Anxiety - Post-Traumatic Stress Disorder

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General Information

DEFINITION - A type of anxiety seen in people who experience an event that would be extremely distressing to most human beings. Such events (natural disasters, murder, rape, war, imprisonment, torture, car accidents) produce psychological stress in anyone. Some people do not recover normally. PTSD is characterized by a persistent re-experiencing of the trauma and other associated symptoms. The symptoms may begin right after the event or may develop several months later.

BODY PARTS INVOLVED - Nervous.

SEX OR AGE MOST AFFECTED - Both sexes; all ages (children often are affected).

SIGNS & SYMPTOMS

• Recurrent, intrusive and distressing recollections of the event.
• Recurrent dreams relating to the event.
• A sense of reliving the event (flashbacks).
• Chronic anxiety.
• Insomnia.
• Difficulty in concentrating.
• Memory impairment.
• A sense of personal isolation.
• Diminished interest in activities.
• Phobic reactions to situations, or avoidance of activities, that recall memories of the event.
• Emotional effects (irritable, restless, tremulous, explosive outbursts of behavior, a deadening of feelings, painful guilt feelings).

CAUSES

• Exposure to an overwhelming event. A variety of factors seem to combine to produce PTSD: The event's suddenness and unexpectedness.
• Bloody and brutal event.
• More prolonged and chronic stress during the event.
• Psychological and constitutional strengths and weaknesses of the victim.
• Bodily injury (especially head injury).
• Type and availability of social support.

RISK INCREASES WITH - People with a history of childhood neglect or dysfunctional families, children of alcoholic parents or childhood abuse, low educational attainment.

HOW TO PREVENT - Crisis intervention immediately after a traumatic event may prevent the development of PTSD.

What To Expect

DIAGNOSTIC MEASURES

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory and medical tests as needed to rule out any brain disorder.
• Psychiatric exam and psychological testing.

APPROPRIATE HEALTH CARE

• Psychotherapy and counseling. Several different methods of therapy are available including behavior therapy, desensitization (See Glossary for both), hypnosis and others. Individual or group therapy as needed.
• Psychiatric hospitalization for suicidal patient or one who is severely dysfunctional with activities of daily living.

POSSIBLE COMPLICATIONS

• Chronic PTSD, which can lead to loss of job, marital conflicts and disability.
• Injury to self during a re-enactment of the trauma.
• Drug or alcohol dependency.
• Suicide.

PROBABLE OUTCOME - For some patients, the symptoms disappear spontaneously after 6 months; additional patients can be helped with treatment, while in others, the disorder may run a chronic course for months or years.

How To Treat

GENERAL MEASURES

• Make a commitment to yourself to work on the problem.
• Learn relaxation techniques. They are particularly helpful, especially in helping with sleep problems.
• Support groups are highly effective and available through Veterans Administrative Centers and community crisis centers.

MEDICATION - Your doctor may prescribe antianxiety or antidepressant drugs for short periods of time.

ACTIVITY - No restrictions. A routine physical exercise program is helpful in relieving some stress.

DIET - No special diet.

Call Your Doctor If

• You have symptoms of post-traumatic stress disorder.
• Symptoms don't improve or worsen after treatment begins.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

From the Complete Guide to Symptoms, Illness & Surgery by H. Winter Griffith, M.D. © 1995 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.