Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Posttraumatic stress disorder (PTSD) is an emotional illness that was first formally diagnosed in soldiers and war veterans and is usually caused by terribly frightening, life-threatening, or otherwise highly unsafe experiences but can also be caused by devastating life events like unemployment or divorce.
PTSD symptom types include re-experiencing the trauma, avoidance, emotional numbing, and hyperarousal.
PTSD has a lifetime prevalence of 7%-30%, with about 5 million people suffering from the illness in any one year. Girls, women, and ethnic minorities develop PTSD more than boys, men, and Caucasians.
Complex posttraumatic stress disorder (C-PTSD) usually results from prolonged exposure to traumatic event(s) and is characterized by long-lasting problems that affect many aspects of emotional and social functioning.
Symptoms of C-PTSD include problems regulating feelings, dissociation, or depersonalization, persistent depressive feelings, seeing the perpetrator of trauma as all powerful, preoccupation with the perpetrator, and a severe change in what gives the sufferer meaning.
Untreated PTSD can have devastating, far-reaching consequences for sufferers' medical, emotional, and vocational functioning and relationships, their families, and for society. Children with PTSD can experience significantly negative effects on their social and emotional development, as well as their ability to learn.
Although almost any event that is life threatening or that severely compromises the emotional well-being of an individual may cause PTSD, such events usually include experiencing or witnessing a severe accident or physical injury, getting a frightening medical diagnosis, being the victim of a crime or torture, exposure to combat, disaster, or terrorist attack, enduring any form of abuse, or involvement in civil conflict.
Issues that tend to put people at higher risk for developing PTSD include female gender, minority status, increased duration or severity of, as well as exposure to, the trauma experienced, having an emotional condition prior to the event, and having little social support. Risk factors for children and adolescents also include having any learning disability or experiencing violence in the home.
Disaster preparedness training may be a protective factor for PTSD as can rapid intervention and certain personal, interpersonal, and environmental factors.
Medicines that treat depression (for example, serotonergic antidepressants or SSRIs)
or that decrease the heart rate (for example, propranolol) are thought to be effective tools in the prevention of PTSD when given in the days immediately after an individual experiences a traumatic event.
SSRIs seem to be most effective in treating people whose PTSD is the result of noncombat-related trauma.
Individuals who wonder if they may be suffering from PTSD may benefit from taking a self-test as they consider meeting with a
health-care professional. Professionals may use a clinical interview in adults, children, or adolescents, or one of a number of structured tests with children or adolescents to assess for the presence of this illness.
Diagnosing PTSD can present a challenge for professionals since sufferers often come for evaluation of something that seems to be unrelated to that illness at first. Those symptoms tend to be physical complaints, depression, or substance abuse. Also, PTSD often co-occurs with other anxiety disorders, manic depression, or with eating disorders.
Challenges for the assessment of PTSD in children and adolescents include an
adult caretakers' tendency to be unaware of the extent of the young person's symptoms and the tendency for children and teens to express symptoms of the illness in ways that are quite different from adults.
Treatments for PTSD usually include psychological and medical treatments. Education about the illness, helping the individual talk about the trauma directly, exploration and modification of inaccurate ways of thinking about it, and teaching the person ways to manage symptoms and are the usual techniques used in psychotherapy. Family and couples' counseling, parenting classes, and education about conflict resolution are other useful psychotherapeutic interventions.
Directly addressing the sleep problems that are associated with PTSD has been found to help alleviate those problems, thereby decreasing the symptoms of PTSD in general.
Medications that are usually used to help PTSD sufferers include serotonergic antidepressants (SSRIs) and medicines that help decrease the physical symptoms associated with illness. Other potentially helpful medications for managing PTSD include mood stabilizers and antipsychotics. Tranquilizers have been associated with withdrawal symptoms and other problems and have not been found to be significantly effective for helping individuals with PTSD.
Some ways that are often suggested for PTSD patients to cope with this illness include learning more about the illness, occupational therapy including service dog therapy, talking to others for support, using relaxation techniques, participating in treatment, increasing positive lifestyle practices, and minimizing negative lifestyle practices.