An attending psychiatrist from Harvard University discusses post-traumatic stress disorder.
Problem
I am 22 years old and when I was 7-years-old I witnessed my older brother get hit by a stray bullet while we were playing in our front yard. My older brother who was 10 years old at the time died in my arms. The killer was never found and it was suspected that my brother was the victim of two ongoing gangs battling over turf. Since this incident I have never been the same, I have flashbacks of the incident, I am terrified of crowds and prefer to be alone, I am hyper-vigilant when outside and have difficulty in establishing relationships with the opposite sex. I just can't love and am terrified of marriage due to my inability to love. Despite all of these emotional struggles I excelled in school and am currently applying to Grad school. I feel as if the weight of the world is on my shoulders and am terrified of disappointing my parents and surviving siblings.
Discussion
According to the National Institute of Mental Health, 5.2 million adult Americans suffer from PTSD (Post Traumatic Stress Disorder). PTSD is an anxiety disorder that is used for severe and ongoing emotional reactions to an extreme psychological trauma. This trauma can include and is not limited to rape, severe physical assault, combat, accidents, witnessing a murder or experiencing a near death experience. Recent literature suggests that suffering from a medical illness such as cancer can also lead to PTSD.
Remember not all people who are exposed to the aforementioned stressors will develop PTSD. In addition, PTSD should not be confused with traumatic stress or acute stress disorder. What differentiates PTSD apart is the severity and duration of the adverse symptoms. Symptoms include the following.
1. nightmares
2. flashbacks
3. emotional detachment,
4. difficulty in sleeping
5. avoidance of reminders of the incident
6. loss of appetite,
7. hyper-vigilance
8. memory loss
9. excessive startle response
10. clinical depression
11. anxiety
12. difficulty in establishing and maintaining romantic relationships
Not all of these symptoms need to be met in order to receive treatment for PTSD. It is also not uncommon for people suffering from ADHD to also suffer other psychiatric illnesses such as MDD, bipolar disorder, generalized anxiety disorder and various addictions.
After the predisposing event the first month of experienced symptoms is referred to as acute stress disorder. If the symptoms subside, great, but if the symptoms last longer then one month then the diagnosis of PTSD is considered.
Treatment
Treatment is focused on treating the symptoms. This can be done by medication, which addresses the anxiety and depression, talk therapy and group therapy. A very effective form of therapy would be CBT (Cognitive Behavioral Therapy) which will focus on the initial negative thoughts that the sufferer of PTSD possesses and confronts these thoughts with cognitive restructuring that helps the sufferer effectively deal with their emotions. Without treatment, the symptoms can affect the sufferer in all levels of their life and prevent them from reaching their full potential as a person. Eventually this will cause problems with their loved ones and can even lead to medical illness. Luckily, we are living in an era in which help is available for those who suffering from debilitating affects of PTSD.
Further reading
1. http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
2. http://www.omh.state.ny.us/omhweb/ebp/adult_ptsd.htm
The author is an attending psychiatrist and clinical instructor in psychiatry at Harvard Medical School. His articles are for informational purposes only and not meant as a diagnosis for any readers. Islamic Insights does not seek to replace trained psychologists or psychiatrists and runs these articles for informational purposes only.
