Supervisor Name] Post-Traumatic Stress Disorder (PTSD) Following

Supervisor Name]

Post-Traumatic Stress Disorder (PTSD)

Following an unusual and an unexpected event, that is stressful, such as being diagnosed with cancer, one may develop characteristic symptoms that may differ slightly from person to person. This normal human response has been classified into two broad categories; adjustment disorder and post traumatic stress disorder. (Nicholas A., Nicki R., Brian R., and John A.A.)

Post traumatic stress disorder is a type of response, which has a delayed onset and is of a prolonged nature, to events that are particularly threatening in quality, for example, being part of, or witnessing an earthquake. Slightly differing from the novel definition, this disorder can also occur with events that may not be life threatening. According to the diagnostic and statistical manual of mental disorders, PTSD can occur due to an actual or even a threatened death or injury to oneself or to others. Needless to say, the incident or incidents must only be perceived as threatening by the individual. Recent evidence indicates that PTSD can also result from distressing medical treatments, sexual abuse or bullying. (Nicholas A., Nicki R., Brian R., and John A.A. )

In a survey conducted regarding bone marrow chemotherapy and PTSD amongst women, using the DSM-IV criteria, twelve to nineteen percent of the patients were suffering from symptoms of this disorder. According to this study, PTSD was related to poorer physical and mental health and lack of sleep.

The term post-traumatic stress disorder was first coined in the mid 1970s, which included the post-Vietnam syndrome. Dating back from this era, this disorder was mostly and exclusively only observed in military personnel. However, recently, as a result of modern living, PTSD has entered the gateway of institutions, offices and homes. With an increase in technological advances, widespread warfare, global communication and the war on terror, there has been a greater scope for traumatic imagery. Media, too, could have played a greater role by portraying non-traumatic incidents in an exaggerated stressful manner.

The symptoms of PTSD are divided into primary and secondary. The primary symptoms form the basis of the DSM criteria. The secondary symptoms are associated features which have been observed to coexist with the disorder, but do not form part of the diagnostic criteria. (Kirtland C., Maurice F., and Robert A. 11-35)

To be classified as a PTSD sufferer, there needs to be a recognizable stress factor, which would evoke a response of distress in most people, along with a combination of symptoms. These symptoms include: (Kirtland C., Maurice F., and Robert A. 11-35)

1) Re-experiencing the incident either through recall of memories, repeated dreams of the event or a sudden feeling as if the traumatic event was about to re-occur through an association of environmental stimulus. These nightmares or typical flashbacks cause the patient to be in a state of anxiety, symptoms of autonomic arousal, emotional blunting and avoidance of situations which evoke these flashbacks. (Kirtland C., Maurice F., and Robert A. 11-35)

2) Decreased interest in the present surrounding, following the trauma, as shown through decreased responsiveness, feeling of aloofness from people and a constrained affect. (Kirtland C., Maurice F., and Robert A. 11-35)

At least two of the following qualities that were not present before the traumatic incidence need to be present: (Kirtland C., Maurice F., and Robert A. 11-35)

1) Increased alertness or an exaggerated startle response to a stimulus.

2) Irregular sleep patters or a decreased quality in sleep.

3) Feeling of guilt about survival.

4) Decreased concentration and memory.

5) Avoidance of activities that evoke memories of the traumatic event.

6) Intensification of symptoms with exposure to events or conversations that resemble or remind one of the incidents.

The secondary symptoms include anxiety and depression, which are usually associated with PTSD. Excessive use of alcohol or abusing drugs frequently complicates the clinical condition. (Kirtland C., Maurice F., and Robert A. 11-35)

PTSD is a dynamic, complex disease rather than one which has a set of symptoms that are uni-dimensional, therefore there is no fixed treatment plan. The therapist should have sound knowledge of PTSD before making a diagnosis. Such data can be taken from the National Center for PTSD. Diagnosis can be made with psychological assessment tests and a clinical interview in which the history of trauma is very important. The therapist must also ask for any co-morbid conditions. It is important to note the sequence of events in chronological order to ensure there are no discrepancies in the story. The patient may be hard to deal with in the initial assessment phase so he needs to be made comfortable and should feel safe in the clinical setting. He must not feel pressured to spill details of the trauma in one go; rather it should be a slow process. Effective treatment requires the cooperation of both the therapist and the patient. (Wilson, Friedman, & Lindy, 2001).

The following are a few treatment approaches for the management of PTSD:

1) Psycho pharmacotherapy: Drugs such as selective serotonin reuptake inhibitors, Monoamine Oxidase (MAO) inhibitors, beta blockers, benzodiazepines, and anticonvulsants are usually prescribed to treat various symptoms of PTSD. The goal of this treatment is to facilitate normal homeostasis. (Wilson, Friedman, & Lindy, 2001).

2) Cognitive-behavioral therapy: The patient is told to talk about the problem. This therapy is aimed at reducing the level of stress and anxiety when reminded of the situation and to help the patient gain confidence about his ability to cope with it. The patient is also asked to write about his problem and to say it out loud inside and outside the therapy session. (Wilson, Friedman, & Lindy, 2001).

3) Dual diagnosis: Some patients come in with PTSD along with other problems which could have occurred before or after it, for instance substance abuse. For such patients both conditions must be treated. (Wilson, Friedman, & Lindy, 2001).

4) Group psychotherapy: A group of people with PTSD talk to each other about the problems they faced. There may be a few therapists to accompany them. They share their stories, talk about different strategies they used to cope with their problem, encourage, criticize and support fellow members. It helps them realize that they are not alone and that there is hope. (Wilson, Friedman, & Lindy, 2001).

5) Cross cultural: People from different cultural backgrounds react differently to severe stressors. This knowledge therefore helps therapists decide which strategy would work best on the patient. (Wilson, Friedman, & Lindy, 2001).