What is PTSD?

If you have read any of my other posts about mental illness on this blog, you might have realized I create the artwork featured at the top of these posts. For this post I tried to represent the feeling of intrusive thoughts that accompany post-traumatic stress disorder. The colorful arranged triangles were meant to represent normal everyday thoughts. The gray triangles represent intrusive thoughts trying to arrange themselves into the normal thought pattern. I think for this specific mental illness it’s important to mention the art because of the link between art and trauma, the cause of PTSD. Art therapy as a branch of psychology is very underrepresented in research, but of the research that exists, a lot of it pertains to clients with PTSD and it has been found to be effective in reducing trauma related stress, when combined with other psychotherapies (Volker, 1999).

Contents:

- Overview

- Symptoms

- Diagnosis

- Treatment

- What can you do?

- Removing Stigma

Overview

An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and up to 20 percent of these people go on to develop post traumatic stress disorder, or PTSD. This equates to 8% of the U.S, or 24.4 million people (Sidran Institute). This is an extremely high incidence for a disease, especially one that is continuously stigmatized and stereotyped. In this article I hope to explain what PTSD is, the stigma that exists, and how to help. I will be focusing in on PTSD that exists in adults rather than children.

Symptoms

With post traumatic stress disorder, symptoms have to be occurring for at least a month to be diagnosed, although they may not develop immediately after the traumatic event, it could take months for symptoms to arise. The individual has to have experienced a trauma, witnessed a trauma, or been told about a trauma of close friends/family. The symptoms are separated into categories, re-experiencing or intrusion, avoidance, arousal, and cognition & mood. The DSM -5 states that in the one month period the person has to experience at least one symptom of re-experiencing and avoidance and at least two symptoms of arousal, cognition & mood.

Re-experiencing (Intrusion)

- Nightmares

- Intrusive thoughts, memories of the event, related to the event

- Flashbacks

- Emotional or physical distress when presented with triggers related to the traumatic event

Avoidance

- Keeping away from anything that might trigger the individual physically

- Emotionally blocking out thoughts and memories related to the event

Arousal (reactivity)

- Trouble sleeping

- Trouble concentrating

- Hypervigilance

- Irritability

- Aggression

Cognition & Mood

- Loss of interest in activities once cared about (anhedonia)

- Negative outlook, negative self-image

- Loss of memory of parts of the traumatic event

- Feelings of guilt

Diagnosis

When seeking help for PTSD a doctor will first rule out any physical problems, medication, or drug abuse that might be explaining certain symptoms. When seeking help a psychologist or other form of therapist are the best professionals to see. You can be referred by your primary care doctor, but they won’t be able to diagnose you and most likely will not prescribe medication. With PTSD, a therapist is going to diagnose a client using the DSM - 5, which catalogs the criteria for mental disorders and includes treatment options. The diagnostic criteria is listed above in the symptoms, the most important part of DSM diagnosis is that the symptoms are causing distress or impairment of daily functioning.

Treatment

Like with all mental illness, PTSD has no cure, but the most typical form of treatment is a combination of medication and psychotherapy. Types of medication that can help treat the symptoms are antidepressants, typically SSRIs and SNRIs. Similarly, to bipolar disorder, a doctor may co-prescribe a mood stabilizer such as lithium if the patient experiences severe mood swings. The type of psychotherapy that has been proven to be most effective for PTSD is Cognitive Behavioral Therapy (CBT). In CBT a therapist might use exposure therapy where (with the client’s consent) slowly expose them to triggers to help reduce their negative association to the event.

What can you do?

Individual with PTSD

· Do not be so hard on yourself

· Don’t worry about people being afraid of you or judging you for getting treatment

· Do not be afraid to seek help, things won't get better if you don't. Therapists are understanding and ethically bound to remain judgement free, empathetic, and confidential. Anything you say to a therapist (aside from threatening to harm oneself or others) is held in complete confidence between you and the therapist.

· Asking for help does not make you weak, you can't get over other diseases without going to the doctor. Why is this different?

· Don't be disappointed if treatment doesn't work immediately, medications and therapy take time to be effective. It also might take time to find the right medication and/or therapist.

· Try to make lifestyle changes. There are many smaller factors that people overlook that when combined with proper treatment make is more effective. Things like eating well, exercising, being social, having a schedule, etc.

· Don’t be ashamed of avoiding triggers

· You are not what society stereotypes you as

· Set smaller goals for yourself that are achievable over time

Loved One

· Be aware when your loved one has experienced trauma, recognize the symptoms and be aware of changes in behavior

· Talk to that person, don't pressure them if they are uncomfortable but make them aware that you love them and are there for them if they need to talk.

· Pay attention to warning signs of suicidal ideation and call the National Suicide Prevention Hotline (1-800-273-8255) if necessary.

· Be accepting and understanding, help them understand that this is not their fault and they don't need to seek treatment alone

· Respectfully ask about triggers, as to help the individual avoid them

· Don’t stigmatize them based on what you’ve seen about PTSD in media

Things you shouldn't say to those with PTSD:

- Me too!

- Get over, or it’s been such a long time

- Did you serve in the military/ I thought only soldiers had PTSD

- Others have it worse than you

- Just be happy

- What happened to you?

- But you seem happy

- Man up

Removing Stigma

A big stereotype that exists with PTSD is that all the individuals suffering from it are veterans who are traumatized by combat. This may have been historically where it received its initial attention from psychologists, initially naming it “shell shock”, but it is not the only form of trauma that can cause PTSD. Female sufferers of sexual abuse or physical abuses make up a large percent of sufferers. Women in general are twice as likely to develop PTSD than men (Sidran, 2016). Veterans suffering from PTSD deal with more stigmatization, because they are perceived publicly as the main sufferers. They are often stigmatized as being unstable, violent, crazy but this is far from the truth.

Sources

Post traumatic stress disorder (ptsd) [PDF file]. (February 2016). Retrieved from https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/ptsd-508-05172017_38054.pdf

Sidran Institute. (2016). Post traumatic stress disorder fact sheet. Retrieved from https://www.sidran.org/resources/for-survivors-and-loved-ones/post-traumatic-stress-disorder-fact-sheet/

Volker, C. A. (1999). Treatment of sexual assault survivors utilizing cognitive therapy and art therapy (Unpublished Dissertation). Dissertation Abstracts International: Section B. 60(5B), 2374.