| Imagine, if you will, that you are walking alone at | | | | success here is beginning the initial medication |
| night in an unfamiliar neighborhood. You think you | | | | treatment within two weeks of the trauma. Then |
| hear footsteps behind you so you walk a little faster. | | | | the goal of therapy, breaking the pattern of |
| Suddenly someone steps out from behind a bush. | | | | self-defeat by reexamining the traumatic event and |
| You turn around but someone is behind you as well. | | | | the patient responses to it, can begin. Education |
| They are both bigger than you and you are scared | | | | about the disease and recognition of cues or |
| to death. Possibly you are mugged or raped. Maybe | | | | situations that trigger symptoms are invaluable. |
| you escape harm, but you've still had a harrowing | | | | Complete education and healing consists of:* |
| experience. You could end up suffering from | | | | ExposureExposure to the event via imagery allows |
| Posttraumatic Stress Disorder (PTSD) if you have an | | | | you to reexperience the event in a safe, controlled |
| experience like this or have exposure to any real or a | | | | environment where your reactions can be |
| perceived life-threatening trauma where you | | | | monitored.* ExaminingExamining feelings such as |
| responded with intense fear.PTSD is a medically | | | | anger, shame, guilt, etc. allows you to work on |
| recognized anxiety disorder that occurs in normal | | | | resolving these feelings.* New Coping SkillsNew |
| individuals under extremely stressful situations. | | | | coping skills teach you how to handle reminders, |
| Symptoms may appear immediately and then | | | | reactions and feelings without becoming |
| disappear after several months. At other times | | | | overwhelmed or emotionally numb. This can help |
| symptoms may take up to 6 months to emerge and | | | | foster your relationships with others. Some of the |
| may never completely go away. Half of those who | | | | techniques used are:* Relaxation (i.e. breathing |
| meet the DSM-IV criteria for PTSD will still suffer | | | | techniques, visualization)* Biofeedback* Cognitive |
| from symptoms a year after diagnosis and 1/3 will | | | | restructuring* Managing Anger* Preparing for stress |
| still have weekly symptoms ten years after the | | | | reactions* Addressing urges to use alcohol or drugs* |
| trauma.CRITERIA FOR PTSD* Exposure to a | | | | Communications and relating effectively with |
| traumatic event marked by intense fear, helplessness | | | | peopleGroup treatment has also proven to be quite |
| or horror* Symptoms from each of the three | | | | helpful for PTSD sufferers. This type of setting |
| symptom clusters:* Intrusive recollections (evoke | | | | allows you to share with others who are more |
| panic, fear, dread, nightmares, grief, despair, daytime | | | | empathetic to your feelings. Being able to share instills |
| fantasies, etc.)* Avoidant/numbing symptoms | | | | more confidence and helps you to trust again. After |
| (avoidance of trauma related stimuli, trouble leaving | | | | being allowed to share your trauma you are freer to |
| the house, cannot tolerate strong emotions, etc.)* | | | | engage proactively in current relationships.Eye |
| Hyperarousal symptoms (symptoms resemble panic | | | | Movement Desensitization and Reprocessing |
| attacks, generalized anxiety, insomnia, irritability, | | | | (EMDR)This is a relatively new treatment that |
| startle response, hypervigilance that may come | | | | combines elements of exposure therapy, cognitive |
| across as paranoia)You may also use the mnemonic | | | | behavior therapy and then uses techniques (eye |
| "DREAMS"D = DETACHMENTR = REEXPERIENCING | | | | movements, hand taps, sounds, etc.), which creates |
| THE EVENTE = EVENT HAD EMOTIONAL EFFECTSA | | | | an alteration of attention back and forth across the |
| = AVOIDANCEM = MONTH IN DURATIONS = | | | | person's midline. Fourteen controlled studies have |
| SYMPATHETIC, HYPERACTIVITY OR | | | | been done on EMDR. The last five done on trauma |
| HYPERVIGILANCESTATISTICSCertain populations | | | | patients (abuse, rape, accident victims, etc.) have |
| are more at risk than others. Here are just a few | | | | found that 84-90% of the individuals suffered no |
| examples:* 2% in post-partum women* 18% in | | | | PTSD after only three sessions. In a study for |
| professional fire fighters* 34% in adolescent | | | | combat veterans, 77% showed no PTSD symptoms |
| survivors of car accidents* 48% in female rape | | | | after twelve sessions. Like all therapy the progress |
| victims* 67% in prisoners of warUp to 80% of | | | | rate depends on the individual and the type of |
| patients with PTSD will have a comorbid psychological | | | | trauma. To administer EMDR, therapists must |
| or psychiatric disorder. The most common diseases | | | | undergo special training.Although PTSD manifests |
| that occur with PTSD are:* major depression* | | | | itself in a wide variety of symptoms there is a |
| substance abuse* dysthymia* bipolar disorder* | | | | common factor. If you have lived through any type |
| generalized anxiety disorder* panic disorder* phobias* | | | | of experience that has caused you to feel |
| dissociative disordersTREATMENTSMedicationsTypical | | | | threatened by death (either real or perceived) or |
| first line treatment is with selective serotonin | | | | threatened serious physical injury to yourself or to |
| reuptake inhibitors (SSRI's) such as Prozac, Paxil, | | | | others, and you felt intense fear, horror or |
| Zoloft or Lescol. Trazadone and nefazadone | | | | helplessness, you could be suffering from PTSD and |
| (Serzone) are being re-studied since the have SSRI | | | | may not even be aware of it. If you have |
| properties and they also reduce or suppress REM | | | | experienced a traumatic event, lived an abused life, |
| sleep, thus reducing or eliminating nightmares. Tricyclic | | | | or cannot deal with something that you were |
| antidepressants and MAOI's have been tried but | | | | confronted with, please seek the help of a |
| there is no proven efficacy for these types of | | | | professional. No one should have to live a life in |
| medications.Benzodiazepines were once the first line | | | | constant fear or helplessness.Terry J. Coyier is a |
| of treatment but the efficacy has not been proven | | | | 37-year-old college student studying for an |
| in controlled studies. They can also cause dependency | | | | Associates of Applied Sciences degree. She is also a |
| problems for people who must deal with substance | | | | freelance writer who writes about bipolar disorder |
| abuse issues. These types of medications also come | | | | and other mental illnesses. Terry was diagnosed with |
| with a variety of discontinuation | | | | bipolar ten years ago. She lives with her son in the |
| problems.PsychotherapyOnce medications relieve the | | | | Dallas/Ft. Worth Metroplex. Terry is an author on |
| most distressing symptoms a patient can then | | | | which is a site for Writers and her personal portfolio |
| concentrate on psychotherapy. A key element to | | | | can be viewed here. |