About Post-Traumatic Stress Disorder

Americans most likely remember the television images of airplanes hitting the Twin Towers or the teenagers running out of a school building during the shootings at Columbine. Drivers have at some time been in traffic jams due to horrible car accidents that block an entire freeway. According to the Rape, Abuse & Incest National Network, every two minutes someone is sexually assaulted in the United States. Unfortunately, these examples are infinite. Trauma is a part of life, and with the media and technology of today, traumatic events and the ability to witness themis increasing.

 

Traumatic events can be viewed on a spectrum. On one end of the spectrum, there is life threatening “Trauma” such as natural disaster, car accidents, war, or physical/sexual assault, and on the other end is life “trauma” such as divorce, death of a parent, being teased in school, etc. Often psychological trauma can lead to serious disorders such as posttraumatic stress disorder (PTSD), dissociative identity disorder and other anxiety disorders.
 

Since World War II, we have learned much about how trauma affects the mind and the body. What used to be called “hysteria” in women and “shell shock” in veterans has now been termed posttraumatic stress disorder (PTSD). It is a debilitating psychiatric disorder that can inflict anyone who has been the victim of, or witnessed a traumatic event that threatened to cause death or injury. Usually tied with the event is an experience of fear, helplessness or horror. PTSD is coupled with biological reactions and changes in the body; however the personal and spiritual affects can be devastating. Judith Herman said it best in her book Trauma and Recovery when she explained,
 

“Traumatic events call into question basic human relationships. They breach the attachments of family, friendship, love, and community. They shatter the construction of the self that is formed and sustained in relation to others. They undermine the belief systems that give meaning to human experience. They violate the victim's faith in a natural or divine order and cast the victim into a state of existential crisis.”(Herman, 1997)


According to the DSM-IV-TR (Fourth edition, text revised 2000), these are the main criteria for meeting a diagnosis of PTSD:

 

  • Experienced or witnessed a traumatic event that involved actual or perceived threat of life or bodily injury, and the person's emotional response included fear, helplessness or horror.
  • "Intrusive recollection" symptoms, "avoidance/numbing" symptoms, and "hyperarousal" symptoms.
  1. “Intrusive recollections" include nightmares, flashbacks, hallucinations, and fantasies. These symptoms are the most unique to PTSD and demonstrate how the traumatic event remains a dominating psychological experience that evokes intense fear, panic, despair, grief and horror when reenacted in invasive memories.
     
  2. “Avoidance and numbing" reactions demonstrate to what level the victim will do anything to avoid re-experiencing the traumatic event. In an effort to avoid triggers of the event, their behavior begins to resemble agoraphobia in that they are afraid to leave the house and encounter a reminder. In order to avoid strong emotions of any kind there is often a "psychic numbing," an emotional inhibitor that prevents the forming of meaningful relationships and experiencing any emotions.Hyperarousal" resembles panic and anxiety disorders. Usually symptoms of insomnia, irritability, hypervigiliance, paranoia, and heightened startle response are common.
     

These symptoms must cause significant distress or impairment in social, occupational, or other important areas of performance, cannot have been present prior to exposure of trauma, and must endure for more than one month.
 

There are many theories regarding the biochemistry of PTSD and how trauma changes the body. The most popular and well-accepted theory is that trauma destabilizes the autonomic nervous system and changes body chemistry. Because of some of these neurochemical changes, survivors of trauma have a high incidence of depression and substance abuse problems.
 

When experiencing trauma, the adrenal glands are hard-wired to pump either adrenaline or noradrenaline into the system. Adrenaline will propel the body into a state of hyperalterness, increasing heart rate, blood pressure, muscle tensions and blood-sugar levels. This provides a charge of energy and is responsible for the fight or flight reaction, where increased blood flows to the head and body enhance thinking, movement and strength. During these surges, digestion slows, blood coagulates quicker, the lungs become more efficient to provide increased oxygen in order to fight or run, and senses are increased. The adrenaline surge also plays a part in the hyperalterness symptom of PTSD. On the other hand, noradrenaline creates the freeze reaction where moving and acting is impaired, and a person typically freezes.
 

The body can be permanently damaged or altered when exposed to prolonged trauma. Under stress, several neurotransmitters are released to help regulate the intensity of emotions and feelings. Under repeated stress or prolonged trauma, certain neurotransmitters may become depleted and lead to clinical depression, mood swings, explosive outbursts, overreactions, and startle response.
 

Researchers have taken notice of PTSD and designed studies for possible treatments. Although various treatments are used, the most common forms are pharmacotherapy, group therapy, psychoeducation, relaxation training, cognitive-behavioral therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR). Typically, the most common form of treatment is a combination of medication and talk therapy.
 

By Ashley Kuehne​
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