an upsetting traumatic, dangerous or life-threatening event. This exposure can be in three ways:
(1) Experience trauma directly in which the individual directly faces life-threatening events.
(2) Experience trauma indirectly in which exposure to life-threatening events occurred to a close family member or friend.
(3) Witnessing in person i.e. the life-threatening event or trauma experienced by others. An example is bystanders in case of a road traffic accident.
Symptoms of Post-Traumatic Stress disorder are severe and can persist even after years of traumatic events. One of the common symptoms of PTSD is flashbacks. The patient feels as if the traumatic event is reoccurring. Another common symptom is the avoidance of reminders to that event. For example, after a road traffic accident, a patient with PTSD refuse to travel or go outside. Sometimes symptoms are severe enough to lead a person towards maladaptive behaviors. These behaviors include drug abuse and self-harm. Not every person exposed to traumatic even suffers from this disorder. Some persons are prone to develop this disorder. These will be discussed later.
The person finds himself in a situation that mimics a traumatic event. This can take three forms
Not all people who are exposed to trauma develop PTSD. However, there are factors that predict the likelihood of this disorder
These are divided into three factors:
These are the factors that decrease the chance of developing this disorder after the exposure to a traumatic event
Use of illicit drugs; This is a common complication of PTSD. The patients use these to get rid of disturbing memories, but these further serve as interrupting the recovery process.
Self-harm or destructive behavior; The patients of PTSD have a great deal of self-guilt. They are in a habit of derogating themselves and in order to overcome it, they use ineffective ways of coping and among which self-harm is common.
Aggression; One of the bad coping styles is aggression often being directed towards people or objects. It doesn’t help to recover from trauma. Yet causes further complications
Not all patients who are a victim of trauma suffer from PTSD. So, after the traumatic event, the first step is to identify those who are at risk. Risk factors are described above. The next step is following those people whether they develop symptoms of PTSD.
These are simple techniques that can be taught to the patient. They can prevent the development of this disorder. Similarly, they are also a strategy of choice with an early and less severe form of PTSD. These are
There is a need for structured psychotherapy when the above measures are not working or when the symptoms are severe. Common techniques are exposure therapy, CBT, and EMDR. The major benefit of psychotherapy is that it is highly effective. Most patients recover from illness.
In this technique, the patient is exposed to reminders of traumatic events. This exposure can be imaginative. For example, the patient tells details of a traumatic event to the therapist. Similarly, it can be a real-life exposure. The example is going to the place road traffic accident.
Cognitive errors are common in PTSD. The aim of this is to target the negative thoughts and behaviors and to enable the patient to use effective ways of coping.
In most cases, there is no need to start medicine. This is because, most patients recover with the above interventions. However, if the symptoms are severe or other psychiatrist illness is present then there is need for medicine. These are usually antidepressants. Sedative drugs should be avoided as maximum as possible.
Mr. M.A. a 50-year-old businessman was admitted to the hospital shortly after he tried to kill himself. His wife had filed a divorce against him, and he felt as though his life was falling apart. He was angry, hostile, frustrated, distrusting and chronically anxious. The detailed history revealed that he experienced a road traffic accident one year back. This happened while he was driving a car and his very close friend died in that accident. In the hospital, he said he was distressed by the memories of his past. He frequently experienced the flashbacks as if the accident is occurring again. He became very much disturbed whenever someone tried to talk about that event. He even stopped driving sitting in a car. Till now he is using public transport. Another important finding was that he started excessive smoking. He considered himself responsible for the death of his friend. And he tried to commit suicide twice. The diagnosis of PTSD is made. The psychiatrist noticed that his excessive thoughts of guilt, bad copying style such as smoking, and avoidance of traveling in any car are prolonging the illness. He was managed on lines of CBT.