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PTSD Does Not Mean You’re Crazy

[no_toc]What is PTSD?

understandingptsd_booklet

Posttraumatic Stress Disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something terrible and scary that you see, hear about, or that happens to you, like:

  • Combat exposure
  • Child sexual or physical abuse
  • Terrorist attack
  • Sexual or physical assault
  • Serious accidents, like a car wreck
  • Natural disasters, like a fire, tornado, hurricane, flood, or earthquake

During a traumatic event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening around you. Most people have some stress-related reactions after a traumatic event; but, not everyone gets PTSD. If your reactions don’t go away over time and they disrupt your life, you may have PTSD.

How does PTSD develop?

Most people who go through a trauma have some symptoms at the beginning. Only some will develop PTSD over time. It isn’t clear why some people develop PTSD and others don’t.

Whether or not you get PTSD depends on many things:

  • How intense the trauma was or how long it lasted
  • If you were injured or lost someone important to you
  • How close you were to the event
  • How strong your reaction was
  • How much you felt in control of events
  • How much help and support you got after the event

What are the symptoms of PTSD?

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

There are four types of symptoms of PTSD:

  • Reliving the event (also called re-experiencing symptoms) You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
    • Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:
      • You may have nightmares.
      • You may feel like you are going through the event again. This is called a flashback.
      • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
  • Avoiding situations that remind you of the event You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
    • You may avoid crowds, because they feel dangerous.
    • You may avoid driving if you were in a car accident or if your military convoy was bombed.
    • If you were in an earthquake, you may avoid watching movies about earthquakes.
    • You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
  • Negative changes in beliefs and feelings The way you think about yourself and others may change because of the trauma. You may feel fear, guilt, or shame. Or, you may not be interested in activities you used to enjoy. This is another way to avoid memories.
    • You may not have positive or loving feelings toward other people and may stay away from relationships.
    • You may forget about parts of the traumatic event or not be able to talk about them.
    • You may think the world is completely dangerous, and no one can be trusted.
  • Feeling keyed up (also called hyperarousal) You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. This is known as hyperarousal.
    • You may have a hard time sleeping.
    • You may have trouble concentrating.
    • You may be startled by a loud noise or surprise.
    • You might want to have your back to a wall in a restaurant or waiting room.

What other problems do people with PTSD experience?

People with PTSD may also have other problems. These include:

  • Feelings of hopelessness, shame, or despair
  • Depression or anxiety
  • Drinking or drug problems
  • Physical symptoms or chronic pain
  • Employment problems
  • Relationship problems, including divorce

In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.

Will I get better?

“Getting better” means different things for different people, and not everyone who gets treatment will be “cured.” Even if you continue to have symptoms, however, treatment can help you cope. Your symptoms don’t have to interfere with your everyday activities, work, and relationships.

What treatments are available?

When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better. There are two main types of treatment, psychotherapy (sometimes called counseling) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist. There are different types of psychotherapy:

  • Cognitive behavioral therapy (CBT) is the most effective treatment for PTSD. There are different types of CBT, such as cognitive therapy and exposure therapy.
    • One type is Cognitive Processing Therapy (CPT) where you learn skills to understand how trauma changed your thoughts and feelings.
    • Another type is Prolonged Exposure (PE) therapywhere you talk about your trauma repeatedly until memories are no longer upsetting. You also go to places that are safe, but that you have been staying away from because they are related to the trauma.
    • A similar kind of therapy is called Eye Movement Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand movements while you talk about the trauma.

Medications for PTSD

Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD. Another medication called Prazosin has been found to be helpful in decreasing nightmares related to the trauma.

IMPORTANT: Benzodiazepines and atypical antipsychotics should generally be avoided for PTSD treatment because they do not treat the core PTSD symptoms.

Source: National Center for PTSD

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