Good Answers to Tough Questions About Traumatic Experiences

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This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters and many other traumatic events. Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also cause PTSD. PTSD can cause many types of symptoms. The symptoms can be generally grouped into three categories:.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car. Hyper-arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event s. They can make the person feel continually stressed and angry, making it difficult to do daily tasks, such as sleeping, eating or concentrating.

Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, it might be PTSD. Most people with longstanding PTSD find that the symptoms are not steady in their severity.

For some people, PTSD symptoms gradually fade over time. Other people find that symptoms may increase when they encounter reminders of their traumatic events. Read the rest of Dr.

Post-traumatic stress disorder - Post-Traumatic Stress Disorder - NCBI Bookshelf

Krystal's answer on our Ask an Expert page. A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD. The diagnosis is made after the doctor talks with the person who has symptoms of PTSD. A number of treatment techniques, sometimes combined with one another, are being used with varying degrees of success:.

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Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include:. Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful or destructive behaviors.

Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

What does it mean to be “Trauma Informed?”

It is important to remember that not everyone who lives through a dangerous event experiences post-traumatic stress disorder PTSD. In fact, most will not get the disorder. Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event.

Researchers are studying the importance of various risk and resilience factors. With further researcher, it should become possible to predict who is likely to get PTSD, how resilience can be learned and prevent it. A significant number of veterans suffer from PTSD: up to 20 percent of those who served in the Iraq and Afghanistan wars and up to 30 percent of those who served in Vietnam. But PTSD can result from a variety of traumatic or life-threatening incidents such as sexual assault, child abuse, accidents, bombings, or natural disasters such as tornadoes, for example. Even witnessing a traumatic event can cause PTSD.

During a given year, some five million adults are coping with PTSD. In their 20 years of treating and studying trauma survivors, Dennis S. Charney, M. Southwick, M. Our operating expenses are covered by separate foundation grants. Eating Disorders. Mental Illness General. Suicide Prevention. Other Brain-Related Illnesses. This guideline applies to patients for whom PTSD is the main problem. Whether or not PTSD is the problem that should be the focus of treatment depends on the severity and urgency of other disorders and problems, such as social problems, health problems and safety issues.

This may include practical problems such as safe housing, support in court cases, and a range of psychological symptoms. In order to establish whether or not PTSD is the main psychological problem, it is useful to ask trauma survivors:. Individuals should be fully assessed before a management plan is devised.

Other factors, for example suicide risk, may determine what the most important focus should be in the first instance. Simply because there is a trauma history, it should not be assumed that there is PTSD. This raises the following clinically important questions:. Whether or not the comorbid diagnoses are secondary to PTSD i. Kessler et al showed that PTSD was primary to comorbid affective or substance use disorders in the majority of cases, and was primary to comorbid anxiety disorders in about half of the cases.

In many cases comorbid problems that are secondary to the PTSD, such as comorbid depression, general anxiety or alcohol or substance misuse, improve with trauma-focused psychological treatment. For example, patients with comorbid secondary major depression no longer met diagnostic criteria for major depression after PTSD treatment Blanchard et al , b.

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However, in patients with a long history of PTSD or patients who have experienced multiple traumatic events and losses, the depression can become so severe that it needs immediate attention i. Psychological treatments for PTSD often involve discussing the traumatic events and their meanings in detail.

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Extremely severe depression would need to be treated before patients could benefit from such trauma-focused treatments. For PTSD sufferers who are so severely depressed that this makes initial psychological treatment of PTSD very difficult for example, as evidenced by extreme lack of energy and concentration, inactivity, or high suicide risk , healthcare professionals should treat the depression first.

For PTSD sufferers whose assessment identifies a high risk of suicide or harm to others, healthcare professionals should first concentrate on management of this risk. Similarly, many patients with PTSD misuse both alcohol and a range of drugs in an attempt to cope with their symptoms, and treatment of their PTSD symptoms will help them with reducing their substance use. However, if substance dependence i.

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  4. In cases where the drug or alcohol dependence is severe, collaborative working with specialist substance misuse services may be required. For PTSD sufferers with drug or alcohol dependence, or in whom alcohol or drug use may significantly interfere with effective treatment, healthcare professionals should treat the drug or alcohol problem first.

    Patients with personality disorders may present two kinds of problems with regard to PTSD. First, as a result of their interpersonal difficulties they may at times find themselves in situations in which they are more likely to be harmed and suffer PTSD as a consequence of the harm suffered.

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    Second, in some cases there is a history of abuse in childhood as a factor in the development of the personality disorder. It has been assumed by some therapists and researchers that personality disorder is a contraindication for many treatments. Patients with personality disorder therefore could benefit from trauma-focused psychological interventions. When offering trauma-focused psychological interventions to PTSD sufferers with comorbid personality disorder, healthcare professionals should consider extending the duration of treatment.

    People with PTSD often have difficult life circumstances. For example, they may have housing or serious financial problems, live under ongoing threat e.