According to The National Center for PTSD, posttraumatic stress disorder is an anxiety disorder that happens after you have been through a traumatic event that is life-threatening to yourself or to others. This event can cause feelings of fear, confusion, and anger. Events that can result in PTSD symptoms include sexual or physical assault, serious accidents, natural disasters, and combat or military exposure. The first four weeks after an experience of a traumatic event, one can have symptoms of associated with Acute Stress Disorder which is characterized by the development of severe anxiety, dissociative, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor (e.g., witnessing a death or serious accident), according to the American Psychiatric Association. Further, the APA states that “as a response to the traumatic event, the individual develops dissociative symptoms. Individuals with Acute Stress Disorder have a decrease in emotional responsiveness, often finding it difficult or impossible to experience pleasure in previously enjoyable activities, and frequently feel guilty about pursuing usual life tasks. A person with Acute Stress Disorder may experience difficulty concentrating, feel detached from their bodies, experience the world as unreal or dreamlike, or have increasing difficulty recalling specific details of the traumatic event (dissociative amnesia).” “In addition, at least one symptom from each of the symptom clusters required for Posttraumatic Stress Disorder is present. First, the traumatic event is persistently reexperienced (e.g., recurrent recollections, images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the event, or distress on exposure to reminders of the event). Second, reminders of the trauma (e.g., places, people, activities) are avoided. Finally, hyperarousal in response to stimuli reminiscent of the trauma is present (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, an exaggerated startle response, and motor restlessness).”
Specific Symptoms of Acute Stress Disorder:
Acute stress disorder is most often diagnosed when an individual has been exposed to a traumatic event in which both of the following were present:
- The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
- The person’s response involved intense fear, helplessness, or horror
Either while experiencing or after experiencing the distressing event, the individual has 3 or more of the following dissociative symptoms:
- A subjective sense of numbing, detachment, or absence of emotional responsiveness
- A reduction in awareness of his or her surroundings (e.g., “being in a daze”)
- Dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.
Acute stress disorder is also characterized by significant avoidance of stimuli that arouse recollections of the trauma (e.g., avoiding thoughts, feelings, conversations, activities, places, people). The person experiencing acute stress disorder also has significant symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).
For acute stress disorder to be diagnosed, the problems noted above must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
The disturbance in an acute stress disorder must last for a minimum of 2 days and a maximum of 4 weeks, and must occur within 4 weeks of the traumatic event. Symptoms also can not be the result of substance use or abuse (e.g., alcohol, drugs, medications), caused by or an exacerbation of a general or preexisting medical condition, and can not be better explained by a a Brief Psychotic Disorder, provided in summary byAmerican Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Post Traumatic Stress Disorder is diagnosed after a 4 week time period when symptoms continue or worsen. PTSD symptoms can arise many weeks or months after the time frame of Acute Stress Disorder of 4 weeks has passed. According to Web MD, Post-traumatic stress disorder (PTSD), once called shell shock or battle fatigue syndrome, is a serious condition that can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened. PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster. Families of victims can also develop post-traumatic stress disorder, as can emergency personnel and rescue workers.
Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear, and even guilt. These reactions are common; and for most people, they go away over time. For a person with PTSD, however, these feelings continue and even increase, becoming so strong that they keep the person from living a normal life. People with PTSD have symptoms for longer than one month and cannot function as well as before the event occurred. The resources from Web MD cite further detailed information about PTSD as ”
What Are the Symptoms of PTSD?
Symptoms of PTSD most often begin within three months of the event. In some cases, however, they do not begin until years later. The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer.
Symptoms of PTSD often are grouped into three main categories, including:
- Re-living: People with PTSD repeatedly re-live the ordeal through thoughts and memories of the trauma. These may include flashbacks, hallucinations, and nightmares. They also may feel great distress when certain things remind them of the trauma, such as the anniversary date of the event.
- Avoiding: The person may avoid people, places, thoughts, or situations that may remind him or her of the trauma. This can lead to feelings of detachment and isolation from family and friends, as well as a loss of interest in activities that the person once enjoyed.
- Increased arousal: These include excessive emotions; problems relating to others, including feeling or showing affection; difficulty falling or staying asleep; irritability; outbursts of anger; difficulty concentrating; and being “jumpy” or easily startled. The person may also suffer physical symptoms, such as increased blood pressure and heart rate, rapid breathing, muscle tension, nausea, and diarrhea.
Young children with PTSD may suffer from delayed development in areas such as toilet training, motor skills, and language.
Who Gets PTSD?
Everyone reacts to traumatic events differently. Each person is unique in his or her ability to manage fear and stress, and to cope with the threat posed by a traumatic event or situation. For that reason, not everyone who experiences or witnesses a trauma will develop PTSD. Further, the type of help and support a person receives from friends, family members and professionals following the trauma may influence the development of PTSD or the severity of symptoms.
PTSD was first brought to the attention of the medical community by war veterans, hence the names shell shock and battle fatigue syndrome. However, PTSD can occur in anyone who has experienced a traumatic event. People who have been abused as children or who have been repeatedly exposed to life-threatening situations are at greater risk for developing PTSD. Victims of trauma related to physical and sexual assault face the greatest risk for PTSD.
KLF Counseling and Consulting, PA provides treatment for those who have experienced traumatic events using evidenced based approaches. Additionally, through the practice additional resources can be provided or consultation with the patient and/or family for other providers and/or treatment options can be given to aid the individual and/or family who are experiencing PTSD symptoms.
If you are concerned about someone having PTSD, you may take a free, on-line assessment by visiting KLFCounseling.com, then proceed to http://www.mentalhealthscreening.org/screening/Welcome.aspx . You may choose from several screenings, one of which is PTSD, to determine if this a possibility which may need intervention by your local family physician, mental health practitioner (psychiatrist, licensed professional counselor, social worker, or psychologist). Take your results to the practitioner to discuss your treatment options which may include therapy and medication to relieve symptoms.
Several resources are noted below to provide guides on various areas of PTSD, Acute Stress Disorder that affects children, teens, college age students, adult, families, couples, and geriatric patients. Take a few minutes to review these resources as they may provide valuable and timely information for somone in need.
Teens Got Bounce—http://www.apa.org/helpcenter/bounce.aspx
Supporting Teens Through A Disaster–http://www.sesamestreet.org/parents/topics/stress/stress01
National Center for PTSD —http://www.ptsd.va.gov/
PTSD in Children and Teens—http://www.ptsd.va.gov/public/pages/ptsd-children-adolescents.asp
Understanding PTSD–(a booklet) http://www.ptsd.va.gov/public/understanding_ptsd/booklet.pdf
Fathers in Recovery-After PTSD Treatment–http://www.projectfatherhood.org/assets/uploads/6_fatherhood_in_recovery_ptsd_tello.pdf
Assessment-After Deployment-Free Online Assessment–http://www.afterdeployment.org/web/guest/topics-post-traumatic-stress
KLF Counseling & Consulting, PA also participates with the Give an Hour Program to provide an hour of free counseling to military families or veterans/active duty service men. Call to ask for your time to be scheduled.
Kathy L. Fortner, EdS., LPC, NCC also provides Critical Incident Stress Management services through a variety of programs such as Employee Assistance Companies, Insurance Companies, and contracted service providers. She is a volunteer member of the Horry County Public Fire and Rescue Team where she is available to provide such services to those in need after a critical incident or during a disaster relief situation. For further information, contact the office.a
It is hoped this information provided can give insight into the challenges facing those who have been in the military, been exposed to a serious event, or who have been traumatized by unforseen life events.