Post Traumatic Stress Disorder

Trauma can be defined as any kind of emotionally painful, shocking, horrifying, stressful, or life-threatening situation (that may or may not involve physical harm) that one either suffers, is threatened by, or witnesses, or that someone close to them is either threatened by or experiences.

Not everyone who suffers trauma develops PTSD. The person’s response to the trauma is what is key. If they experience prolonged or repeated feelings of intense fear, horror, helplessness, or hopelessness, then they may be experiencing PTSD.

There are a number of symptoms associated with PTSD, and they typically fall into four major categories:

1. Intrusive memories

The first category of symptom is that of intrusive memories. These include any sort of unwanted recurrent, distressing memories or flashbacks of the traumatic event. These may be experienced as dreams or nightmares about the traumatic event.

This may also include extreme emotional or mental distress when confronted with something that brings the event to mind, such as being in a similar situation or even some kind of minor trigger such as when someone’s face looks similar to the face of someone involved in the trauma.

2. Avoidance

Avoidance happens when the victim tries to avoid talking or thinking about the traumatic event. They will also try to avoid situations, activities, people, or places that might remind them of the trauma. Although this is natural to some extent, it becomes a problem when it begins to interfere with the victim’s daily life in undesirable ways.

For instance, the victim may begin to avoid good friends that (through no fault of their own) remind them of the trauma or cause painful memories. They may also start to avoid going to places or discontinue activities that they previously enjoyed because they are afraid of being reminded of the trauma.

3. Negative alterations of thoughts or moods

Trauma can also produce unwelcome changes in thoughts or moods. This can include any of the following:

• Negative self-image
• Disillusionment with others and the world in general
• Trouble being positive and emotional numbness
• Hopelessness about the future
• Memory loss, including about details of the trauma
• Trouble maintaining close relationships, including detachment from family and friends
• Apathy about activities you previously enjoyed

4. Hyperarousal

Hyperarousal symptoms are the symptoms that people typically associate with PTSD. These are the types of symptoms characterized by the following symptoms:

• Always being on the alert for danger
• Being easily startled or frightened
• Self-destructive behavior
• Irritability or outbursts of anger
• Aggressive behavior
• Substance abuse
• Addiction to danger
• Insomnia
• Difficulty concentrating
• An overwhelming sense of guilt or shame

Children 6 years old or younger may also manifest the following symptoms:

• Nightmares that may or may not be of the trauma
• Re-enacting of the trauma in their play

There is a spectrum of trauma responses that may lead up to and include PTSD. 

Normal Stress Response: This occurs when the person is exposed to the traumatic event or situation, whether as victim or observer. Symptoms can include reliving the event, bad memories, emotional numbness, body tension or distress, and a feeling of disconnection from reality. Normal stress response does not have to result in PTSD.

Acute Stress Disorder: The next level of trauma response is Acute Stress Disorder, which involves more extreme symptoms such as panic attacks, extreme insomnia, paranoia, mental confusion, dissociation, and inability to maintain basic self-care, work duties, and relationships.

Few people suffer from Acute Stress Disorder after only suffering from a single traumatic incident. Typically, it occurs in situations where the trauma is repeated or ongoing.

Uncomplicated PTSD: The first level of PTSD is called Uncomplicated PTSD, characterized by replays of the traumatic event, avoidance symptoms, hyperarousal symptoms,and emotional numbness. A wide variety of approaches may be used to successfully treat this type of PTSD.

Comorbid PTSD: Comorbid PTSD occurs when the PTSD exists in association with some other mental illness such as alcohol abuse, depression, other anxiety disorders, eating disorders, or anger issues. In such situations, the PTSD and the accompanying disorder are best treated in tandem. Comorbid PTSD will typically respond to the same types of treatments as Uncomplicated PTSD, while any accompanying disorders are treated separately but simultaneously.

Complex PTSD: Otherwise known as “Extreme Stress Disorder,” Complex PTSD occurs in individuals who have been exposed to prolonged experiences of trauma. Though the trauma can be experienced at any point in life, it is especially prevalent among those exposed to long-term trauma in their childhood years.

Antisocial personality disorders and dissociative disorders are commonly exhibited by individuals with Complex PTSD and they may also manifest symptoms of hyperarousal such as aggression, insomnia, or self-destructive behaviors such as eating disorders or substance abuse.

Because of the nature of Complex PTSD, the treatment is much more involved and takes place over a much longer period.

There are a number of treatment options available for treating Post Traumatic Stress Disorder. Since everyone is different, it should come as no surprise that there is no “one-size-fits-all” treatment option, and people will respond individually to the various treatments.

Each patient, in conjunction with their doctor and/or therapist, must work out a treatment plan that is fitted to their individual needs and that will have the highest chance of success.

Psychotherapy

• Cognitive therapy

Cognitive therapy is a type of talk therapy that helps the patient to identify cognitive patterns that are contributing to their disorder. Such thought patterns might include negative self-image, negative beliefs about others, or fear of a repetition of the trauma.

In Cognitive therapy, the therapist first helps the patient to evaluate the traumatic memories and understand how they are viewing them. The patient is then guided into a different and more compelling evaluation of the trauma. This new evaluation is then integrated into the traumatic memory.

• Exposure therapy

Often used in conjunction with cognitive therapy, exposure therapy teaches effective coping mechanisms that are especially helpful in treating nightmares and flashbacks. It leads the patient to face frightening situations and traumatic memories that they might otherwise avoid by exposing them to the situation in order to break the cycle of fear. The therapist creates a safe situation in which the patient can be exposed to the situations and memories that they avoid because of fear.

• Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a therapy that is designed to literally reprogram the brain and how it stores memories of the trauma. In this way, it aims to eliminate symptoms which are a reaction to the trauma.

Medications

• Antidepressants

Antidepressants are used to treat more than just depression. They are also useful for treating Post Traumatic Stress Disorder, helping to control anxiety, and improving sleep and concentration problems (and, of course, depression). Zoloft and Paxil (both selective serotonin reuptake inhibitors) have proven effective and have been approved by the FDA for treating PTSD.

• Anti-anxiety medications

Since anxiety is such a huge component of PTSD, it is only natural that doctors prescribe anti-anxiety medications to relieve it. As with many medications, this type can be addictive, so doctors will need to provide careful supervision and limit their use to short periods.

• Prazosin

Prazosin is a controversial option for nightmare suppression that some seem to respond well to. However, recent studies have offered conflicting results, leading some to conclude that it is ineffective. Having said this, trials are still ongoing, and if you think this might be an option for you, speak to your physician to see if this would be a suitable medication to try.

Any medication can produce side effects so you should report any that you experience to your doctor. He or she may need to adjust your schedule, your dosage, or even try a combination of medications in order to find what works.

Counseling for Post Traumatic Stress Disorder can be an extremely helpful and effective method for treating and overcoming PTSD. The professional Christian counselors at Seattle Christian Counseling are trained and equipped to help you learn proven coping methods for dealing with your PTSD symptoms. Contact us today or browse our online counselor directory to schedule your appointment.