Post Traumatic Stress Disorder (PTSD)

Definition

Post traumatic stress disorder means a delayed and protracted response to a stressful event of a catastrophic nature, such as natural calamities, terrorist activity, serious accidents and witnessing violent deaths. There is flashback of traumatic episode, sleep disturbance, nightmares, emotional blunting, numbing of responsiveness to such reminders and persistent, hyper arousal and avoidance of any situation that evokes memories of the trauma.

Symptoms

The symptoms of this disorder appear within the first month. This is known as acute stress disorder. The symptoms may include remembrance of the event, numbing, going into depressive state, loss of appetite, sleeplessness, irritability, frustration, forgetfulness, and nervousness. Sometimes there can be nightmares and aggressiveness. Small children may show the symptoms through their plays or they can have nightmares.

Types

There are three types of post traumatic stress orders. Some times the symptoms appear as soon as the event gets over. The patient will show the symptoms as soon as the trauma takes place. This is known as acute post traumatic stress disorder. Sometimes the symptoms appear only after three to four months after the event has taken place. This is known as chronic post traumatic stress disorder. Sometimes the symptoms appear only after decades or years after the event has taken place. This is known as delayed post traumatic stress disorder.

Patho-physiology

Patho-physiology can be explained with the help of a cluster of three symptoms. Sometimes the patient will not be able to express their fear and feelings through actions. In this case it will appear as nightmares or as flashbacks and due to this the person can go into a state of depression. And this is known as Intrusion. Sometimes the patient will get startled by the least motion or sound and will be in a state of fight or flight. There is intense anxiousness and this is known as Hyper-arousal. In later stages the person will avoid contact with each and everyone and will make himself isolated with everything and will avoid having the memories of the trauma. This will lead to a stage of depression. And this stage is known as avoidance.

Treatment

The best treatment that has been applied now-a-days are Eye Movement Desensitization and Reprocessing (EMDR). Before Critical Incident Stress Management (CISM) has been used but it has proven to have iatrogenic effects. Post traumatic stress disorder is mainly treated using psychotherapy and psychotropic drugs are given. The treatment also includes explanation of the condition and providing safety and security.