Post-Traumatic Stress Disorder (PTSD)

What is Post-Traumatic Stress Disorder? Is it a disease you catch from an animal? Is it comparable to mad cow disease? Can you die from Post-Traumatic Stress Disorder? How do you know if you have Post-Traumatic Stress Disorder? If you do get Post-Traumatic Stress Disorder how do you cure it? Here

are a few of many question about an illness commonly referred to as PTSD or Post-Traumatic Stress Disorder. I intend to examine the most frequently asked questions about Post-Traumatic Stress Disorder, which are as follows: what is PTSD, how do you cure or cope with PTSD? Also, I will be going deeper into my study by showing a few examples of the illness.

Post-Traumatic Stress Disorder is a serious psychological anxiety illness in which people repeatedly remember, relive, or dream about a terrible experience. The disorder may result from experiencing or witnessing a natural disaster, warfare, a personal assault, or any other violent or life threatening incident. PTSD is most commonly found in soldiers involved in combat. (Nadelson) During World War I PTSD was known as “Battle Fatigue,” and in World War II it was known as “Shell Shock.” PTSD gained prominence in the United States in the 1970s, as the mental health community sought to ameliorate the extreme postwar readjustment difficulties experienced by some Vietnam War veterans. PTSD was listed as a diagnostic category by the American Psychiatric Association in 1980. (Post-Traumatic Stress Disorder, 2007) PTSD may persist for many years. Some people held as prisoners of war or concentration camp inmates during World War II (1939-1945) showed symptoms of the condition more than fifty years later. (Nadelson) Some psychologists believe that PTSD has been over diagnosed, due partly to a broadening definition of trauma (which originally meant direct exposure to serious threat, such as combat or rape). PTSD is actually infrequent, and well-intentioned attempts to have people relived the trauma may exacerbate their emotions and help there mind to process normal stress reactions. (Myers)

PTSD involves the reaction of intense horror or fear, often accompanied by a deep sense of helplessness. This disorder can affect people at any age. (Carol C. Nadelson) Everyone suffers at least one traumatic event in their lifetime, but only about one in ten women and one in twenty men develop PTSD. (Myers) Studies report that about one percent of the population has suffered the disorder at one time or another. Others report that the lifetime average of people who suffer from PTSD is as high as fourteen percent. With in a year the National Institute of Mental Health (NIMH) estimates about four percent of population will experience symptoms of PTSD. (Carol C. Nadelson) Research shows that greater one’s emotional distress during a trauma the higher the risk for post traumatic symptoms. It also shows that the more frequent and severe the assault experiences the more adverse and long term the psychological damages tend to be. (Myers)

Prompt treatment following the trauma may help prevent PTSD or lessen its severity. One factor of attaining PTSD is the severity of the event itself. Seeing one’s friend murdered is much more disturbing than seeing the same friend held up at gunpoint. Similarly, the individual’s proximity to the event is important: being in a plane crash is worse than seeing it at a distance, which in turn is worse than hearing about it secondhand.

An episode of prolonged suffering is often harder to endure than a brief, quick tragedy. A soldier’s experience in combat is a good example of many traumatic events spread out over a period of months or years. The soldiers in World War I who experienced shell shock usually did so after prolonged exposure to shelling rather than after the first explosion. Similarly, a prisoner of war, a political prisoner, or a concentration camp inmate typically suffers for extended periods of time in situations of isolation, uncertainty, and the possibility of torture and death. In such cases, the arbitrary nature of the outcome and the victim’s inability to change his or her fate make the experience all the more difficult to endure.

Some people are more susceptible to PTSD than others. Such as people with previous psychological problems or a family history of anxiety disorders may increase an individual’s chance of developing PTSD after he or she experiences a trauma. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) emphasizes, that this disorder can develop in individuals without any predisposing psychological conditions, particularly if the stressor (the traumatic event) is especially extreme. (Carol C. Nadelson) A sensitive limbic system also seems to increase vulnerability, by flooding the body with stress hormones.

Suffering from a traumatic event can also lead to what Richard Tedeschi and Lawrence Calhoun (2004) call Post-Traumatic growth. Tedeschi and Calhoun have found that the struggle with Challenging crises, such as facing cancer often leads people later to report an increased appreciation for life, more meaningful relationships, increased personal strength, changed properties, and a richer spiritual life. Similarly, most combat-stressed veterans and most political dissidents who survive dozens of episodes of torture do not later exhibit PTSD. Instead they find it as a life altering, character building experience. For example, more than nine in ten New Yorkers, although stunned and grief stricken by the “Nine Eleven Attacks,” did not respond pathologically to this traumatic experience. By the following January the stress symptoms of the rest had mostly subsided. (Myers)

Sometimes it takes months or years for symptoms to occur, because people refuse to grieve over the lose of a loved one or either they repress the traumatic event only for it to surface in the future (maybe years after). (Carol C. Nadelson) Chief symptoms of PTSD include repeated dreams, and memories. Other symptoms include sleeplessness, difficulty concentrating, being easily startled, outbursts of anger, and flashbacks. (Nadelson)

Flashbacks are one of the most interesting symptoms of PTSD. Flashbacks are vivid involuntary recollections of the incident or traumatic event. Here is a testimony from a young girl and her traumatic experience. She is a rape victim and now suffers from PTSD. “I started having flashbacks. They kind of came over me like a splash of water. I would be terrified. Suddenly, I was reliving the rape. Every instant was startling. I felt like my entire head was moving a bit, shaking, but that wasn’t so at all. I would get very flushed or a very dry mouth and my breathing changed. I was held in suspension. I wasn’t aware of the cushion on the chair that I was sitting in or that my arm was touching a piece of furniture…Having a flashback can wring you out. You’re really shaken.”

People that suffer from PTSD often have flashbacks such as the one described by the rape victim, which may produce a dissociative may state (a disconnection from reality) lasting seconds, hours, or even days.

Another form of flashbacks is hallucinations. Hallucinations in which the person sees, hears, and smells things that isn’t really there. (Carol C. Nadelson)

What triggers these symptoms such as flashbacks and hallucinations is anxiety. Anxiety manifest itself by physical symptoms such as increased heart rate, sweating, blurred vision, dizziness, breathlessness, and the risk of having a panic attack and developing other anxiety disorders increase. (Carol C. Nadelson) There are also emotional symptoms of anxiety such as feelings of anger, fear, helplessness, and guilt. In some cases there have also been signs of emotional numbness (seeming to have no emotions at all). Symptoms of children with anxiety issues exemplarily such qualities as restlessness, they tend to repeat the trauma in play (acting, playing with friends, etc.) and having frequent nightmares. (Nadelson)

People who have PTSD and made it through a harrowing experience safely when others did not are sometimes plagued by an irrational guilt known as “Survivor Guilt.” Other common symptoms of “Survivor Guilt” include behaviors of self –destructiveness, impulsiveness, somatic complaints (headaches, stomach aches, back pain, etc.), feelings of shame, despair, hopelessness, hostility, being permanently damaged, and loss or belief of things that were recently important. (Carol C. Nadelson)

More uncommon symptoms of PTSD include diminished interest in pastimes that he or she used to enjoy, including activities associated with tenderness, intimacy, and sexuality. Also, withdrawals from ordinary activities are not unheard of. Some people feel a sense of foreshortening of the future believing that they will never have a career, marry, raise children, or have a normal life span. (Carol C. Nadelson) Although, these symptoms are more uncommon they are not unheard of. A general display of these symptoms is a decreased responsiveness to the external world and restricted emotional responses. These reactions are part of a psychological attempt by the suffering mind to insulate its self from experiencing further pain. (Carol C. Nadelson)

My first PTSD example comes from weeks after the devastating tornado in Greensburg, Kansas. Residents fight to survive not only the tornado but PTSD as well.

Right after the tornado wiped out his town, 11-year-old J.D. Colclazier heard screams over his father’s emergency radio. It was another father yelling into his emergency radio: “My kids are pinned! I need help now!” When the screaming stopped, J.D. asked, “Does that mean they’re dead?” “No, that means there’s help on the way,” John Colclazier said, partly to reassure his son. John doesn’t know whether J.D. suffered psychological trauma when he heard the cries for help, but he is certain his son will never forget it.

Five weeks after the tornado hit, the psychological fallout has only reached the early stages. It will take several months or longer for the most severe cases including post-traumatic stress disorder to manifest themselves, mental health officials say. One official expects that the number of PTSD cases could be higher than normal because the tornado uprooted a community whose residents were so deeply rooted.

There’s the 3-year-old, so terrified that it took three hours of coaxing to get her to leave her sanctuary under a bed when a storm blew through days after the tornado.

There’s the elderly, vibrant woman whose short-term memory is so diminished, she wonders whether she is now suffering from Alzheimer’s.

There’s the 32-year-old sheriff’s deputy who helped save lives but now feels survivor guilt.

There’s the woman who worries because her husband is drinking more than ever.

There’s the dispatcher who stayed so calm as she handled emergency communications the night of the tornado who has had three anxiety attacks at home, triggered by storms.

And there’s 6-year-old Bailey Burns, son of Kiowa County Undersheriff Tom Burns, who won’t let go of two donated toys because he fears they will blow away, as all of his other toys did the night of tornado.

In a recent interview, a Wichita Eagle reporter asked Greensburg’s new mayor, John Janssen, what kind of assistance the town still needs. “I think some of them need counseling, and that’s not a popular thing in a small, rural community,” Janssen said. “They don’t want to share their feelings. “It’s post-traumatic stress…that’s what it is for a lot of these folks.”

The night of May 4, Bill Odle, a Kiowa County deputy sheriff and storm-spotter, used his fire radio frequency to call in one of the first warnings, which helped lead to tornado sirens being set off in Greensburg. After the storm hit, Odle felt desperate to get to his children and check on them. He would later learn they were OK. But before he could reach them, he had to stop and assist others. He heard people screaming and saw dazed people creeping out of the rubble. “It was just like a zombie movie,” he said. “People didn’t know what to do. They were lost.” He saw a puddle of blood. He saw a body.

During the house-to-house search-and-rescue, he heard a rumor that a 2-year-old was missing. As he spotted children’s toys scattered and soaked, he wanted to cry. Although he had helped warn people, he felt what experts call “Survivor Guilt.”

He second-guessed himself. “What more did I need to do to protect these people?” he asked himself. He went 36 hours without sleep. He tried to prepare people at the shelter in Haviland, Kansas, for what they would see when they drove back into town the first time after being evacuated. “Prepare yourself for the worst you can ever imagine,” he told them. Later, he went to shop in Pratt but felt out of place. The abnormal state in Greensburg had started to seem normal to him. For two weeks after the storm, his memory was shot. He would see people he had known for years, but he couldn’t remember their names. One night he bolted awake, thinking he was hearing a tornado siren, but it was only the whine of an oscillating fan. (Potter)

My second example of PTSD brings us to the war in Iraq, or better yet the war inside the solider. As I previously stated PTSD is most commonly found in war veterans because of the horrible things that happen on the battle field.

Army Spec. Jeans Cruz helped capture Saddam Hussein. When he came home to the Bronx, important people called him a war hero and promised to help him start a new life. The mayor of New York, officials of his parents’ home town in Puerto Rico, the borough president and other local dignitaries honored him with plaques and silk parade sashes. He was hounded by recurring images of how war really was for him; not the triumphant scene of Hussein in handcuffs, but visions of dead Iraqi children.

In public, the former Army scout stood tall for the cameras and marched in the parades. In private, he slashed his forearms to provoke the pain and adrenaline of combat. He heard voices and smelled stale blood. Soon the offers of help evaporated and he found himself estranged and alone, struggling with financial collapse and a darkening depression.

At a low point, he went to the local Department of Veterans Affairs medical center for help. One VA psychologist diagnosed Cruz with post-traumatic stress disorder. His condition was labeled “severe and chronic.” In a letter supporting his request for PTSD-related disability pay, the psychologist wrote that Cruz was “in need of major help” and that he had provided “more than enough evidence” to back up his PTSD claim.

Yet abundant evidence of his year in combat with the 4th Infantry Division covers his family’s living-room wall. The Army Commendation Medal With Valor for “meritorious actions…during strategic combat operations” to capture Hussein hangs not far from the combat spurs awarded for his work with the 10th Cavalry “Eye Deep” scouts, attached to an elite unit that caught the Iraqi leader on Dec. 13, 2003, at Ad Dawr. They wrote back explaining that there was not enough evidence to support his psychological claim to PTSD to receive and forms of compensation.

Veterans Affairs will spend $2.8 billion this year on mental health. But the best it could offer Cruz was group therapy at the Bronx VA medical center. Not a single session is held on the weekends or late enough at night for him to attend. At age 25, Cruz is barely keeping his life together. He supports his disabled parents and four year old son and cannot afford to take time off from his job repairing boilers. The rough, dirty work, with its heat and loud noises, gives him panic attacks and flesh burns but puts $96 in his pocket each day. Once celebrated by his government, Cruz feels defeated by its bureaucracy.

Tens of thousands endured psychological disorders in silence, and too many ended up homeless, alcoholic, drug-addicted, imprisoned or dead before the government acknowledged their conditions and in 1980 officially recognized PTSD as a medical diagnosis. Between 1999 and 2004, VA disability pay for PTSD among veterans jumped 150 percent, to $4.2 billion. By this spring, the number of vets from Afghanistan and Iraq who had sought help for post-traumatic stress would fill four Army divisions, some 45,000 in all. American Psychological Association reports that twenty percent of the soldiers in Iraq screened positive for anxiety, depression and acute stress. (Hull)

My third and final example leads us to the Gulf Coast where hurricane Katrina struck New Orleans, but only a few months ago.

Billy Bob Hopson finds his therapy in collecting and tinkering with the rusted lawn mowers, mangled wall clocks and other debris that his neighbors toss on the curbs as they clear wreckage from Hurricane Katrina. “I’m trying to keep my mind busy,” he said, hefting junk into his battered trailer. “I’ve got a hurting thing….I lost more than I can handle. It’s like someone cut off your arm. You keep looking for your arm, and you can’t find it.”

Suicide rates in New Orleans have nearly tripled, a mental health hot line in Mississippi is swamped and the region’s few remaining psychiatrists are overwhelmed with cases of depression, post-traumatic stress disorder and related problems. By several estimates, half a million residents need mental health care. “We really have a mental health crisis, and we’ve had it for months,” said Dr. Janet Johnson, a psychiatrist at Tulane University in New Orleans. Most psychiatrists have left, she said, and major hospitals with mental health beds have closed, as have wards for substance abusers.

A few cases have hit the headlines in New Orleans: Two police officers shot themselves last September; a prominent pediatrician hanged himself in November, a news photographer went crazy earlier this month and taunted a police officer to kill him. These are only the most visible signals of massive and often hidden trauma.

In response, officials in Louisiana and Mississippi are revamping health-care systems, including mental health services. Private help is stepping in too. A project funded by the W.K. Kellogg Foundation, for example, aims to train parents, clergy and counselors to ease anxiety. Regional officials have asked Congress for clearance to use crisis-counseling money for long-term treatment. Most people along the Gulf Coast are handling the “hurting thing” the way Hopson does, treating themselves as best they can. (Schmickle)

The most common way people deal with PTSD is by coping with it. Although the best way to cope with PTSD is through professional help, not everyone has the money or time. A few ways people tend to cope with PTSD is by the avoidance of thoughts connected with the trauma. The mind blocks hurtful memories by diminishing feelings; this can reach the level of amnesia, in which the person is unable to recall the traumatic event or some important aspects of their life.

People with PTSD also develop a phobia (fear) of situations that resemble the trauma or make them recall it. Such as the anniversary of the tragedy or if it was a natural disaster, weather conditions that resemble those of the day the traumatic event happened may also trigger anxiety that in return will trigger PTSD symptoms, such as flashbacks, anger, etc.

The mind will also replay the traumatic event over and over again through dreams and flashbacks. Not only does this numb one’s emotions it slowly desensitizes one’s morals of right and wrong. The mind does this because it tires to confront the stressful event by replaying it again and again with the subconscious hope that the event will play out differently. (Carol C. Nadelson)

The victims of PTSD typically experience an initial state of numbness while trying to assimilate the traumatic experience. Modes of therapy used to deal with PTSD include behavioral techniques, administration of sedating drugs, group therapy, and individual psychotherapy. Their common aim is the help the individual to understand and accept the traumatic experience that happened to them and to restore one’s self esteem.

A common treatment for PTSD is a combination of psychotherapy and medication. Psychotherapy for stress disorder is a well used treatment. During psychotherapy people are expected to talk about the hurtful event, which allows the patient to release pent up feelings and purge painful emotions by revisiting the events in a therapeutic context. This is known as “Debriefing.” With the therapist’s help, the patient also has the opportunity to gain control over terrifying incidents. Frightening experiences that were fragmentary and unintelligible when they took place may make more sense—and therefore seem more controllable—when the patient reviews them during therapy. Understanding what happened becomes a form of power.

In a cognitive approach, the therapist specifically addresses the patient’s anxiety-provoking thoughts. In a behavioral approach, the therapist uses exposure and desensitization techniques to gradually accustom the patient to dealing with places, objects, or situations that he or she has been avoiding. Relaxation and breathing exercises help the patient control the onset of anxiety. Group therapy sessions help the patient release his or her painful emotions, while offering an opportunity for the patient to develop supportive, healing relationships with other people.

Many specific symptoms of stress disorder can be eased by using appropriate medication, which can, in turn, help patients benefit from psychotherapy. Antidepressants, for example, are often useful in treating depressive reactions. Use of benzodiazepines can calm feelings of anxiety and help with difficulty sleeping. These drugs can also help control flashbacks and dissociative reactions. Because benzodiazepines can be addictive, however, extreme caution must be exercised in its use.

A class of drugs known as antipsychotics can also be helpful in treating stress disorders, particularly if hallucinations or other dissociative symptoms have occurred. To prevent these symptoms, a low dose of haloperidol may be prescribed. In addition, clonidine and propranolol, which are typically used for high blood pressure, are sometimes prescribed for stress disorders; by blocking physiological arousal, these drugs can reduce some of the symptoms of anxiety. (Carol C. Nadelson)

In summary, I have described what Post-Traumatic Stress Disorder is. How it forms through being mentally and emotionally unstable and through anxiety. I have stated the various symptoms that attribute to Post-Traumatic Stress Disorder. I have given numerous examples of cases that could or have cause PTSD in the people affected by the traumatic events. I have shown the forms of treatment for PTSD and also ways of coping with the disorder through everyday life.

Post-Traumatic Stress Disorder is an unruly and difficult illness to manage. If you’re not careful, it could easily take over you life and even push some to ending their life. Sadly, it affects a vast amount of people in our society today. PTSD is best handled with the help of a professional psychologist who is highly trained to help with mental illnesses such as PTSD. Although drugs do help cure the illness temporarily, it is best to go to the root of the problem. Getting help from a trained professional is recommended to take care of the psychological root. Post-Traumatic Stress Disorder is truly a huge problem in our society today. It is a well known cause of suicide, depression, and in some cases stress related death. With the help of schools, government, doctors, psychologists, and society in general, surely we can minimize its effects.

Bibliography

Carol C. Nadelson, M.D. Uneasy Lives: Understanding Anxiety Disorders. Philadelphia: Chelsea House Publishers, 2000.
Hull, Dana Priest and Anna. “The War Inside.” 17 June 2007. SIRS Knowledge Source. 8 November 2007 .
Myers, David G. Exploring Psychology: Seventh Edition. New York : Worth Publishers, 2008.
Nadelson, Theodore. “Post-Traumatic Stress Disorder.” World Book (2003): 709.
Online, Grolier. “Post-Traumatic Stress Disorder.” 14 January 2007. Grolier Multimedia Encyclopedia. 8 November 2007 .
Potter, Tim. “Weeks After Devastating Tornado, Kansad Residents Struggle with PTSD.” 11 June 2007. SIRS Knowledge Source. 8 November 2007 .
Schmickle, Sharon. “Mental Health Problems Aboud a Year After Katrina.” 20 August 2006. SIRS Knowledge Source. 8 November 2007 .

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