Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder develops in people who have experienced or witnessed the most shocking and traumatic situations in their lives. It is a human tendency to have fear or stress after you’ve been through a traumatising event. Usually, people might have different reactions to address the trauma like shock, nervousness, or guilt, and they usually recover from these. It can become a matter of concern if these reactions persist or increase for a prolonged period.

People can suffer from PTSD at any age. Veteran soldiers are likely to have PTSD from the war, then there are victims of assaults, rape, bullying, and dangerous accidents. These people are frequently frightened and stressed even when there are no signs of danger.

What Is PTSD?

Post-Traumatic Stress Disorder is a prolonged psychiatric illness that is caused by certain life circumstances. These can either be life-threatening or not so dangerous for example:- the death of a loved one, sexual assault, rape, deadly accidents, terrorist attacks, bullying, or a natural calamity.

The traumatic events can be seriously endangering a person’s life or safety and well-being. A short-term incident or a long-term incident can cause trauma. You don't need to be the direct victim of the trauma, you can be a witness of it and still get traumatised.

What Are the Different Types of PTSD?

PTSD manifests in different types depending on various factors.

Normal Stress Response - This occurs before the beginning of PTSD in an individual. It does not elevate and manifest into complete PTSD. People with this disorder are likely to suffer from normal stress from general stressful matters of life. A person’s nervous, endocrine, and immune systems are affected due to this type of disorder. Talk Therapies and psychotherapy are proven treatment methods for normal stress response.

Acute Stress Response - Acute stress response is a type of PTSD that occurs right after a person is exposed to a traumatic event. The person starts to experience this type of PTSD after three days or within a month of the event. The person may show symptoms like intrusive memories about the traumatic event, anxiety, and hypervigilance. Through various therapies, the symptoms of Acute Stress Response can be managed.

Uncomplicated PTSD - The symptoms of this type are similar to other types of PTSD. People with uncomplicated PTSD may feel that they are re-experiencing the traumatic event again and again. It is easy to treat this form of PTSD. People will have flashbacks, and nightmares, be easily agitated, etc.

Complex PTSD - This type of PTSD is the complete opposite of uncomplicated PTSD. This is a type where a person frequently suffers from a traumatic event like - war, domestic violence or abuse, bullying, or sexual assault for a prolonged period. Complex PTSD also has physical symptoms like fatigue and chronic pain. The treatment is similar to other types but slightly intense. People of this type show signs of agitation, depression, and panic.

Comorbid PTSD - People with comorbid PTSD also have co-occurring disorders at the same time it is also sometimes coupled with substance abuse. The health care professionals may use therapies and medications to treat comorbid PTSD and co-occurring disorders.

What Are the Signs and Symptoms of PTSD?

Post-traumatic stress disorder symptoms develop in the first three months after the traumatic situation, but in some cases, it takes time to develop the situation. The realization that you have PTSD may happen after recognition of those symptoms happens after months or even years.

Re-Experience - You may relive your traumatic symptoms again and again through nightmares, flashbacks, suffering from physical signs of stress like racing heart and sweating

Avoidance - Avoiding people, words, places, and anything that is somehow linked or reminds you about the traumatic events. Eg- a person will avoid riding his or her vehicle after an accident.

Arousal & reactivity - A person becomes hypervigilant, finds it difficult to focus, and gets easily agitated. They also have exaggerated emotional outbursts. People also engage in destructive and reckless activities.

Cognition and mood symptoms - People will not remember significant facts about the traumatic incident. People build a negative perception of the world, and they may develop negative emotions about the people they are associated with, also they may have a sense of guilt.

Diagnosis of PTSD

There is no specific form of test to diagnose PTSD. Your healthcare provider will first evaluate your symptoms, medical and mental health history, and your traumatic history.

Physical exam:- To know the medical concerns and issues that are triggering your symptoms.

Psychiatric assessment:- This includes talking about your symptoms and the trauma that causes these. You can also fill out questionnaires asking about your traumatic experiences and symptoms.

What Is the Treatment of PTSD?

The main treatment used for PTSD is Psychotherapy or talk therapy like CBT - Cognitive Behavioral Therapy. You must get therapy provided by experienced psychologists or psychiatrists.

Cognitive processing therapy: This therapy was specifically developed for the treatment of post-traumatic stress disorder. It treats replacing the negative feelings and cognitions as a result of the trauma, such as shame and guilt. In addition, it enables you to confront negative memories or feelings.

Eye movement desensitization and reprocessing (EMDR) therapy: It involves moving the eyes in a particular way when engaging with traumatic memories. The purpose of EMDR is to assist you in the recovery process from trauma and other adverse life events. EMDR is quite young as compared to other therapy techniques. However, dozens of clinical trials prove that this technique works and aids a person quicker than most techniques.

Group therapy: This kind of therapy helps survivors of similar traumatic occurrences to express experiences and emotions in a relaxing and bias-free environment. Family therapy may also be useful as problems of PTSD can impact the entire family. Prolonged exposure therapy: This therapy involves reconstruction of the traumatic event in imagination or graduated exposure to the precipitants of symptoms in a non-dangerous context. This costs a person dearly as they get into a position to face and conquer fear and learn how to.

Trauma-focused CBT: This is one of the therapies that help the client understand his or her body to stress and trauma. You will also learn about cognitive distortions and modifying them as well as learning skills in handling the symptoms. So on the practical level, it is also an exposure therapy.

Medications

Many kinds of medicines are available to make symptoms of PTSD better:

Antidepressants. These relieve the symptoms of depression and anxiety. They also can help make sleep problems and concentration better. The selective serotonin reuptake inhibitor (SSRI) medicines sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) to treat PTSD. Venlafaxine (Effexor XR) also may be prescribed. Talk with your healthcare team about possible side effects.

Anti-anxiety medicines. These medicines can ease severe anxiety and related problems. Some anti-anxiety medicines could be misused. Generally, they are used only for a short time.

Research studies on medicines for PTSD include:

Stellate ganglion block. It is a process where medicine is injected into a collection of nerves on the side of the neck. While the FDA has not approved this procedure to treat PTSD, studies have shown promising results.

Difference Between Post-Traumatic Stress Disorder and Acute Stress Disorder

PTSD is known as Post-Traumatic Stress Disorder and ASD stands for Acute Stress Disorder – the two mental health disorders that develop in reaction to traumatic situations. Despite this similarity, they are different regarding the onset of symptoms, their duration, and severity. Each of these differences must be taken into consideration in the context of the diagnostic and therapeutic approach.

A diagnosis of PTSD is made when the symptoms last for over a month after the traumatic experience occurred. PTSD often manifests later, sometimes months or even years after the event, which distinguishes it from other reactions as a delayed response to trauma.

Whereas Acute Stress Disorder happens within the first three days to a month after the incidence of a traumatic event. If the symptoms develop within this period then the person is diagnosed with ASD.

PTSD is a long-term disorder that may persist for months, or even years, in case the patient fails to seek treatment. PTSD takes longer, and this means that the quality of life of the affected individuals is more likely to be affected in their relationships, work, and overall lifestyle.

Whereas Acute Stress Disorder is a relatively short-term condition, which typically persists for some days up to a month at most. When the symptoms persist beyond this time, it is usually referred to as Post-Traumatic Stress Disorder or PTSD.

The clinical manifestations of PTSD include a wider range of emotional effects, such as anger, depression, severe anxiety, and the continued avoidance of stimuli related to the trauma.

In contrast, ASD shows a higher likelihood of presenting dissociative manifestations, which are, for example, the belief in being alienated from the environment or emotional apathy.

Myths About PTSD

Myth: Only combat veterans in war zones get PTSD.

PTSD illness is not just restricted to soldiers and war veterans but anyone who suffers from or witnesses traumatic experiences has the chance of getting PTSD

Myth: People with PTSD are violent or dangerous.

This is a common misconception that people with PTSD are dangerous. This perception has been generated through movies where a person gets easily triggered and indulges in violence which is not the case in reality. On the contrary, people with PTSD are victims of violence.

Myth: A person with PTSD is a weak person.

A person who suffers from PTSD is not weak. It is natural for human beings to act a certain way after they have been through a traumatic event.

Coping and Living With PTSD

It takes a lot of courage to come out and seek help when a person has PTSD due to the stigmatisation around it. It can be difficult to live with the illness but there are certain ways by which one can cope with the disorder.

You must keep transparent communication with your psychiatrist or psychotherapists and follow your treatment plan without fail.

Engage yourself in activities that reduce stress like going to a gym and workout, yoga, meditating, or getting a hobby.

Maintain a healthy schedule for diet, exercise, and sleep.

Keep achievable goals and concentrate on how you can manage and achieve them.

Spend quality time with your close ones and educate them about your triggers and symptoms so that they can also support you.

Expect your symptoms to improve gradually, not immediately. Keep patience while you are undergoing your treatment.

Avoid alcohol or drug consumption.

How to Support Your Loved Ones with PTSD

When you find out that your close ones have PTSD, it will be difficult for you to accept it. The person might seem completely different to you, this is a crucial time and you must be there for them so they don’t feel isolated. Here are a few tips or ways to support them.

Learn about the disorder to understand what they are suffering through.

Don’t be judgmental towards them.

They will withdraw themself from you and may act like they don’t need help because they are better alone but you must be there for them and give them their personal space.

Become an active listener when they open up to you about their triggers and symptoms.

Encourage them for treatment and to interact with their family and friends.

How Does Jagruti Rehabilitation Centre Treat People With PTSD?

It is not easy to talk about the trauma one must’ve endured or witnessed so people at Jaguti Rehabilitation Centre give them the comfort where you can communicate and talk about their traumatic experiences with our experienced psychiatrist or psychologist. Our trauma-informed therapy program helps in addressing and experiencing your traumatic situations and learning healthy coping ways. This form of therapy is important and appropriate for people with PTSD to learn and manage their causes and symptoms without relying on substances. We at Jagruti Rehabilitation Centre have different levels of care where one can be free of their disorders and live an independent life. If you or someone you know shows symptoms of PTSD and it is disturbing your lifestyle then contact Jagruti Rehabilitation Centre today.

Statistics About Post-Traumatic Stress Disorder

The study also revealed that PTSD in India is at 0.2% which is significantly lower than global averages. Around 70% of people globally will experience a potentially traumatic event during their lifetime (1), But only a minority (5.6%) will go on to develop PTSD (2). An estimated 3.9% of the world population has experienced PTSD at some point in their lives (2). The likelihood of developing PTSD varies depending on the type of traumatic event experienced. For example, rates of PTSD are more than three times (15.3%) higher among people exposed to violent conflict or war (3). PTSD rates are especially high following sexual violence (1). Up to 40% of people with PTSD recover within one year (1). There are many effective treatments for PTSD, yet only 1 in 4 people with PTSD in low- and middle-income countries (LMICs) report seeking any form of treatment (2).

Source -https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder

PTSD statistics by age

PTSD in adults was highest in 45- to 59-year-olds (5.3%) as of 2001-2003. (Harvard Medical School, 2007)

PTSD in adolescents was highest in female adolescents aged 13 to 18 (8%) as of 2001-2004. (Journal of American Academy of Child and Adolescent Psychiatry, 2010)

PTSD prevalence was lowest in adults aged 60 or older (1%) as of 2001-2003. (Harvard Medical School, 2007)

PTSD statistics by trauma

PTSD is rooted in traumatic events. The following statistics illustrate the percentage of people who will likely develop PTSD after experiencing these traumatic events:

Sexual assault: 49%

Severe physical assault: 32%

Serious accidents: 16.8%

Shoot and stabbing victims: 15.4%

The unexpected death of a loved one: 14.3%

Parents of children with life-threatening illnesses: 10.4%

Witnesses of violence: 7.3%

Natural disaster victims: 3.8%(Sidran Institute, 2018)

PTSD in veterans statistics

An estimated 354 million adult war survivors globally have PTSD and/or major depression. (European Journal of Psychotraumatology, 2019)

In one study of 1,938 veterans, a PTSD prevalence of about 14% was present in veterans who served in Iraq. (U.S. Department of Veterans Affairs)

In reports, a 10% prevalence of PTSD has been extrapolated for all Gulf War veterans. (American Journal of Epidemiology, 2003)

About 30% of Vietnam veterans have had PTSD in their lifetime. (American Psychological Association, 1990)

PTSD treatment statistics

Studies have demonstrated that up to 46% of people with PTSD show improvement within the first six weeks of psychotherapy. Antidepressants are also a treatment option to alleviate the symptoms of PTSD, including anxiety, with studies showing up to 62% of people receiving medication for PTSD show improvement. (American Family Physician, 2003)