Post-Traumatic Stress Disorder: Substance Abuse, and Trauma - Research Paper Example

? Post-traumatic stress disorder (PTSD) Substance abuse, and trauma Post-traumatic stress disorder (PTSD) Introduction Over the past decades, there have been numerous debates and studies on post-traumatic stress disorder (PTSD), what causes this type of disorder and how to treat it. This disorder may occur as a result of a traumatic incident that may have threatened a person’s safety making that person feel helpless. In most cases, a majority of people have been linking this disorder with battle-scarred soldiers and they specifically say that it is commonly evident in military combat especially in men (Yehuda, 2002). However, it is clear that post-traumatic stress can be triggered by any overwhelming life experience. This happens in cases where the event feels unpredictable and uncontrollable. This form of disorder may affect everyone involved in it directly or indirectly. For instance, PTSD not only affects the person who experienced the tragedy but also ends up affecting everyone around that person, from those who witnessed the tragic moment, to those that helped the victim to pick up his or her pieces afterwards, and any other person who attaches him or herself to the victim (Friedman, 2000). In addition, this disorder may even develop to family members and friends of the person who went through the ordeal. Intervention strategy There are many methods and strategies that have been suggested by doctors as solutions to helping patients suffering from PTSD. It is important however, to identify the causes of PTSD. This includes options that involve focus on individuals taking medication by themselves. It could also include the notion that an individual who develops one type of disorder has a high probability of developing another disorder (Fisher & Roget, 2009). The development and dissemination of the best practices for the treatment of PTSD is also very important. Patients seeking treatment for PTSD have shown similar symptoms to those seeking treatment and help for dependency on drugs and the abuse of drugs. Different programs have come out of different research works conducted by different scientists. Over the years, research has evolved to include exploration of the relations between symptoms that fluctuate in patients and the conditions that occur over time. Cases of severe PTSD are closely linked to dependence on alcohol and other substance abuse. Methods of engagement The manner in which a psychiatrist deals with a patient determines to a large extent how fast the patient will recover from trauma. To a large extent, it also determines how effective the treatment plan will be on the patient. Therapy is one of the ways that a patient can use to obtain treatment. During the therapy sessions, clients engage closely with their therapists. They go back to the experience that caused them trauma and are asked to describe the whole event as if it is happening to them all over again in the present (Zayfert & Becker, 2006). The effectiveness of this method is that it allows the patient to find relief from their trauma. Continuous and repeated recounting of the tragic and traumatizing experience causes less severe reactions from the brain and makes the whole memory seem less traumatic. It is therefore important that proper diagnosis and treatment are made to patients. Patients with PTSD and a history of drug and substance abuse need to be treated with the help of psychiatrists as well as people who know how to deal with drug users. Rehabilitation facilities may not be the best places for such individuals as they are not staffed to deal with persons experiencing post-traumatic stress disorder. A psychiatric hospital or institution may also not help as the staff there may not know how to work with addicts effectively. For this reason, such a patient needs care that is integrated where the recovery equipment and staff are located in one institution and the staff is able to take care of such kind of patients. Assessment framework Cognitive-behavioral therapy (CBT) is a counseling method where patients are assisted to understand that the thoughts they have regarding the world and their traumatic experiences will either cause or reduce the stress they have. There are several types of CBT that are used for different types of clients (Monson & Fredman, 2012). These types vary due to different responses of the patients to the various methods of treatment. One of the most common methods of CBT is exposing a patient to prolonged therapy. This includes asking the patient to repeat and recount the cause of their trauma, known as imaginal exposure. Another method of CBT is cognitive therapy. Here, the patient is asked to differentiate between thoughts and emotions. They are then asked to point out the things they feel cause them to experience bad or fearful thoughts. They are then encouraged to develop and have in them positive thoughts. This method is of great importance as it helps a patient to improve their self-esteem and acquire an improved perception of the world. The patients also become better placed to adapt to the thoughts and believes caused by or related to their trauma. CBT offers training to patients on how to deal with stress. Treatment plan The treatment of PTSD requires constant support from family members, friends and above all the help of professionals. Since the patients suffering from PTSD are not ready to seek help, they also find themselves abusing drugs as a method of numbing their feelings. This causes patients to harbor feelings of guilt and shame as a result of their trauma. For patients to achieve full recovery, they need to work closely with professionals dealing with mental health and expert counselors who can clearly understand the needs of PTSD patients (Carmichael, 2011). A good treatment plan is one that includes psychotherapy sessions for individuals. These are particularly important as an individual is taught how to deal with the triggers that lead to abusing drugs and other substances. Clients that have a history of drug abuse as well as PTSD can also benefit from counseling sessions. Therapy for couples and counseling for families with the intention of strengthening family ties can be done to patients, clients and their families. This can also help to provide education to the family members of a patient or client about the disorder that their loved one is going through. Groups consisting of individuals that are seeking treatment for PTSD can be helpful in assisting patients to recover by providing them moral support. A treatment plan can also involve medication therapy with anti-addiction drugs such as antidepressants and drugs that help to prevent anxiety. Another type of therapy that seems to have a place in the PTSD treatment is the pharmacotherapy. Previous studies have clearly shown that there is no way that one can relief PTSD symptom like depression, anxiety, and insomnia by using drugs or substance. Of all the research that has been carried out there is no definite treatment for PTSD. However, there are medications that are of great importance for symptom relief (Lahad & Doron, 2010). This has enabled many patients to participate in psychodynamic, group, cognitive-behavior, and many other forms of psychotherapy. However, patients with chronic or severe PTSD do not react positively to this form of treatment. Treatment goals Treating a PTSD patient is complex but very important as well. A professional should approach every case differently and independently in order to effectively help the patient. One of the goals of treatment of PTSD patients is to increase the way in which patients process the information emotionally in a way that helps them to reduce their anxiety. This will also help patients to avoid escaping and behaviors of escaping. Treatment of PTSD assists individuals to develop esteem, trust, and feelings of safety and restore intimacy in relationships. Another goal of treating individuals with PTSD is to add on to the knowledge regarding the prevalence of PTSD and the kinds of sleeping patterns that different patients have. Treatment options for clients are done with the aim of reducing the anxiety they feel and coping with the thoughts, memories and feelings associated with PTSD. Contracting issues Even with the emerging technologies there are no laboratory tests that can clearly detect PTSD. However, the symptoms start to emerge a month after the traumatic event. Experts have done many researches but until now they have not come to conclusion on what causes some of the people to develop PTSD (UMMC, 2013). What they have come to assume is that this disorder occurs when one is confronted with a tragic or traumatic event. According to scientists who have been studying the brain, there is a significant difference between the brain structure and chemistry of a PTSD patient and that of a normal person. In addition, other researchers have majored their studies on the brain area that is accountable for memory and how we deal with trauma (Kloet, Oitzl & Vermetten, 2008). This brain area is known as the hippocampus. What they are trying to research is whether there are any changes that occur in the hippocampus in people with PTSD. Methods of intervention In addition to CBT, the use of counseling in treating PTSD is also helpful. This may be done in groups as a group therapy. Members of the group talk about and share their experiences as well as the methods they use to cope with PTSD symptoms (Carey, 2006). Groups are an effective intervention strategy as members with similar experiences are put together. Through sharing of experiences, individuals learn that they are not awkward and whatever they are going through is a phase that will pass. In addition, these groups can include individuals who have recovered from PTSD to share their experience in how they managed to recover. Counseling of the family of a patient together with the patient at the same time as well as involving a spouse or partner in a counseling session is an important strategy in the treatment of PTSD and persons who depend on drugs. Using the family of the patient to help in the treatment of their loved one helps the patient feel loved and cared of. These are important in the recovery process as one develops feelings of reassurance and comfort while seeing their family members helping to get them better (Orner & Schnyder, 2003). A patient of PTSD may need to talk about their experiences to people they trust, like a spouse or trusted family member, and it is up to the family to be supportive and offer sympathy when need arises. Another strategy that is very effective is one that involves combining treatment for PTSD and that of substance abuse. This is especially necessary for those individuals who turn to drugs and alcohol in order to numb themselves so as to avoid feelings associated to the traumatic experience that they had. According to the American Medical Association, if these two treatments are combined, the result is improved PTSD symptoms as well as improved substance abuse symptoms. This method of treatment is in contradiction with the normal knowledge that is used in the treatment of PTSD and drug abuse. Termination This refers to the point at which a patient or client can be deemed recovered or has made tremendous improvement in their recovery. At this point, the client is ready to continue with their daily life and does not need to return for counseling and therapy sessions unless the client feels the need to return. Using CBT, various factors are considered before determining if a patient has recovered and ready to stop attending counseling sessions. For instance, the patient needs to have acquired different perceptions about how the trauma they experienced should shape their lives (Flatten, Walte, & Perlitz, 2008). They need to understand that when tragedy strikes, we need to possess the ability to overcome the sadness and negative emotions that come with it. Individuals also need to know how to focus on positive thinking and how to relieve feelings of anger and frustration that may come. Individuals also need to identify areas in their lives that they tend to feel stuck or stagnated and come up with solutions with the help of their psychiatrists. Clients should also be able to handle the emotions that relate to their traumatic experiences. Evaluation strategies Numerous PTSD diagnoses have shown that a majority of people who are exposed to tragic events are not necessarily prone to acquire PTSD. There are vast evaluation strategies to cope with victims of traumatic event. In addition, a majority of people have distinct ways in dealing with PTSD patients. The kind of trauma that one undergoes is similar to pain and is not necessarily an external phenomenon that one can entirely objectify (Walser & Westrup, 2007). Therefore, just like pain the traumatic experience is filtered through a cognitive and emotional strategy called appraisal. Certain traumatic events may be appraised or evaluated as a challenge with which an individual can handle while some are evaluated as severe threat to that person and maybe to people around him or her. This evaluation strategy plays a very important role in the psychological processing of a tragic event. Re-experiencing principle is another strategy that is used to evaluate the readily identifiable and the distinctive PTSD symptoms that have emerged. The traumatic events may remain for a long period of time or perhaps throughout the entire life of the victim. This is referred to as PTSD flashback. Stimulus or situations that were of the current traumatic event trigger the PTSD symptoms (Ehlers, Clark, Hackmann, McManus & Fennell, 2005). Researchers have proposed fear conditioning as a conceptual model for PTSD. This is because certain trauma-related stimuli tend to change one’s behavior such as fear which was not evident before the event occurred. In addition, this evaluation clearly illustrates how PTSD patients become easily alarmed by any stimuli as they tend to view the world as a very dangerous place. Follow-up Treating persons with post-traumatic stress disorder is one way to the realization of a better and stress free life for that person. This cannot be achieved without a proper follow-up of the PTSD patient. Therefore, emphasis should be raised on the need to visit a specialist who deals with PTSD patients, such as psychiatrist or psychologist for continuous evaluation and treatment (Schiraldi, 2000). Failure to have a proper follow-up may result to this disorder transforming to a severe one thus, causing severe damage on the life of a PTSD patient. Conclusion Humans have managed to survive traumatic events such as genocide, rape, earthquakes, and torture because of certain psychobiological adaptive mechanisms. It is important for everyone to handle such patients with a lot of care and tenderness to avoid causing more damage to their brain or entire life. Lastly, understanding the cause of the PTSD in a patient is paramount because it will help one to avoid taking the patient to a similar traumatic scenario thus helping the patient to recover quickly. Government and other medical stake holders should intervene and make sure that there are several treatment hospitals for people suffering from post-traumatic stress disorder. References: Carey, L. J. (2006). Expressive and creative arts methods for trauma survivors. London: Jessica Kingsley Publishers. Carmichael, J. A. (2011). Multi-component treatment for post-traumatic stress disorder: Including strategies from clinical psycho-physiology and applied neuroscience. San Rafael, CA: ISNR Research Foundation. Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., & Fennell, M. (2005). Cognitive therapy for post-traumatic stress disorder: development and evaluation. ScienceDirect.com | Search through over 11 million science, health, medical journal full text articles and books. Retrieved July 9, 2013 Fisher, G. L., & Roget, N. A. (2009).Encyclopedia of substance abuse prevention, treatment, & recovery. Los Angeles: SAGE. Flatten, G., Walte, D., & Perlitz, V. (2008). Self-efficacy in acutely traumatized patients and the risk of developing a posttraumatic stress syndrome. National Center for Biotechnology Information. Retrieved July 10, 2013, Friedman, M. A. (2000). Post-Traumatic Stress Disorder. Untitled Page.  Retrieved July 10, 2013, from Kloet, E. R., Oitzl, M. S., & Vermetten, E. (2008). Stress hormones and post-traumatic stress disorder: basic studies and clinical perspectives. Amsterdam: Elsevier. Lahad, M., & Doron, M. (2010). Protocol for treatment of post-traumatic stress disorder SEE FAR CBT Model: beyond cognitive behavior therapy. Amsterdam: IOS Press. Monson, C. M., & Fredman, S. J. (2012).Cognitive-behavioral conjoint therapy for PTSD: harnessing the healing power of relationships. New York: Guilford Press. Orner, R., & Schnyder, U. (2003).Reconstructing early intervention after trauma: innovations in the care of survivors. Oxford: Oxford University Press. Schiraldi, G. R. (2000). The post-traumatic stress disorder sourcebook a guide to healing, recovery, and growth. Los Angeles, Calif.: Lowell House. UMMC (2013) Post-traumatic stress disorder | University of Maryland Medical Center. (n.d.). Home | University of Maryland Medical Center. Retrieved July 10, 2013, from Walser, R. D., & Westrup, D. (2007).Acceptance & commitment therapy for the treatment of post-traumatic stress disorder & trauma-related problems a practitioner's guide to using mindfulness & acceptance strategies. Oakland, Calif.: New Harbinger Publications. Yehuda, R. (2002). Post-Traumatic Stress Disorder. New England Journal of Medicine, 346(2), 108-114. Zayfert, C., & Becker, C. (2006).Cognitive-Behavioral Therapy for PTSD a Case Formulation Approach. New York: Guilford Publications. Read More