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John sustained serious injuries in a motor
vehicle accident. Despite the fact he showed
rapid recovery from his physical injuries, he
was experiencing symptoms of significant emotional
distress. He was depressed, anxious, losing
weight, and having sleep difficulties. He had
been experiencing nightmares, intrusive recollections
of the accident, and had feelings of impending
doom. His personality and behavioral changes
were noticeable to friends and family. John
had difficulty adjusting back to work and was
more distant in his relationships. John was
puzzled feeling guilty he was not grateful for
his recovery and felt responsible for his inability
to be more responsive to his family and work.
It was only after months of battling his feelings
that he sought psychological treatment. His
symptoms were clear to the therapist: They were
characteristic of post-traumatic stress disorder
(PTSD).
Post-traumatic stress disorder is an anxiety
disorder that's triggered by one's memories
of a traumatic event witnessed. The disorder
commonly affects survivors of traumatic events,
such as sexual assault, physical assault, war,
torture, a natural disaster, an automobile accident,
an airplane crash, a hostage situation or a
death camp. PTSD can also affect rescue workers
at the site of a tragic accident or event.
Not everyone involved in a traumatic event experiences
post-traumatic stress. The Mayo Clinic statistics
indicate the disorder affects more than 5 million
adults each year in the United States. Post-traumatic
stress disorder is twice as common in women
as it is in men.
Signs and symptoms of post-traumatic stress
disorder typically appear within three months
of the traumatic event. However, in some instances,
they may not occur until years after the event
and may include:
Flashbacks and distressing dreams associated
with the traumatic event.
Distress at anniversaries of the trauma.
Efforts to avoid thoughts, feelings and activities
associated with the trauma.
Feelings of detachment or estrangement from
others and an inability to have loving feelings.
Markedly diminished interest or participation
in activities that once were an important
source of satisfaction.
Hopelessness about the future - no hope of
a family life, career or living to old age.
Physical and psychological hypersensitivity
- not present before the trauma - with at
least two of the following reactions: trouble
sleeping, anger, difficulty concentrating,
exaggerated startle response to noise, and
physiological reaction to situations that
remind you of the traumatic event. Your doctor
or a mental health professional may suggest
a combination of medications and behavior
therapy to treat post-traumatic stress disorder.
The objectives of treatment are to reduce
your emotional distress and the associated
disturbances to your sleep and daily functioning,
and to help you better cope with the event
that triggered the disorder.
Treatment may involve a combined approach including
medications and behavior therapy designed to
help you gain control of your anxiety.
Selective serotonin reuptake inhibitors
(SSRIs). These antidepressants act
on the chemical serotonin, the neurotransmitter
in your brain that helps brain cells (neurons)
send and receive messages. These medications
can help control anxiety as well as depression.
Tranquilizers.
Cognitive-behavior therapy.
This treatment teaches you effective ways of
managing thoughts or situations that remind
you of the trauma you've experienced. The goal
of this therapy is to promote a sense of recovery
and a feeling of mastery over your anxiety.
Stress management training.
This approach also involves learning to manage
your anxiety through relaxation. You work with
the help of a therapist to develop skills to
decrease your preoccupation with negative thoughts
and the sense of being overwhelmed by the traumatic
event.
Cognitive therapy. You identify
distorted thoughts and beliefs that arouse psychological
stress and learn ways you can view and cope
with a traumatic event differently. There is
special emphasis on learning to develop a sense
of mastery and control of your thoughts and
feelings.
Effective treatment is often successful in
helping patients in their adjustment back to
life and work.
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