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, and
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 and emotional 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
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 ethnicity, 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.
Medicines that treat depression (for example, serotonergic antidepressants or
SSRIs), that decrease the heart rate (for example, propranolol), or increase the
action of other body chemicals (for example, hydrocortisol) 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 persons whose PTSD is the result of non-combat 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 practitioner. Professionals
may use a clinical interview in either 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 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
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, talking to others for support,
using relaxation techniques, participating in treatment, increasing positive
lifestyle practices, and minimizing negative lifestyle practices.
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