Definition, Symptoms and Interventions for Post-Traumatic Stress Disorder - Coursework Example

Running Head: Post-Traumatic Stress Disorder Definition, Symptoms and Interventions for Post-Traumatic Stress Disorder Rebecca Anne Guerrieri Abstract This paper discusses post-traumatic stress disorder (PTSD) as defined by the Diagnostic Statistical Manula of Mental Disorders IV. It describes the symptoms and criteria to determine whether or not a patient suffers from the disorder. It describes the experiences of patients suffering from the disorder and the interventions being used to treat it. It also describes the experiences of famous personalities who were diagnosed with this disorder. This paper was conducted through journal and literature review of studies and various papers and articles related to PTSD. This paper was able to establish that PTSD is characterized by a previous exposure to a traumatic event that produces intrusive recollections, avoidant symptoms and hyper-arousal symptoms. This disorder is treated through psychotherapy, serotonergic drugs, and through cognitive therapy. Patients suffering from the disease have recurring nightmares involving their traumatic experience, they also become easily agitated, and tend to withdraw themselves from their families and from the rest of society. NBA referee Bob Delaney and war veterans James Miller and Joseph Dwyer are just some of the few who have suffered or are suffering from this disease. Hopefully this paper will put a sharper and clearer focus on this disorder and its crippling effects to many war veterans and victims of trauma. Post-Traumatic Stress Disorder Definition The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) defines post-traumatic stress disorder (PTSD) based on several diagnostic criteria. It is characterized by a history of exposure to a traumatic event which meets two symptoms from each of the three symptom clusters, which are: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. The first criterion of the illness speaks of a traumatic event that involved “actual or threatened death or serious injury, physical injury to oneself or others” (American Psychiatric Association, 2000). The American Psychiatric Association (2000) discusses that according to the DSM IV criteria, the second criterion of PTSD involves disturbing recollections whereby the traumatic event is persistently re-experienced through persistent images, thoughts, or dreams. The APA also describes that often, there is a feeling of the traumatic event recurring through illusions, hallucinations, and dissociative feedbacks. Internal and external reminders of the traumatic event often cause extreme psychological distress. The DSM IV describes the third criterion as the persistent numbing or avoidance of stimuli associated with the trauma. PTSD patients in this instance often hide their thoughts and feelings about the trauma. They sometimes do not recall some aspects of their traumatic experience, and they avoid activities, people and places that remind them of the experience. PTSD sufferers often have a decreased interest in significant activities and have a feeling of detachment from others. Sometimes they also can be unemotional and do not see themselves having a good future-a career, a family life, or even a normal life span (American Psychiatric Association, 2000). The fourth criterion that characterizes PTSD is hyper-arousal. One or two of the following symptoms is seen in a PTSD sufferer: difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hyper-vigilance, and exaggerated startle response (American Psychiatric Association, 2000). The fifth criterion needed to fit the illness is that the symptoms--intrusive recollections, avoidant/numbing symptoms, and hyper-arousal should be exhibited for more than a month. Persistence of symptoms for more than a month indicates a deeper trauma that is challenging the patient’s consciousness. The final criterion to consider in defining PTSD is the functional significance of the trauma. In this instance, the trauma experienced by the patient and the symptoms that later came about because of the trauma causes significant and clinically unbearable distress and impairment in the patient’s normal functioning-from his social, occupational, to his family life (American Psychiatric Association, 2000). Treatment Post Traumatic Stress Disorder is treated in a variety of ways. Treatment includes psychological and medical interventions. The vital aspect of treating PTSD patients is in helping them deal with their traumatic experience. This can be usually helped by psychotherapy. In a paper submitted to Emedicine.net, Dryden-Edwards (2007) discussed that through psychotherapy, the patient can be assisted in managing the trauma by talking about the experience and exploring ways on how to modify and manage the stress brought about by the traumatic experience. She further discusses that, educating the patient about the disease can enlighten the patient’s mind. Many patients often feel discriminated by others because of the disease, hence are embarrassed about seeking treatment for their symptoms. This leads many PTSD patients to self-medicate. By educating patients about PTSD, they become more open about seeking help and discussing their feelings and experiences. The professionals who would now be dealing with them can help suggest ways of coping with and minimizing the intensity of their symptoms (Dryden-Edwards, 2007). Professionals can also help the patient deal with their trauma, and not be overwhelmed by the memories of their experience. Through psychiatric health professionals, the family can be drawn into assisting the patient handle the overwhelming symptoms of grief, hurt, and pain. (Healthy Place, 2000). Recovery from PTSD and any other form of mental illness is often largely attributed to a strong support system-more importantly, the family. Through psychotherapy, the patient can learn how to manage his anxiety and anger. Patients can also be assisted in learning relaxation skills and in controlling their emotions. Cognitive therapy helps PTSD patients recognize trauma-related thoughts by teaching them the relationship between thoughts and feelings and how alternative interpretations to their thoughts can produce new feelings. (Dryden-Edwards, 2007) The eye-movement desensitization and reprocessing therapy (EMDR) is another treatment option for PTSD. In EMDR, the practitioner draws the patient into talking about the traumatic event and the feelings generated by the event. This is done while the patient is focusing on the practitioner’s rapidly moving finger. The effects of the treatment are similar to cognitive therapy (Dryden-Edwards, 2007). Addressing the sleep problems of the patient has also been found to effectively reduce the symptoms of PTSD. According to Dryden-Edwards (2007), helping the patient to cope with nightmares through relaxation techniques and positive self-talk effectively reduce PTSD symptoms. Medications like serotonergic antidepressants (like Prozac) “help PTSD sufferers modify information that is taken in from the environment (stimuli) and to decrease fear” (Dryden-Edwards, 2007). These medications also help reduce anxiety, depression and panic. Mood stabilizers like lamotigrine and antipsychotics also help manage PTSD symptoms. The combination of psychotherapy, a strong support system, and psychiatric medications can help the patient recover from PTSD. Living with Post-Traumatic Stress Disorder The experiences of PTSD sufferers run a range of emotions-from fear, to pain, to anger, and to hurt. The more common sufferers of the disease are soldiers who have experienced and fought in wars and active combat. Other sufferers may also be rape victims, those who were physically, emotionally, and/or sexually abused, and others who have experienced some form of shocking or traumatizing event in their lives (Timms, 2005). Some veterans and soldiers who have fought in wars and have participated in active combat narrate that every night they re-live the horrors they have seen in the war. Some experience 2-3 recurring nightmares every night. PTSD sufferers usually do not like to deal with people; they hate crowded places, and they prefer staying home. Often, PTSD sufferers cut themselves off from their families and they have a very limited circle of friends. They are security conscious around their house and tend to be very suspicious of anyone and anything. Because of these manifestations, PTSD sufferers often find it hard to get work. They often cope with their symptoms by drinking heavily. When they are diagnosed with PTSD, some sufferers gradually take part in the treatment. With the treatment, they are able to re-write their traumatic experiences and consequently have reduced nightmares. (Australian Prescriber, 1999) Children and adolescents who suffer from PTSD are often agitated and confused. “They also may show intense fear, helplessness, anger, sadness, horror or denial” (American Academy of Childhood and Adolescent Psychiatry, 1999). Sometimes their traumatic experience leads them to disconnect from the pain or trauma. They avoid places and situations that remind them of the trauma and tend to withdraw from their own feelings. They may also have upsetting dreams about their experience, and they may develop some physical and emotional symptoms every time they are reminded of the event. Because of their trauma, children with PTSD often worry about dying at an early age. They also lose interest in everyday activities. They also often show sudden emotional reactions that may not fit the situation. Some children also find it hard to concentrate and to fall asleep. Sometimes, they also tend to regress and act younger than their age (American Academy of Childhood and Adolescent Psychiatry, 1999). Famous People who suffered from Post Traumatic Stress Disorder There were not too many famous people who suffered from PTSD. The few who are mentioned in this paper have not been thoroughly studied and documented. The little information gathered from reports on their condition is now discussed in this paper. One well-known personality who revealed to have suffered from PTSD was Bob Delaney. An article by Steve Davis (2008) documents that before Bob Delaney became an NBA referee, he was an undercover police officer who successfully infiltrated the New Jersey mafia. He spent three years as a police informant and his hard work eventually brought down 30 members of the New Jersey mafia. After his undercover work, he experienced symptoms which are now characterized as PTSD. He had nightmares about his experiences with the mafia; he became isolated and easily agitated; he had this constant fear of being eventually killed by the mafia and so he became very conscious of his safety and security. He was not aware that his condition was a mental illness until an interaction with a former college psychology professor enlightened him about his possible illness. He later underwent informal psychotherapy sessions with the psychology professor. His passion for basketball helped him cope with his illness, and this passion later landed him in the NBA as a referee. James Blake Miller was made famous by a photograph. His photo and his face became the symbol of the war against terror. His photo triggered the nation’s determination towards achieving victory in Iraq. He became known throughout America as the ‘Marlboro man’ because of the dangling cigarette in his mouth. However, beyond the fame brought to him by the photograph, was a tormented soldier. “As the war has dragged on, Millers life has collapsed in the face of post-traumatic stress disorder” (Harris, 2006). Miller suffers from nightmares, panic attacks, and survivor’s guilt. In Iraq, he participated in ambushes and firefights; and he lost close friends and comrades. When he returned to the States, he had difficulty dealing with his traumatic experience. He often feared that he might hurt his loved ones; he pulled imaginary triggers in his sleep; he was quick to anger; he jumped at cars backfiring; and in his sleep, he sometimes tightened his arm around his wife’s neck. Because of PTSD, he is now divorced from his wife, and has asked to be given reprieve from the media in order to pick up the broken pieces of his life (Harris, 2006). Hopefully he will successfully recover from his affliction. Another photograph that gained nationwide fame and attention is the photo of Medic Joseph Patrick Dwyer racing away from a battle zone carrying an Iraqi boy. He too suffered the emotional devastation of war. “...he was consumed by the demons of combat stress he could not exorcise” (Kennedy, 2008). He would sit with his back to the wall; he jumped at sudden loud noises; he avoided crowds, stayed away from friends; and he abused inhalants. He was later committed to a mental institution for treatment. After years of substance abuse, depression, and of struggling with PTSD, Joseph Patrick Dwyer died of an accidental overdose. He was 31 years old. Works Cited Davis, S. (25 August 2008). NBA Referee Bob Delaney Talks about His Undercover Life With Steve. WBAL.com. Retrieved 23 October 2008 from http://wbal.com/apps/news/templates/davis_show.aspx?articleid=11577&zoneid=20 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 4th Ed. (2000). American Psychiatric Association. Washington D.C.: American Psychiatric Association. Dryden-Edwards, R. (7 December 2007). Post Traumatic Stress Disorder. EMedicine.net. Retrieved 24 October 2008 from http://www.medicinenet.com/posttraumatic_stress_disorder/page6.htm DSM-IV-TR criteria for PTSD. (22 May 2007). United States Department of Veteran Affairs. Retrieved 23 October 2008 from http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_dsm_iv_tr.html Harris, P. (2 July 2006) Focus: A soldiers story. The Observer. Retrieved 24 October 2008 from http://www.guardian.co.uk/world/2006/jul/02/usa.paulharris Kennedy, K. (8 July 2008) Medic in Famous Photo Dies after PTSD Struggle. Army Times. Retrieved 24 October 2008 from http://www.armytimes.com/news/2008/07/military_suicidedwyer_070308w/ Post-traumatic stress disorder: a personal experience. (1999). Australian Prescriber. Retrieved 24 October 2008 from http://www.australianprescriber.com/magazine/22/2/34/6/ Posttraumatic Stress Disorder (PTSD). (October 1999). American Academy of Childhood and Adolescent Psychiatry. Retrieved 24 October 2008 from Post-traumatic Stress Disorder (PTSD) Overview. (2000). Healthy Place. Retrieved 24 October 2008 from http://www.healthyplace.com/communities/abuse/site/ptsd_overview.htm http://www.aacap.org/cs/root/facts_for_families/posttraumatic_stress_disorder_ptsd Timms, P. (January 2005). Post Traumatic Stress Disorder (PTSD). Royal College of Psychiatrists. Retrieved 24 October 2008 from http://www.rcpsych.ac.uk/mentalhealthinfo/problems/posttraumaticstressdisorder/posttraumaticstressdisorder.aspx Read More