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Post-Traumatic Stress Disorder

Medication and therapy can help

The human nervous system learns well, sometimes too well. A life-threatening experience, just once, can teach your brain to be cautious about anything even remotely resembling that experience, for years. This, says psychiatrist Jim Phelps, appears to be central in the development of post-traumatic stress disorder.

What is PTSD?

Post-traumatic stress disorder (PTSD) can develop after a person experiences a traumatic event that harmed or threatened them or a loved one, or they witness such an event. Examples include: violent assault, the death of a child, natural or manmade disasters, military combat, and automobile accidents. "After I watched my brother get shot, I felt afraid all the time. Although he recovered, I just couldn't seem to get over it. I had awful nightmares and memories; I'd cry and shake. Medication and therapy really helped and I am starting to feel like myself again."

Fear, an emotion that evolved to protect us from danger, causes an automatic protective response of hormones and neurotransmitters. But for people with PTSD, that response continues to occur long after the danger has passed.

PTSD is often accompanied by depression, substance abuse or an anxiety disorder. Symptoms can start within about three months of the event or not until years later. Some people get better within months, while others may have the illness for much longer.

What are the symptoms of PTSD?

If you have PTSD, you often have nightmares or frightening thoughts about the experience you went through. You may try to avoid anything that reminds you of your experience.

You may experience symptoms like these for a month or longer:

  • feeling emotionally numb,
  • feeling unable to trust or care about other people,
  • having sleeping difficulties,
  • losing interest in things you used to enjoy,
  • feeling guilty,
  • become angry or more aggressive,
  • having trouble doing everyday things,
  • having difficulty remembering important aspects of the event,
  • having difficulty concentrating.

Physical symptoms such as headaches, gastrointestinal distress, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common in people with PTSD. Often, doctors treat these symptoms without being aware that they stem from an anxiety disorder.

How is it treated?

  • Certain medications and certain kinds of psychotherapy have proven successful in treating the symptoms of PTSD. Choose a doctor who has special training and experience in treating people with PTSD.
  • Therapy Three kinds of psychotherapy have been shown to be effective in the treatment of PTSD: Anxiety management teaches coping skills, including relaxation techniques, assertiveness training and positive self-talk.
  • Cognitive therapy helps patients learn to recognize the distorted thoughts and beliefs that cause pain and replace them with those that help them feel and function better. In exposure therapy, patients relive their traumatic experience, in a safe way, and gradually confront situations that trigger their unrealistic anxiety.
  • Medications For patients with severe symptoms, medications may be used. These include antidepressants, usually SSRIs; antianxiety medications; and when necessary, antipsychotic medications, anticonvulsants and benzodiazepines. It may take a few weeks for the medicine to work.

Self help

These steps can help speed up the healing process:

  • Learn about the disorder
  • Talk to others about what you're experiencing
  • Use aerobic exercise for its calming effect
  • Meditate to relax.
  • Avoid caffeine which can make symptoms worse
  • Don't use alcohol or drugs to mask your pain
  • Ask family members for their support
  • Remember that it's not your fault

For more information about PTSD

  • Find a qualified PTSD professional at Facts for Health, Madison Institute of Medicine
  • PTSD Alliance: Educational materials for professionals, individuals diagnosed with PTSD and their loved ones, and the general public.
  • The Anxiety Disorders Association of America Information, resources and referrals

Understanding anxiety disorders

Specific phobias

A specific phobia is an intense fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. While adults with phobias realize that these fears are irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety. Specific phobias affect an estimated 19.2 million adult Americans and are twice as common in women as men. They usually appear in childhood or adolescence and tend to persist into adulthood. If the feared situation or feared object is easy to avoid, people with specific phobias may not seek help; but if avoidance interferes with their careers or their personal lives, it can become disabling and treatment is usually pursued. Specific phobias respond very well to carefully targeted psychotherapy. Cognitive behavioral therapy has the best track record for helping people overcome most phobic disorders. The goals of this therapy are to desensitize a person to feared situations or to teach a person how to recognize, relax, and cope with anxious thoughts and feelings. Medications, such as anti-anxiety agents or antidepressants, can also help relieve symptoms. Sometimes therapy and medication are combined to treat phobias.