John sustained serious injuries in a motor vehicle
accident. Despite the fact he showed rapid recovery
from his physical injuries, he was experiencing
symptoms of significant emotional distress. He was
depressed, anxious, losing weight, and having sleep
difficulties. He had been experiencing nightmares,
intrusive recollections of the accident, and had
feelings of impending doom. His personality and
behavioral changes were noticeable to friends and
family. John had difficulty adjusting back to work
and was more distant in his relationships. John
was puzzled feeling guilty he was not grateful for
his recovery and felt responsible for his inability
to be more responsive to his family and work. It
was only after months of battling his feelings that
he sought psychological treatment. His symptoms
were clear to the therapist: They were characteristic
of post-traumatic stress disorder (PTSD).
Post-traumatic stress disorder is an anxiety disorder
that's triggered by one's memories of a traumatic
event witnessed. The disorder commonly affects survivors
of traumatic events, such as sexual assault, physical
assault, war, torture, a natural disaster, an automobile
accident, an airplane crash, a hostage situation
or a death camp. PTSD can also affect rescue workers
at the site of a tragic accident or event.
Not everyone involved in a traumatic event experiences
post-traumatic stress. The Mayo Clinic statistics
indicate the disorder affects more than 5 million
adults each year in the United States. Post-traumatic
stress disorder is twice as common in women as it
is in men.
Signs and symptoms of post-traumatic stress disorder
typically appear within three months of the traumatic
event. However, in some instances, they may not
occur until years after the event and may include:
- Flashbacks and distressing dreams associated
with the traumatic event.
- Distress at anniversaries of the trauma.
- Efforts to avoid thoughts, feelings and activities
associated with the trauma.
- Feelings of detachment or estrangement from
others and an inability to have loving feelings.
- Markedly diminished interest or participation
in activities that once were an important source
- Hopelessness about the future - no hope of
a family life, career or living to old age.
- Physical and psychological hypersensitivity
- not present before the trauma - with at least
two of the following reactions: trouble sleeping,
anger, difficulty concentrating, exaggerated startle
response to noise, and physiological reaction
to situations that remind you of the traumatic
Your doctor or a mental health professional may
suggest a combination of medications and behavior
therapy to treat post-traumatic stress disorder.
The objectives of treatment are to reduce your emotional
distress and the associated disturbances to your
sleep and daily functioning, and to help you better
cope with the event that triggered the disorder.
Treatment may involve a combined approach including
medications and behavior therapy designed to help
you gain control of your anxiety.
Selective serotonin reuptake inhibitors
(SSRIs). These antidepressants act on the
chemical serotonin, the neurotransmitter in your
brain that helps brain cells (neurons) send and
receive messages. These medications can help control
anxiety as well as depression.
Cognitive-behavior therapy. This
treatment teaches you effective ways of managing
thoughts or situations that remind you of the trauma
you've experienced. The goal of this therapy is
to promote a sense of recovery and a feeling of
mastery over your anxiety.
Stress management training. This
approach also involves learning to manage your anxiety
through relaxation. You work with the help of a
therapist to develop skills to decrease your preoccupation
with negative thoughts and the sense of being overwhelmed
by the traumatic event.
Cognitive therapy. You identify
distorted thoughts and beliefs that arouse psychological
stress and learn ways you can view and cope with
a traumatic event differently. There is special
emphasis on learning to develop a sense of mastery
and control of your thoughts and feelings.
Effective treatment is often successful in helping
patients in their adjustment back to life and work.