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Post Traumatic Stress Disorder (PTSD) is an anxiety disorder for which symptoms develop as a consequence of exposure to a traumatic life threatening event such as war, accidents, natural disasters, sexual or physical assault or domestic violence. The person may have experienced the traumatic event directly or they may have witnessed it. People who suffer from PTSD typically experience intense emotional distress when recalling traumatic memories or when exposed to situations that are similar to the traumatic event. As a result the PTSD sufferer typically tries to avoid memories of the trauma as well as the people, objects, places and situations that remind him or her of the event. PTSD is relatively common with estimates indicating that 75% of adults will experience a life threatening event at some point. Of these approximately 25% will develop PTSD. Of those that do develop PTSD 50% will recover without professional intervention over the following 2 years post trauma. Moreover, some estimates have indicated that 6% of the population meets the criteria for a diagnosis of PTSD at any given time.
What are the Symptoms of PTSD? The essential feature of PTSD is an interlocking set of anxiety disorders that develop as a result of exposure to a traumatic life threatening event or sequence of events. The DSM-IV (the book psychologists use to diagnose psychological disorders) lists the following as symptoms of PTSD -
- persistent re-experiencing of the event (e.g. recurring memories or
dreams, flashbacks)
- feelings of guilt
- self destructive and impulsive behaviours
- dissociative symptoms
- somatic complaints
- feelings of ineffectiveness, shame, despair, hopelessness
- hostility, social withdrawal
- feeling constantly threatened
- impaired relationships with others
Note- If PTSD symptoms occur but are resolved within 1 month then the term acute stress disorder is used.
What Can Be Done to Treat PTSD? Exposure based is widely recognised as the gold standard for treatment of PTSD. Compared to other therapies CBT, with a strong exposure component, has been better supported by the scientific literature and generally achieves faster results than other therapies. This type of therapy essentially assists clients to approach traumatic memories, people and situations in such a way as to reduce the anxiety producing effect of them. It typically involves several sessions of education and desensitisation to physical anxiety symptoms. Strategies to reduce the effect of anxiety stimuli and to reduce fearful thoughts may also be taught prior to exposure therapy. When conducted well this form of CBT is not overwhelming for clients and produces a fast and durable reduction in anxiety and PTSD symptoms.
Due to the fact that traumatic memories are more powerful than other memories they cannot typically be eliminated completely, but good CBT can make them tolerable and stop them from intruding into consciousness unnecessarily, enabling them to fade naturally over time. Well conducted CBT typically achieves superior long term results when compared to techniques such as distraction or relaxation which typically are employed in an attempt to push away traumatic memories. Such techniques can bring immediate relief but typically sensitise you more to the traumatic memories and feelings. Because of this, when seeking treatment for PTSD, it is important that you find a psychologist who is well practised in the application of CBT for anxiety disorders to minimise the risk of becoming further traumatised by poorly applied treatment.
What about Medication? As with other anxiety disorders alcohol, prescription and non-prescription drugs often become relied upon by individuals experiencing PTSD as a way of relieving the symptoms of anxiety. Although using drugs and medications can bring some initial relief they can also reduce the ability of your mind to go through the natural process of mentally digesting the traumatic memories. For example people with PTSD often experience sleep difficulties and come to rely on sleeping tablets to get to sleep at night. This can stop you from dreaming normally and dreams are also important in the mental digestion of trauma. There are times however, when medications are indicated for the short term treatment of PTSD, particularly if your anxiety symptoms are so severe that you are unable to engage in good exposure based CBT. In these cases there a range of good medications available today which can be prescribed by your doctor. Modern SSRI medications often provide a reduction of symptoms without significant side effects or any long term detriment to your brain chemistry. It is important to remember, however, that relying on medication permanently for relief of symptoms will in most cases prolong the difficulty experienced in relation to the trauma symptoms. In any case you must always seek your doctors advice if you are considering taking, changing or withdrawing from medications.
Remember- Post traumatic stress can develop following the experience of a traumatic event where your life, or the life of someone near you was threatened. Often the symptoms of PTSD resolve without professional assistance. Acute stress symptoms can occur for up to 1 month post trauma but if symptoms persist beyond 1 month a diagnosis of PTSD is indicated. Exposure based CBT has been well evidenced to provide a lasting improvement and in many cases elimination of PTSD anxiety symptoms and the depression which may follow. Avoidance of traumatic memories and the anxiety symptoms they produce via methods such as distraction, alcohol or prescription medications typically lengthens the experience and severity of trauma symptoms. If you have been experiencing PTSD symptoms which are not improving or are getting worse, assistance from a psychologist who specialises in exposure based CBT can help resolve them. Click on contact us for more information on a program that can assist you.
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