaking, headaches,
dizziness, stomach problems, aches and pains, and chest pain
- a weakened immune system can
lead to more frequent infections
- sleep disturbances can result in tiredness and
other problems
There may be long-term behavioral changes that contribute
to problems and work and a breakdown in relationships. The person may start to
consume more alcohol than previously, or to misuse drugs or medications.
Children and teens
In those aged 6 years or under, symptoms
may include:
- bedwetting after
learning to use the bathroom
- inability to speak
- acting out the event in play
- being clingy with an adult
Between the ages of 5 and 12 years, the child may not have
flashbacks and they may not have difficulty remembering parts of the event.
However, they may remember it in a different order, or feel that there was a
sign that it was going to happen.
They may also act out the trauma or express it through
play, pictures, and stories. They may have nightmares and be irritable. They may
find it hard to go to school or spend time with friends or studying.
From the age of 8 years and above, children generally
tend to display similar reactions to adults.
Between the ages of 12 and 18 years, the person may show
disruptive or disrespectful, impulsive or aggressive behavior.
They may feel guilty for not acting differently during the
event, or they may consider revenge.
Children who have experienced sexual abuse are more likely
to:
- feel fear, sadness, anxiety, and
isolation
- have a low sense of self-worth
- behave in an aggressive manner
- display unusual sexual behavior
- hurt themselves
- misuse drugs or alcohol
Screening
As part of the diagnostic process, the person may be given
a screening test to assess whether or not they have PTSD.
The time taken for this can range from 15 minutes to
several one-hour sessions. A longer assessment may be used if there are legal
implications or if a disability claim depends on it.
If symptoms disappear after a few weeks, there may be a
diagnosis of acute stress disorder.
PTSD tends to last for longer and the symptoms are more
severe and may not appear until some time after the event.
Many people recover within 6 months, but some continue to
experience symptoms for several years.
Causes
Some people who
return from conflict zones experience PTSD.
PTSD can develop after a traumatic
event.
Examples include:
- military confrontation
- natural disasters
- serious accidents
- terrorist attacks
- loss of a loved one, whether or
not this involved violence
- rape or other types of abuse
- personal assault
- being a victim of crime
- receiving a life-threatening diagnosis
Any situation that triggers fear, shock, horror, or
helplessness can lead to PTSD.
Risk
factors
It remains unclear why
some people develop PTSD while others do not. However, the following risk
factors may increase the chance of experiencing symptoms:
- having additional problems after
an event, for example, losing a loved one and losing a job
- lacking social support after an
event
- having a history of mental
health problems or substance use
- past experience of abuse, for
example, during childhood
- having poor physical health
before or as a result of an event
Some physical and genetic factors may play a role. These
may impact the chance of having anxiety, depression, and PTSD.
Brain
structure: Brain scans have shown that the hippocampus appears
different in people with PTSD, compared with others. The hippocampus is
involved in processing emotions and memories, and it could affect the chance of
having flashbacks
Response
to stress: Levels of hormones that are normally released in a
fight-or-flight situation appear to be different in people with PTSD.
Gender:
This may play a role. Studies suggest that, while men are more likely to
experience violence, women have a higher chance of having PTSD.
Source: Medical News Today
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