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PTSD: Symptoms and Diagnosis

 

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Post-traumatic stress disorder (PTSD) is a potentially debilitating anxiety disorder triggered by exposure to a traumatic experience. Some events that may cause PTSD include combat, natural disasters, accidents, and sexual assault. Information about PTSD is timely, as even today, young men and women soldiers are returning home from active duty – some bearing unseen wounds from war.

PTSD’s symptoms are broken into three categories: reliving the event, avoidance, and arousal.

1.  Reliving the Event    

If someone relives a traumatic event in a way that disrupts daily activity, they may be suffering from PTSD.  Examples include recurring nightmares, flashback episodes, repeated upsetting memories, and strong reactions to situations that trigger memories of the event.

 2.  Avoidance

The symptoms related to avoidance include emotional numbing and purposeful detachment.  This can cause someone suffering from PTSD to avoid people, places, or thoughts that remind him or her of the event.  It is common to lose interest in normal activities, be unable to recall important parts of the traumatic event, and feel like the future is hopeless.  

3.  Arousal

Examples of PTSD symptoms related to this category include having outbursts of anger, startling easily, experiencing hyper-vigilance, feeling irritable, having difficulty concentrating, and trouble falling and/or staying asleep.

Other symptoms of PTSD – like dizziness, fainting, headache, agitation, and excitability – are typical of stress, anxiety, and tension. Studies indicate that those with PTSD have decreased levels of cortisol and increased levels of epinephrine and norepinephrine.   Those three hormones create the “fight-or-flight” response to stress, which some people with PTSD experience frequently.  Home testing kits can measure hormone levels to assess an imbalance. 

About 3.6% of adult Americans (5.2 million people) suffer from PTSD during the course of a year, and an estimated 7.8 million Americans will experience PTSD at some point in their lives. PTSD can develop at any age, including childhood. Women are more likely to develop PTSD than are men, probably due to the fact that women are more likely to be victims of domestic violence, abuse, and rape.

Diagnosing PTSD

Mental health professionals look for several things when diagnosing PTSD.  The requirements for arriving at the diagnosis are called “Criteria A – F” and are as follows:

Criterion A:  Experiencing or witnessing a traumatic event where there was the threat of death or serious injury, and responding to the event with strong feelings of helplessness, fear, or horror.
 
Criterion B:  Experiencing at least one of the following: recurrent nightmares, recurrent upsetting thoughts or memories; flashbacks, or physically responding (such as with an increased heart rate) to reminders of the event.  

Criterion C:  Experiencing at least three of the following: feeling distant from others, feeling as though life may be cut short, a loss of interest in activities, difficulty experience positive feelings, like love and happiness; difficulty remembering parts of the event, making an effort to avoid feelings, thoughts, or conversations about the event; and making an effort to avoid people and places that remind you of the event.

Criterion D:  Experiencing at least two of the following:  difficulty concentrating, difficulty falling or staying asleep, feelings of irritability or outbursts of anger, feeling like danger is around every corner, being easily startled or “jumpy.”

Criterion E:  The symptoms described in the first four criteria must have lasted for more than a month.  Symptoms that have lasted less than a month may be related to Acute Stress Disorder.

Criterion F:  The symptoms described in the first four criteria must have a great negative impact on the quality of life, interfering with relationships or work.

Once identified, PTSD treatment often includes both medication and psychotherapy.   Medications known to treat the symptoms of PTSD include antidepressants, anti-anxiety medications, antipsychotics, and prazosin.  Types of therapy include cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR).

 


  http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/
  http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder?page=2

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.