Medical Devices

What Is Post Traumatic Stress Disorder? What Is PTSD? What Causes PTSD?

and later PTSD susceptibility not linked - an interesting study found that if a person experiences a panic attack during a traumatic event that they will be no more likely to suffer from PTSD in the future. How is Post-Traumatic Stress Disorder (PSTD) diagnosed? Most GPs (general practitioners, primary care physicians) in North America, Europe, and many other parts of the world are able to diagnose PTSD after discussing all the symptoms with the patient. The doctor will need to know how the patient feels, his/her overall health, and how they are sleeping. There are especially-designed questionnaires which help a doctor diagnose PTSD. The diagnosis is made based on signs and symptoms and a psychological evaluation. Often, GPs may refer the patient to a psychologist for further evaluation. The patient will also be asked to explain his/her symptoms in detail, including how severe they are, when they occur, and how long they last. The patient will probably be asked to describe the event that led to the symptoms. Doctors may also carry out a physical exam to check for any other physical problems. A person with PTSD must meet the criteria spelled out in the DSM (Diagnostic and Statistical Manual of Mental Disorder) published by the APA (American Psychiatric Association). The manual is used by psychologists, psychiatrists, and other mental health professionals to diagnose mental conditions by insurance companies to determine reimbursement for treatment (in the USA). Scientists at the University of Alberta in Edmonton, Canada are getting closer to being able to use brain scans to help diagnose PTSD. The criteria for post-traumatic stress disorder to be diagnosed include: *The patient experienced or witnessed an event involving either death or serious injury, or the threat of death or serious injury. *The patient responded to the event with intense fear, shock, horror and a sense of helplessness. *The patient relieves the experiences of the event, this may include having distressing memories or images, disturbing dreams, flashbacks, and even perhaps some physical reactions. *The patient deliberately avoids situations or triggers that may remind him/her of the traumatic event. *The patient may feel a sense of emotional numbness. *The patient feels he/she is constantly in a state of alert for signs of danger. This may bring with it sleeping problems and difficulties with mental concentration. *The patient"s symptoms have continued for more than one month. *The symptoms may interfere with the patient"s ability to carry out his/her normal daily tasks, or cause significant distress. What is the treatment for Post-Traumatic Stress Disorder (PTSD)? In the UK the GP will most likely refer the patient to a mental health professional, this could be a counselor, a community psychiatric nurse, a psychologist or a psychiatrist. A good health care professional will explain to the patient exactly how he/she plans to go ahead with treatment. PTSD is a medically recognized anxiety disorder - in order to achieve the most effective treatment results it is important that the patient and his/her loved ones acknowledge this fact. PTSD is generally treated with psychotherapy, medication or both. Below are examples of possible treatments: *Playing some computer games - playing "Tetris" after traumatic events could reduce the flashbacks experienced in PTSD, preliminary research by Oxford University psychologists suggests. *CBT (Cognitive-behavioral therapy) - this involves teaching learning skills that help the patient change his/her negative thought processes. It also includes mental imagery of the traumatic event to help work through the trauma, in order to gain control of the fear and distress. *EMDR (Eye movement desensitization and reprocessing) - the patient recalls the event while making several sets of side-to-side eye movements. This has been shown to lower distress levels for people with PTSD, allowing the patient to have more positive emotions, behaviors and thoughts. *Exposure therapy - this involves making the patient safely confront the very thing that upsets and disturbs him/her, so that he/she can learn to cope with it effectively. This type of therapy has become controversial, with some well respected experts indicating that it may, in fact, do more harm than good. However, this interesting article indicates that most therapies have unclear outcomes, except for "exposure therapy", which appears to be effective. *Medications: *SSRIs (selective serotonin reuptake inhibitors) - these are the most commonly prescribed medications for PTSD; paroxetine is an example of such a drug. They also help treat depression, anxiety and sleep problems - symptoms often linked to PTSD. Patients under 18 should not take SSRIs, with the exception of fluoxetine under specialist advice. *Benzodiazepines - these are effective for treating irritability, insomnia and anxiety. They should be used with caution because people with PTSD may become dependent. They are, nevertheless, very effective in treating PTSD symptoms, especially feelings of anxiety. *Ecstasy - MDMA - the pharmaceutical version of Ecstasy - may help suffers of post-traumatic stress learn to deal with their memories more effectively by encouraging a feeling of safety, according to an article published by SAGE. *Cortisone hormone therapy - a study by Ben-Gurion University of the Negev (BGU) researchers found that a high dose of cortisone could help reduce the risk of PTSD. *NICE (National Institute for Health and Clinical Excellence) , a UK organization that approves drugs and treatments for the National Health Service (free universal healthcare), has the following guidelines for PTSD treatment: *If symptoms are mild and have been present for less than four weeks - watchful waiting. *All patients should be offered trauma-focused CBT or EMDR on an individual outpatient basis. *Young people, including children, should be offered trauma-focused CBT adapted for their circumstances and age. *Medication should not be routinely used as first line treatment in preference to trauma-focused psychological treatment. Medication should be considered as first line of treatment only for adults who refuse to take part in psychological treatment. *Debriefing sessions should not be routine practice (single sessions focusing on the traumatic event). All disaster plans need to have a planned psychological response to a disaster, with health care workers having clear responsibilities agreed beforehand. Complications *Brain may be physically affected - this study found that children with post-traumatic stress disorder and high levels of the stress hormone cortisol were likely to experience a decrease in the size of the hippocampus - a brain structure important in memory processing and emotion. *Higher mortality among some heart patients - in patients who receive implantable cardiac defibrillators after a sudden heart event, there is a higher likelihood of death within five years if they experience symptoms of post-traumatic stress disorder, this study found. *Higher risk of long-term health problems - a study found that veterans suffering from PTSD are as likely to have long-term health problems as people with chronic disease risk factors such as an elevated white blood cell counts and biological signs and symptoms. *Heart disease risk - older men with PSTD have a higher risk of developing heart disease, according to a study carried out by researchers at the Harvard School of Public Health. Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

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