Post traumatic stress disorder is an anxiety disorder brought on by a person experiencing one or more traumatic events. Common stressor events could be sexual assault, the threat of death, sustaining a serious injury, or fighting in a war. The result of the event or events typically leaves the individual with feelings of intense fear, horror, or powerlessness.
Anxiety disorders are based around the feelings of fear; a reaction to a current event, and anxiety: a worry about future events. Physical symptoms of anxiety disorders can be bouts of shakiness or an accelerated heart rate.
For the person suffering from post traumatic stress disorder there are reactions and avoidance behaviors that are common in nature. The subjects of PTSD may avoid thinking about verbally speaking of the stressor event. However, the event or events will haunt the individual. This will occur in the form of intrusive and persistent recollections, such as flashbacks and nightmares. If these manifestations last longer than three months they can be characterized as chronic.
Effects on Children
Chronic stress disorder can result in a myriad of effects and reactions, both physical and mental. For children they include:
The children find it hard to establish relationship boundaries. They also suffer from social isolation, lack of trust, and develop a lack or empathy.
Children’s motor skills become dysfunctional. Medical problems develop and persist.
Effect of Emotional Regulation
There is a problem with expressing emotion. The children also find it hard to communicate their wants and desires to others.
The children may develop amnesia: sometimes about the stressor events. Memory loss also may occur.
Children with the disorder may have trouble controlling their impulses and feelings. They may also suffer from lack of sleep.
Children may suffer from learning retention. They find it hard to process new information. Their language skills will also suffer.
Poor body image, low self-esteem, and excessive shame are common among children suffering from chronic stress disorder.
Effects on Adults
In adults, the characteristics are different in some cases, the same in others. Adults may have extreme difficulty in regulating their emotions. It could result in prolonged sadness, suicidal thoughts, crazy anger issues, or covert anger. Another result of the disorder is emotional swings in consciousness. Stressor events can be forgotten, or relived in the form of flashbacks or nightmares. Adults suffering from chronic stress disorder may feel helpless, guilty, or believe they no longer like other human beings.
If the subject has been traumatized by an individual, he or she may become obsessed with them, either granting them power over their lives, or on the other end of the spectrum, seek revenge against the perpetrator. Relationships with family or friends can be altered or twisted, resulting in isolation behavior or sudden bouts of mistrust.
Post Traumatic Stress Disorder
Chronic stress disorder was first identified in 1997 in Trauma and Recovery by Judith Herman.
Extreme traumatic events are known to be the cause of PTSD. It is believed that if the traumatic event is strong enough, post traumatic stress disorder can manifest itself even when no predisposing conditions exist in the individual. People commonly found to be at risk for the condition are combat military personnel, natural disaster survivors, and the victims of violent crimes.
Survivor syndrome, or survivor’s guilt, can be a by-product of PTSD. It relates to survivors of such tragedies as The Holocaust, 9/11, or natural disasters such as hurricanes, The individuals suffer symptoms such as depression and anxiety, lack of sleep, and nightmares. These individuals are stricken with guilt for having survived, while others close to them perished. Survivor syndrome has been classified as an important symptom of PTSD.
Family violence can be a key element to the possibility of developing the condition. According to studies, approximately 25% of school age children exposed to family violence can experience PTSD. However, just being exposed to such violence may not be a sole determining factor. Sensory episodes in individuals may have more to do with the development of the disorder. Re-experiences of the the traumatic events can be a key factor, especially if the suffering person has those experiences while thinking they are actually occurring in real time vs. being a known re-experience.
The concept of evolutionary psychology is also seen as a determining factor. It seeks to discover what human traits are acquired through evolution. It argues that the human mind has a modular structure similar to the body. The theory is that human behavior develops as a means of surviving recurrent problems. It argues that PTSD psychologically evolved to compensate for an overactivation of the mind’s fear circuits.
Some believe that genetics play a key role when it comes to who is most susceptible to PTSD.
Mammals have two hippocampi. Located within the brain, they play a role in consolidating long term and short term memory. Relating to post traumatic stress disorder, it is believed that people with smaller hippocampus are more likely to develop the disorder after suffering traumatic events.
Effective diagnosis of PTSD can at times not be easily done. Many cases go undiagnosed for substantial periods of time. The lifetime prevalence of the disorder in the United States is 8 to 9 percent. Victims of extreme trauma develop the condition 25 to 30 percent of the time.
Usually, to reach a point where a diagnosis can occur, a patient’s normal activities have to be thrown out of proportion for at least a month. Patients are initially characterized with acute stress disorder if they have been known to have three or more dissociative symptoms. If the problems persist a diagnosis of PTSD may then take place.
Uncovering PTSD in patients can be at times a daunting task. Patients may not realize the link between their abnormal behavior and a traumatic event they suffered through. Or they may not choose to reveal to doctors what happened to them, Off shoot behavior may obscure the root case. Alcohol and drug abuse could become the target of the treatment.
Physicians have to uncover the disorder by asking the correct questions. “Have you been a victim of a violent crime? “Did you suffer a frightening event during your childhood?” are examples.
A specifically designed questionnaire for post traumatic stress disorder reportedly has a sensitivity of 80 percent and a specificity of 97 percent.
Military Related PTSD
The term “war is hell” is short but very true. Combat soldiers that find themselves thrown into the midst of intense and deadly war campaigns exist in a breeding ground for PTSD. It is easy to see why. Most combat soldiers are just regular guys that volunteer or get drafted into military service. Although they receive training, it is unlikely a good percentage of new combat soldiers are prepared for the horrors of war they will be thrust into. In one moment a soldier could be joking with a buddy, and in the next instant his buddy could be shot and killed, or literally blown to bits by a grenade. The solider would be left to grapple with why he survived and his buddy did not.
While the reasons for military personnel to have problems seem quite obvious, diagnosis and treatment face barriers from within the soldier ranks. Many soldiers don’t seek help for fear of being stigmatized as being weak. They have concerns about how reporting mental problems might impact on their careers.
In 2004, the U.S Army conducted a mental health study. It concluded that 1 in 8 troops displayed symptoms of post traumatic stress disorder. The surveys were conducted a few months after troops returned from deployment in Afghanistan or Iraq. 6,200 soldiers were surveyed before they were deployed, and then six to eight months after returning. Symptoms related to PTSD were revealed in 16 percent of the returning troops. Before going off to war the rate was 5 percent.
Studies that were done years after the Vietnam and Persion gulf campaigns show that 15 percent of Vietnam veterans showed signs of the disorder. 2 to 10 percent of Gulf War veterans did the same.
A 2008 study focused on several aspects of army personnel as it related to PTSD. It found that there were varying degrees of disorder-like symptoms connected to troops returning to civilian life.
- One group has to cope with stressors related to their return home, combined with re-living the traumatic events associated with the war. Yet they are able to navigate their feelings enough to reintegrate themselves to civilian life.
- The middle group has some symptoms, but are able to navigate without any major stressors.
- The third group are greatly plagued by their PTSD and have many problems functioning normally.
There have not been many studies on how killing relates to triggering post traumatic stress disorder. A few studies on Vietnam veterans did find a connection between killing and the disorder. But in the case of over the top situations, such as the killing of unarmed civilians, the extreme behavior didn’t contribute to stressors. It was the act of killing that initiated the problems.
Although killing in war is sanctioned by governments, soldiers in combat situations faced with the possibility of killing or being killed themselves reach an overwhelmed breaking point that can lead to symptoms of the disorder.
Managing their return to so-called normal life can be difficult for the returning veteran. One useful device is couples or family therapy. It can work as a preventative measure for the soldier, as well as helping a spouse or children understand the challenges of a combat soldier trying to re-adjust to non-military life. New lines of communication can be established among the family. The veteran can smooth over the feelings that his family will never understand what he went through during the war.
Veterans returning to work or school can also experience difficulties in adjustment. Authority figures could generate negative feeling, due to the veteran having been turned off by military brass he feels betrayed him during the war. Therapy can also be a help with such situations.
The basic method of treating PTSD is a plan to relieve the patient of the disorder’s symptoms by dealing directly with the type of trauma experienced. The patient will be asked to recall the emotions involved with the hope of positively processing them.
During the course of the therapy the patient will be encouraged to thoroughly explore their thoughts and feelings about the trauma. It is hoped that the patients will be able to work through their feelings of guilt, self-blame, and mistrust. They can then cope with and control intrusive memories related to the traumatic event or events. Once this is done the patient can address to problems PSTD has caused in his or her life and relationships.
Cognitive behavioral therapy is a psychotherapeutic approach to behavioral modification that is intended to address dysfunctional emotions and behaviors. A series of goal-oriented systematic procedures are used to treat the patient’s disorder.
CBT is designed to be an effective form of treatment for a variety of conditions and disorders, including mood, anxiety, eating, and substance abuse. Therapists in this field use a mixture of cognitive and behavioral therapy to reach their goal of alleviating the patient’s symptoms and vulnerabilities.
In regards to PTSD, CBT therapy attempts to change the patient’s patterns of thinking or behavior. This form of therapy is considered to be the gold standard by the Unites States Department of Defense.,
Another approach to treating PTSD is the somewhat controversial eye movement desensitization reprocessing procedure. It is a type of psychotherapy pioneered by Francine Shapiro. While thinking about distressing memories, she noticed her eyes were moving rapidly. Her eye movements came under control while thinking less disturbing thoughts.
The basics of the therapy is to use eye movement to facilitate memory processing. Rapid eye movement is used on the patient while he or she focuses on the traumatic memories that have plagued them. Hand movements by the therapist are used to get the patient to move their eyes back and forth. Lessening the eye movement would then lessen the impact of the bad memories. How effective this therapy is continues to be a source of controversy.
A variety of medications have had some success in reducing PTSD symptoms. But there is no clear cut treatment drug. Positive symptoms respond better to medication than negative symptoms. Experts say any drug trial used for the treatment of PTSD should last at least 6 to 8 weeks.
A medication, hydrocortisone, has proven to be effective if taken shortly after a traumatic event, it will decrease the possibility of a person contracting PTSD. Still, at this time, there is no known drug that will prevent post traumatic stress disorder.