Post-Traumatic Stress Disorder

Introduction

Post-traumatic stress disorder or PTSD is a chronic stress disorder arising from exposure to sexual assault, injury, or death. PTSD is among the most common and serious concerns apart from other comorbidities, physical impairment, suicidal ideation, and increased mortality in an individual who was exposed to a traumatic event. Such individuals may experience problems related to sleep and social well-being as well as experience frightening flashbacks of the traumatic event. This can severely affect their mental, social, and emotional well-being as well as reduce their focus and productivity at work. The lifetime prevalence of this disorder is approximately 6.8% with the prevalence being 3.6% of the US adult population in the last year, with women suffering from this disorder more commonly than men.

Causes and Risk Factors of PTSD

To manage, treat, and prevent the onset of PTSD, it is essential to know the factors that trigger PTSD along with the factors that make an individual susceptible to developing PTSD. Causes of PTSD include.

1.  Traumatic event

       a. The perceived or real threat

       b. Physical injury

1. Near-death experience 

2. Trauma-related to combat

3. Sexual assault

4. Child abuse

5. Chronic medical condition

6. Interpersonal conflicts

The biological and psychological risk factors of PTSD are listed below

1. Gender

2. Childhood adversities

3. Mental illness

4. Lack of education

5. Social disparity

6. Low socioeconomic status

7. Nature and severity of a traumatic event

Inside the Brain of PTSD Patients

Stress triggers the activation of the sympathetic nervous system which leads to increased blood pressure, heart rate, and increased arousal in an individual. PTSD also disrupts the levels of other neurotransmitters in the brain including the decline in the levels of serotonin. PTSD also leads to changes in the anatomy of the brain, manifesting as serious mental, emotional, behavioral, and physical effects.

Signs and Symptoms of PTSD

 1. Recurrent and involuntary trauma-associated thoughts.
2. Frightening and/or distressing dreams associated with the traumatic event.
3. Flashbacks of the traumatic event that causes a person to experience or act in a certain way. 4. Psychological distress upon a reminder of the traumatic event.
5. The characteristic physiological state includes increased blood pressure and heart rate             upon a reminder of the traumatic event.
6. The patients demonstrate avoidance of the reminders of the traumatic event.
7. Dissociative amnesia or loss of memory concerning the traumatic event.
8. Distorted cognition, negative beliefs, and emotional state.
9. Elevated arousal is indicated by hypervigilance and exaggerated startled reaction. 10. Sleep     disturbances
11. Aggressive outbursts

12. Disrupted focus and concentration in routine activities.

Effects of PTSD on Close Relationships

Friends and family of an individual suffering from PTSD are also affected significantly. PTSD can challenge integrity, trust, and communication which can weaken a relationship. PTSD takes an emotional and psychological toll on friends and family members and might make it difficult for them to cope with the given situation. When a PTSD patient is a parent, the child/children of that individual may also suffer from psychological, emotional, and social distress which may also manifest as serious concerns as the child grows into an adult.

Treatment and Prevention of PTSD

Early detection and treatment can help manage PTSD symptoms more effectively. Psychotherapy is the first line of treatment and includes the following.

1. Trauma-associated cognitive-behavioral therapy

2. Imaging exposure

3. Cognitive processing therapy

4. Eye movement desensitization and reprocessing

Medications can also be used to manage PTSD symptoms

1. Selective serotonin reuptake inhibitors

2. Serotonin-norepinephrine reuptake inhibitors

3. Sertraline and paroxetine

4. Clonidine and prazosin for nightmares

5. Trazodone and healthy sleeping habits for insomnia 

​Conclusion

PTSD is a common occurrence following exposure to a traumatic event. Individuals suffering from PTSD often experience a myriad of symptoms including psychological distress, sleep disorders, and exaggerated startled reactions. Early diagnosis and interventions (psychotherapy and pharmacotherapy) can speed up the recovery process and help an individual manage PTSD symptoms.

References

1.  https://www.ncbi.nlm.nih.gov/books/NBK559129/

2. https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd

3. https://www.ptsd.va.gov/family/effects_ptsd.asp