Post-Traumatic Stress Disorder
The criteria for Post-Traumatic Stress Disorder (PTSD) are as follows according to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders IV-TR:
A. The individual was exposed to a traumatic event where both the following were present:
-The individual experienced or witnessed, or was confronted with an event/s that involved actual or threatened death, serious injury, or threat to the physical integrity of the individual or another person.
-The individual's response included intense fear, horror, or helplessness.
B. The traumatic event is persistently reexperienced as evidenced in one or more of the following:
-Psychological distress when presented with internal or external cues that remind the individual about an aspect of the trauma
-Feeling as if one is reliving the traumatic event through hallucinations, illusions, and/or dissociative flashbacks
-Intense and disturbing recollections of the event such as perceptions, thoughts, and/or images
C. Persistently avoiding of stimuli that remind the individual of the trauma or numbing of general responsiveness, that was not present before the traumatic event as exhibited by three or more of the following:
-The individual makes efforts to avoid feelings, thoughts, and/or conversations associated with the traumatic event.
-the individual possesses an inability to recall certain important aspects of the traumatic event.
the individual avoids activities, places, or other people that remind him or her of the traumatic event
-diminished interest or participation in significant activities
-the individual has a feeling of a foreshortened future.
exhibits a restricted range of affect
the individual feels estranged or detached from others.
D. Exhibits increased arousal by two or more of the following:
-Exagerated startle response
-Outbursts of anger or irritability
Symptoms in categories C and D last for more than one month.
What does all of this mean?
Let me give you an example of what a person with post-traumatic stress disorder may look like.
C was raped by an acquaintance three months ago. Ever since, she has not been sleeping well. She cannot seem to get to sleep at night; however, when she does sleep, she has awful nightmares of the rape. She also experiences flashbacks where she feels as if the rape is happening all over again. These are especially triggered by certain things that remind her of the trauma. For instance, a vanilla candle was burning in the living room when she was raped, it was dark in the room, and the phone kept ringing. Thus, when she hears a phone ring, she will immediately go into a dissociative flashback, where she feels the rape happening all over again. Because C was raped in her living room, she tries to avoid spending as much time in there as she can. She also threw the vanilla candle away, but told her mother the glass container had shattered on the floor while she was dusting the coffee table. C has not told her parents what happened that night and while she tries to pretend that nothing is wrong, her parents have noticed changes in their daughter's personality. C was a relatively calm teenager before the trauma. She made straight A's in school. However, since the rape, she has been irritable and has become angry at her parents, seemingly yelling at them for no reason at all. Her grades have also dropped because C has experienced an inability in concentrating on her schoolwork.
C has also become very jumpy. She looks over her shoulder a lot and starts at every little noise. When she hears a car backfire or any other loud noise, she goes into a panic attack.
C's case shows us what one individual with PTSD might experience on a daily basis. However, individuals with PTSD rarely, if ever, experience the same symptoms in the same ways.
While there is currently no medication to treat PTSD in its entirety, anti-anxiety medications such as Xanax, Ativan, or Buspar might help take the edge off the symptoms. The only "cure" for PTSD is for the individual to work through the trauma in therapy.
Tomorrow, I'll discuss how loved ones might help a family member or friend with PTSD.