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.
Treatments for PTSD usually include psychological and medical interventions.
Providing information about the illness, helping the individual manage the
trauma by talking about it directly, teaching the person ways to manage symptoms
of PTSD, and exploration and modification of inaccurate ways of thinking about
the trauma are the usual techniques used in psychotherapy for this illness.
Education of PTSD sufferers usually involves teaching individuals about what
PTSD is, how many others suffer from the same illness, that it is caused by extraordinary stress rather than weakness, how it
is treated, and what to expect in treatment. This education thereby increases
the likelihood that inaccurate ideas the person may have about the illness are
dispelled, and any shame they may feel about having it is minimized. This may be
particularly important in populations like military personnel that may feel
particularly stigmatized by the idea of seeing a mental-health professional and
therefore avoid doing so.
Teaching people with PTSD practical approaches to coping with what can be very
intense and disturbing symptoms has been found to be another useful way to treat
the illness. Specifically, helping sufferers learn how to manage their anger and
anxiety, improve their communication skills, and use breathing and other
relaxation techniques can help individuals with PTSD gain a sense of mastery
over their emotional and physical symptoms. The practitioner might also use
exposure-based cognitive behavioral therapy by having the person with PTSD
recall their traumatic experiences using images or verbal recall while using the
coping mechanisms they learned. Individual or group cognitive behavioral psychotherapy can help people with PTSD recognize and adjust trauma-related thoughts and beliefs by educating sufferers about the relationships between thoughts and feelings, exploring common negative thoughts held by traumatized individuals, developing alternative interpretations, and by practicing new ways of looking at things. This treatment also involves practicing learned techniques in real-life situations.
Eye-movement desensitization and reprocessing (EMDR) is a form of cognitive
therapy in which the practitioner guides the person with PTSD in talking about
the trauma suffered and the negative feelings associated with the events, while
focusing on the professional's rapidly moving finger. While
some research indicates this treatment may be effective, it is unclear if this
is any more effective than cognitive therapy that is done without the use of
rapid eye movement.
Families of PTSD individuals, as well as the sufferer, may benefit from
family counseling, couple's counseling, parenting classes, and conflict-resolution education. Family members may also be able to provide relevant
history about their loved one (for example, about emotions and behaviors, drug abuse,
sleeping habits, and socialization) that people with the illness are unable or
unwilling to share.
Directly addressing the sleep problems that can be part of PTSD has been
found to not only help alleviate those problems but to thereby help decrease
the symptoms of PTSD in general. Specifically, rehearsing adaptive ways of
coping with nightmares (imagery rehearsal therapy), training in relaxation
techniques, positive self-talk, and screening for other sleep problems have been
found to be particularly helpful in decreasing the sleep problems associated
with PTSD.
Medications that are usually used to help PTSD sufferers include serotonergic
antidepressants (SSRIs), like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), and medicines that help decrease the physical symptoms
associated with illness, like prazosin (Minipress), clonidine (Catapres),
guanfacine (Tenex), and
propranolol. Individuals with PTSD are much less
likely to experience a relapse of their illness if antidepressant treatment is
continued for at least a year. SSRIs are the first group of
medications that have received approval by the U.S. Food and Drug Administration
(FDA) for the treatment of PTSD. Treatment guidelines provided by the American Psychiatric Association describe these medicines as being particularly helpful for people whose PTSD is the result of trauma that is not combat-related. SSRIs tend to help PTSD sufferers modify information that is taken in from the environment (stimuli) and to decrease fear. Research also shows that this group of medicines tends to decrease anxiety, depression, and panic. SSRIs may also help reduce aggression, impulsivity, and suicidal thoughts that can be associated with this disorder. For combat-related PTSD, there is more and more evidence that prazosin can be particularly helpful. Although other medications like duloxetine (Cymbalta),
bupropion (Wellbutrin), and venlafaxine (Effexor) are sometimes used to treat PTSD, there is little research that has studied their effectiveness in treating this illness.
Other less directly effective but nevertheless potentially helpful
medications for managing PTSD include mood stabilizers like lamotrigine
(Lamictal), tiagabine (Gabitril), divalproex sodium (Depakote), as well as mood stabilizers
that are also antipsychotics, like risperidone (Risperdal), olanzapine
(Zyprexa), and quetiapine (Seroquel). Antipsychotic medicines seem to be most
useful in the treatment of PTSD in those who suffer from agitation,
dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks
in being in touch with reality (brief psychotic reactions). The antipsychotic medications are also being increasingly found to be helpful treatment options for managing PTSD when used in combination with an SSRI.
Benzodiazepines (tranquilizers) such as diazepam (Valium) and alprazolam (Xanax) have unfortunately been associated with a
number of problems, including withdrawal symptoms and the risk of overdose, and
have not been found to be significantly effective for helping individuals with PTSD.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Grief is the feeling one experiences after a loss (of a friendship, death of loved one, job). Complicated grief refers to grief that lasts for more than a year. Mourning describes the customs and rituals that help a bereaved individual make sense of their loss.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heart beat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta blockers.
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Nightmares are dreams that cause high anxiety or terror. Nightmares may be a part of posttraumatic stress disorder (PTSD), and they usually occur during rapid eye movement (REM) sleep. There are several different treatment options for nightmares, including cognitive-behavioral therapy and medications.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
There are many forms of sexual assault, including rape, attempted rape, child molestation, sexual intercourse that you say no to, inappropriate touching, and vaginal, anal, or oral penetration. Sexual assault can also be anything that forces someone to join in unwanted sexual contact or attention, such as voyeurism, exhibitionism, incest, and sexual harassment.
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