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destruction of the World Trade Center, the violent
attack on the Pentagon, and the crashes of hijacked
aircraft have impacted all of our lives. These attacks
upset our basic sense of safety. You may now be
experiencing feelings of shock, disbelief, anger,
and anxiety. You may have trouble concentrating,
or feel overwhelmed by your emotions. All of these
feelings are normal reactions to traumatic events.
With the support of friends, family, faith communities
and counselors, most of us will be able to get back
into the routines of our lives within a few weeks.
However, some people face situations that are so
traumatic that they may become unable to cope and
function in their daily lives. They may become so
distressed by memories of the trauma -- memories
that won't go away -- that they begin to live their
lives trying to avoid any reminders of what happened
to them.
A person who still feels this way months after
a traumatic experience took place may be suffering
from Posttraumatic Stress Disorder, or PTSD, a serious
and common health condition. For these people, getting
beyond the trauma and overcoming PTSD requires the
help of a professional. Untreated PTSD is associated
with an extremely high rate of medical and mental
health service use, and possibly the highest per-capita
cost of any psychological condition.
But there is help and there is hope.
PTSD is a long-term problem for many people. Studies
show that 33-47 percent of people being treated
for PTSD were still experiencing symptoms more than
a year after the traumatic event. Without treatment
many people continue to have PTSD symptoms up to
ten years after the traumatic event.
What are the symptoms of PTSD?
PTSD symptoms are divided into three categories.
People who have been exposed to traumatic experiences
may notice any number of symptoms in almost any
combination. However, the diagnosis of PTSD means
that someone has met very specific criteria. The
symptoms for PTSD are listed below.
Intrusive Re-experiencing (re-living the event)
People with PTSD frequently feel as if the trauma
is happening again. This is sometimes called a flashback,
reliving experience or abreaction. The person may
have intrusive pictures in his/her head about the
trauma, have recurrent nightmares or may even experience
hallucinations about the trauma. Intrusive symptoms
sometimes cause people to lose touch with the "here
and now" and react in ways that they did when
the trauma originally occurred. For example, many
years later a victim of child abuse may hide trembling
in a closet when feeling threatened, even if the
perceived threat is not abuse-related.
Avoidance
People with PTSD work hard to avoid anything that
might remind them of the traumatic experience. They
may try to avoid people, places or things that are
reminders, as well as numbing out emotions to avoid
painful, overwhelming feelings. Numbing of thoughts
and feelings in response to trauma is known as "dissociation"
and is a hallmark of PTSD. Frequently, people with
PTSD use drugs or alcohol to avoid trauma-related
feelings and memories.
Arousal
Symptoms of psychological and physiological arousal
are very distinctive in people with PTSD. They may
be very jumpy, easily startled, irritable and may
have sleep disturbances like insomnia or nightmares.
They may seem constantly on guard and may find it
difficult to concentrate. Sometimes persons with
PTSD will have panic attacks accompanied by shortness
of breath and chest pain.
Who gets PTSD?
PTSD can affect anyone at any age who has been
exposed to a traumatic event where he/she experienced
terror, threat (or perceived threat) to life, limb
or sanity and his/her ability to cope was overwhelmed.
Conservative estimates show that 9-10 percent of
the general population has PTSD. Among people who
were victims of specific traumatic experiences (rape,
child abuse, violent assaults, etc.), the rate of
PTSD is 60-80 percent.
Diagnosis
Unfortunately, it is common for those with PTSD
to avoid treatment. Also, it is common for those
who do seek treatment to be misdiagnosed. Because
PTSD often occurs at the same time as other physiological
and mental health disorders, PTSD symptoms may be
masked or difficult to identify. Examples of common
co-occurring conditions are depression, substance
use/dependence and bipolar disorder. Trauma survivors
may also experience headaches, chest pain, digestive
or gynecological problems as well. However, there
is a growing number of clinicians who are skilled
at recognizing PTSD and still others who are specializing
in treatment of traumatic stress disorders. If you
think you might have PTSD you should seek professional
help for a thorough physical and mental health assessment.
Can PTSD be treated?
Yes. A person who has survived a traumatic event
will probably never feel as if the event didn't
happen, but the disruptive, distressing effects
of PTSD are completely treatable. Depending on the
source of the trauma (manmade vs. natural), the
nature of the trauma (accidental vs. purposeful),
and the age of the victim at the time of the trauma,
treatment strategies may vary. Treatment involves
both managing symptoms and working through the traumatic
event. Most experts agree that psychotherapy is
an important part of recovery. Medications can help
reduce some symptoms allowing psychotherapy to be
more effective.
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