Post-Traumatic Stress Disorder...
Stress Disorder (PTSD)
Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to
a terrifying event or ordeal in which grave physical harm occurred or was
threatened. Traumatic events that may trigger PTSD include violent personal
assaults, natural or human-caused disasters, accidents, or military combat.
ďI was raped when I was 25 years old. For a long time, I
spoke about the rape as though it was something that happened to someone else. I
was very aware that it had happened to me, but there was just no feeling.Ē
I started having flashbacks. They kind of came over me like a splash of water. I
would be terrified. Suddenly I was reliving the rape. Every instant was
startling. I wasnít aware of anything around me, I was in a bubble, just kind
of floating. And it was scary. Having a flashback can wring you out.Ē
rape happened the week before Thanksgiving, and I canít believe the anxiety
and fear I feel every year around the anniversary date. Itís as though Iíve
seen a werewolf. I canít relax, canít sleep, donít want to be with anyone.
I wonder whether Iíll ever be free of this terrible problem.Ē
stress disorder (PTSD) develops after a terrifying ordeal that involved physical
harm or the threat of physical harm. The person who develops PTSD may have been
the one who was harmed, the harm may have happened to a loved one, or the person
may have witnessed a harmful event that happened to loved ones or strangers.
was first brought to public attention in relation to war veterans, but it can
result from a variety of traumatic incidents, such as mugging, rape, torture,
being kidnapped or held captive, child abuse, car accidents, train wrecks, plane
crashes, bombings, or natural disasters such as floods or earthquakes.
with PTSD may startle easily, become emotionally numb (especially in relation to
people with whom they used to be close), lose interest in things they used to
enjoy, have trouble feeling affectionate, be irritable, become more aggressive,
or even become violent. They avoid situations that remind them of the original
incident, and anniversaries of the incident are often very difficult. PTSD
symptoms seem to be worse if the event that triggered them was deliberately
initiated by another person, as in a mugging or a kidnapping. Most people with
PTSD repeatedly relive the trauma in their thoughts during the day and in
nightmares when they sleep. These are called flashbacks. Flashbacks may consist
of images, sounds, smells, or feelings, and are often triggered by ordinary
occurrences, such as a door slamming or a car backfiring on the street. A person
having a flashback may lose touch with reality and believe that the traumatic
incident is happening all over again.
every traumatized person develops full-blown or even minor PTSD. Symptoms
usually begin within 3 months of the incident but occasionally emerge years
afterward. They must last more than a month to be considered PTSD. The course of
the illness varies. Some people recover within 6 months, while others have
symptoms that last much longer. In some people, the condition becomes chronic.
affects about 7.7 million American adults,1but it can occur at any
age, including childhood.7 Women are more likely to develop PTSD than
men,8 and there is some evidence that susceptibility to the disorder
may run in families.9 PTSD is often accompanied by depression,
substance abuse, or one or more of the other anxiety disorders.4
kinds of medication and certain kinds of psychotherapy usually treat the
symptoms of PTSD very effectively.
with PTSD have persistent frightening thoughts and memories of their ordeal and
feel emotionally numb, especially with people they were once close to. They may
experience sleep problems, feel detached or numb, or be easily startled
treatments for post-traumatic stress disorder are available, and research is
yielding new, improved therapies that can help most people with PTSD and other
anxiety disorders lead productive, fulfilling lives.
you think you have an anxiety disorder, the first person you should see is your
family doctor. A physician can determine whether the symptoms that alarm you are
due to an anxiety disorder, another medical condition, or both.
an anxiety disorder is diagnosed, the next step is usually seeing a mental
health professional. The practitioners who are most helpful with anxiety
disorders are those who have training in cognitive-behavioral therapy and/or
behavioral therapy, and who are open to using medication if it is needed.
should feel comfortable talking with the mental health professional you choose.
If you do not, you should seek help elsewhere. Once you find a mental health
professional with whom you are comfortable, the two of you should work as a team
and make a plan to treat your anxiety disorder together.
that once you start on medication, it is important not to stop taking it
abruptly. Certain drugs must be tapered off under the supervision of a doctor or
bad reactions can occur. Make sure you talk to the doctor who prescribed your
medication before you stop taking it. If you are having trouble with side
effects, itís possible that they can be eliminated by adjusting how much
medication you take and when you take it.
insurance plans, including health maintenance organizations (HMOs), will cover
treatment for anxiety disorders. Check with your insurance company and find out.
If you donít have insurance, the Health and Human Services division of your
county government may offer mental health care at a public mental health center
that charges people according to how much they are able to pay. If you are on
public assistance, you may be able to get care through your state Medicaid plan.
people with anxiety disorders benefit from joining a self-help or support group
and sharing their problems and achievements with others. Internet chat rooms can
also be useful in this regard, but any advice received over the Internet should
be used with caution, as Internet acquaintances have usually never seen each
other and false identities are common. Talking with a trusted friend or member
of the clergy can also provide support, but it is not a substitute for care from
a mental health professional.
management techniques and meditation can help people with anxiety disorders calm
themselves and may enhance the effects of therapy. There is preliminary evidence
that aerobic exercise may have a calming effect. Since caffeine, certain illicit
drugs, and even some over-the-counter cold medications can aggravate the
symptoms of anxiety disorders, they should be avoided. Check with your physician
or pharmacist before taking any additional medications.
family is very important in the recovery of a person with an anxiety disorder.
Ideally, the family should be supportive but not help perpetuate their loved
oneís symptoms. Family members should not trivialize the disorder or demand
improvement without treatment. If your family is doing either of these things,
you may want to show them this booklet so they can become educated allies and
help you succeed in therapy.
mental health services in your area, affordable healthcare, NIMH clinical
trials, and listings of professionals and organizations.
unsure where to go for help, talk to someone you trust who has experience in
mental healthófor example, a doctor, nurse, social worker, or religious
counselor. Ask their advice on where to seek treatment. If there is a university
nearby, its departments of psychiatry or psychology may offer private and/or
sliding-scale fee clinic treatment options. Otherwise, check the Yellow Pages
under "mental health," "health," "social
services," "suicide prevention," "crisis intervention
services," "hotlines," "hospitals," or
"physicians" for phone numbers and addresses. In times of crisis, the
emergency room doctor at a hospital may be able to provide temporary help for a
mental health problem, and will be able to tell you where and how to get further
below are the types of people and places that will make a referral to, or
provide, diagnostic and treatment services.
specialists, such as psychiatrists, psychologists, social workers, or mental
departments and outpatient clinics
medical school-affiliated programs
Private clinics and
Local medical and/or