Saturday, October 18, 2008

Recognizing Post-Traumatic Stress Disorder

Ever been in psychotherapy for your PTSD issues -- and have them not resolve? Ever have people in the psych community NOT EVEN DIAGNOSE your clear PTSD symptoms? Several caregivers don't know enough about PTSD to recognize its presence. It's important for us - sufferers and those who love us - to educate ourselves.

Over the course of 20 years I saw several psychotherapists as I saught help for anorexia, insomnia, frequent mysterious medical problems that doctors (since they couldn't diagnose a cause for, say, my skyrocketing liver enzymes) suggested I seek alternative help, and a whole host of other traditional PTSD issues. Even as I sat in front of these professionals talking about and complaining of PTSD red flags, no one saw what was happening to me. It wasn't until I took responsibility for my own healing that I did some research and found the results: I had a classic, extreme case of PTSD.

Need a list of dead give away symptoms? Here they are, courtesy of the Sidran Institute (


There is a growing awareness among healthcare providers that traumatic experiences are widespread and that it is common for people who have been traumatized to develop medical and psychological symptoms associated with the experience.

Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing Post-Traumatic Stress Disorder (PTSD). Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape. PTSD is associated with an extremely high rate of medical and mental health service use, and possibly the highest per-capita cost of any psychological condition.

But there is help and there is hope.

PTSD is a long-term problem for many people. Studies show that 33–47 percent of people being treated for PTSD were still experiencing symptoms more than a year after the traumatic event. Without treatment many people may continue to have PTSD symptoms even decades after the traumatic event.

What Are the Symptoms of PTSD?

PTSD symptoms are divided into three categories. People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. However, the diagnosis of PTSD means that someone has met very specific criteria. The symptoms for PTSD are listed below.

Intrusive Re-experiencing

People with PTSD frequently feel as if the trauma is happening again. This is sometimes called a flashback, reliving experience, or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares, or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.


People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places, or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.


Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled, irritable, and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

Recognizing and Diagnosing PTSD

Three categories—or "clusters"—of symptoms are associated with PTSD. A diagnosis may be considered if:

A specific number of symptoms from each of the three clusters have lasted for one month or longer, and

The symptoms cause severe problems or distress in personal life, at work, or in general affect daily life.

Re-living the event through recurring nightmares or other intrusive images that occur at any time. People who suffer from PTSD also have extreme emotional or physical reactions, such as chills, heart palpitations, or panic when faced with reminders of the event. One or more of these symptoms must be present for diagnosis.

Avoiding reminders of the event including places, people, thoughts, or other activities associated with the trauma. PTSD sufferers may feel emotionally detached, withdraw from friends and family and lose interest in everyday activities. Three or more of these symptoms must be present for diagnosis.

Being on guard or hyper-aroused at all times, including feeling irritable or sudden anger, having difficulty sleeping or a lack of concentration, being overly alert or easily startled. Two or more of these symptoms must be present for diagnosis.

People with PTSD may have low self-esteem or relationship problems, or may seem disconnected from their lives.

Other problems that may mask or intensify symptoms include:

-Psychological problems such as depression or other anxiety disorders, including panic disorder.

-Physical complaints such as chronic pain, fatigue, stomach pains, respiratory problems, headaches, muscle cramps or aches, low back pain, or cardiovascular problems.

-Self-destructive behavior, including alcohol or drug abuse, as well as suicidal tendencies.

-Responses to trauma vary widely and many people who experience extreme trauma do not develop PTSD. However, for those who do, PTSD symptoms usually appear within several weeks of the trauma, but some people don't experience symptoms until months or even years later.


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