Even though it has been some time since the tragic events of September 11th, for many it is still difficult to move on to normal life. As I wrote about in my last column, it will take time to mourn what has happened. Of concern is the far reaching psychiatric problems this tragedy could produce in some people. One of the more severe problems to arise in this sort of situation is Post Traumatic Stress Disorder (PTSD).
PTSD has been estimated to affect between 1-12% of the U.S. population. The rates are even higher in those at greater risk for developing it, including professional firefighters, individuals in law enforcement, survivors of motor vehicle crashes, and rape victims. Symptoms of PTSD can come on immediately, and go away after a few months; but they can also take a while to set in, and last for many years.
Diagnosis
To diagnose PTSD one would have to meet criteria for it; as well the symptoms should have persisted for at least one month, and significantly disturb the patient’s social and/or occupational functioning. The criteria as outlined by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders are the following.
- A traumatic event occurred in which a person witnessed or experienced actual or threatened death or serious injury, and responded with intense fear, horror, or helplessness.
- Memory cues causing the person to re-experience symptoms, like their recollections of fear or helplessness, nightmares, flashbacks, or other psychologic distress.
- The person avoids trauma related stimuli and feels emotionally numb.
- The person is at a heightened state and can be more irritable or experience difficulty sleeping.
Prevention
Of greatest important in stopping PTSD from occurring, of course is prevention of violence. Unfortunately many tragedies happen that are out of our control, including natural disasters. We should try to do our part to curb violence, especially in such circumstances as rape, child abuse, and domestic abuse.
Preventing PTSD once exposure to a traumatic event has already occurred hasn’t been studied so well. A behavioral program for the prevention of chronic PTSD has shown promise in preventing or reducing the symptoms of PTSD, if started within 14 days of the trauma. It combines confronting the fears of the victim with relaxation techniques and education. Based on these findings victims of trauma are encouraged to discuss the traumatic event, and their feelings about it, soon after it has occurred. Studies have found that in the short term such sessions decrease the victim’s anxiety, and give them a greater feeling of empowerment.
Treatment
Each patient is different, and often requires different forms of treatment to meet their needs. Generally the first line treatment for every patient is education about PTSD. After that the patient should receive counseling from a mental health professional, as well as guidance from a PTSD group. Psychotherapy aims to break the pattern of self-defeat. It is done by re-examining the traumatic event and talking with the patient about his/her feelings. Cues or certain situations can trigger the symptoms, so it is important to try to recognize such triggers. Especially since systemic desensitization may help control the symptoms when the triggers present themselves. Psychotherapy also helps teach the patient coping mechanisms including relaxation techniques. Sometimes one member’s PTSD affects the whole family. In that case the family needs to be educated about the disease, and may need to join the patient in family counseling sessions. Medicine given for PTSD is more aimed at treating the symptoms caused by the PTSD including the anxiety, re-experiencing phenomenon, or insomnia. Done in concert with each other, these treatments should help treat the PTSD significantly. It is important to treat any other problems the patient may have to help optimize their chances for recovery including: substance abuse problems, medical problems, or other psychiatric problems they may have.
Hopefully, this column gives you a good introduction to Post Traumatic Stress Disorder. People can be seriously disabled by it, and can have trouble leading a normal life. Whether it is you or someone you care about, it is important to recognize that something isn’t right. You don’t have to diagnose a psychiatric illness yourself, leave that up to the doctor; you just have to ask for help. Often we find ourselves in denial about psychiatric illness, perhaps because we are embarrassed to admit it. Society doesn’t look down on you if you have heart disease, but unfortunately, psychiatric problems have a stigmata associated with them. The only way to combat that prejudice is by education. By writing this column I have done my part, now it is up to you. Seek help if you need it. Force someone you care about to get help, if they need it. Most importantly don’t be judgmental or casual when it comes to your mental health or the mental health of your loved ones.
For more information on PTSD check out the National Alliance for the Mentally Ill’s website at www.NAMI.org, or call 1-800-950-NAMI.
Now that I’ve been writing this column for a few weeks, I’d like to hear from you. E-mail any questions, comments, or what you’d like to read about in future columns to me at aliya_hasan@hotmail.com.