The concept of ptsd. Post-traumatic stress disorder (PTSD): symptoms, causes, treatment

The human psyche can be subject to various shocks. Traumatic events that go beyond a person’s experience and understanding leave a lasting impression and can cause reactions such as prolonged depression, isolation, and fixation on the situation.

Post-traumatic stress disorder (PTSD, PTSD) is a severe reaction of a person to a situation that is traumatic in nature. This condition manifests itself in painful behavioral deviations that persist over a long period.

Post-traumatic stress suggests that a person has experienced a traumatic event or situation that has had a negative impact on their psyche. The traumatic event is significantly different from all other events that the victim has previously encountered, and causes him significant suffering.

Depending on how severe the shock was, the disorder can last from several hours to several years.

What can become a traumatic factor?

A traumatic situation can include military conflicts (that’s why PTSD is sometimes called Afghan or Vietnam syndrome, war neurosis), natural, man-made and other types of disasters, accidents, especially fatal ones, physical violence, forced observation of someone else’s death.

Post-traumatic stress is characterized by an undulating course, but in some cases it becomes chronic and provokes persistent personality changes.

The mental state of the victim is unstable and is characterized by a whole range of abnormalities, ranging from insomnia and anxiety to attacks of unmotivated rage and thoughts of suicide.

Post-traumatic stress disorder is triggered by the following factors:

Experts, based on statistical data, came to the following conclusions:

• 60% of people injured as a result of violent acts develop post-traumatic shock;
• in case of beating with serious consequences, disorder occurs in approximately 30%;
• 8% of people who witness murders and violent acts are at risk of developing PTSD.

People with poor mental health, as well as those who perceive events around them too closely, are most susceptible to developing post-traumatic stress disorder.

Children are more likely to develop this disorder than adults.

Clinical picture

Post-traumatic stress disorder can manifest itself differently in different people and have different symptoms: an emotional explosion is intensified suddenly or gradually, with the symptoms disappearing after a while or, conversely, with an increase in their severity.

There are three main groups of symptoms of the disorder, which, in turn, include several manifestations.

Returning to a traumatic event, re-experiencing it

This group includes a complex of symptoms:

• a feeling of strong emotional stress when a person remembers the experience;
• memories of the event haunt the person, it is impossible to get rid of them no matter how hard the victim tries;
• the presence of physiological reactions in response to memories of a traumatic event (intense sweating, nausea, increased breathing and heart rate);
• dreams that again force the victim to relive the situation;
• the phenomenon of “replaying” (hallucination), a person feels as if the traumatic event is being repeated over and over again in real time and behaves according to the imaginary situation.

Avoiding a traumatic situation

The next group is attempts to avoid reminders of the turning point event. These include the following symptoms:

• avoidance of everything that reminds the victim of the situation: places, sensations, thoughts, things;
• apathy and loss of interest in life after a traumatic event, lack of thoughts about the future and opportunities associated with it;
• inability to remember individual moments of an event.

Psychological and emotional disorders

The last group of PTSD symptoms is associated with manifestations of emotional and mental disorders:

In some cases, the shock is so severe that the person experiences significant physical pain and tension. Sometimes the victim tries to forget himself, to distract himself from haunting thoughts and memories, for which purpose he uses drugs, alcohol, and nicotine.

In children and adolescents, clinical PTSD may also include the following symptoms:

• fear of parting with parents, being away from them;
• sudden loss of acquired skills (including everyday skills);
• development of new phobias due to nervous disorder;
• enuresis;
• return to behavior that is characteristic of younger children.

Experts note that people with post-traumatic syndrome are characterized by distrust of persons who represent authorities. They often develop a craving for gambling, risky and extreme entertainment. The consciousness of the victims narrows.

Diagnosis of the disorder

To diagnose a specific condition such as post-traumatic stress disorder, specialists need to determine how many symptoms characteristic of it are observed in the patient. There must be at least three of them, and their duration should not be less than a month.

If symptoms persist for less time, the diagnosis is not PTSD, but acute stress disorder.

During diagnostic procedures, the psychiatrist must exclude the possibility of other syndromes in the patient that could appear after a traumatic event. Collecting a detailed medical history is the basis on which a diagnosis can be made or refuted.

Goals and treatments for the disorder

Treatment of such a complex disorder as post-traumatic stress disorder has the following goals:

• convey to the patient, who believes that no one has ever encountered such a problem before, the essence and typicality of mental experiences, which will help the patient realize that he is completely normal and can consider himself a full member of society;
• help a person restore his right to personality;
• return a person to society through training in communication skills;
• make the symptoms of the disorder less expressive.

PTSD is treated by a psychiatrist or psychotherapist. It must be comprehensive.

The basis of treatment is psychotherapy. Initially, the specialist must establish a trusting relationship with the patient, otherwise full treatment is simply impossible.

Subsequently, the psychotherapist uses techniques that help the patient accept difficult life experiences, process them, in other words, come to terms with the past.

The following psychotherapy methods are used:

• suggestion (hypnosis);
• relaxation (for example, through breathing exercises);
• self-hypnosis (auto-training);
• the patient's expression of emotions through visual art;
• helping the victim create a clear picture of the future.

The duration of such treatment depends, first of all, on what phase the disorder is in.

Medications are also used in the treatment of stress syndrome. This is necessary to suppress severe symptoms, maintain the patient’s morale, and partly to eliminate the consequences of the resulting psychological trauma.

The following types of medications are used:

1. . These drugs not only suppress the symptoms of the disorder, but also reduce the victim’s craving for alcohol.
2. Benzodiazepines. They have hypnotic and sedative effects and help reduce anxiety.
3. Normotimics. Suitable for imbalance and impulsiveness in the patient’s behavior.
4. Beta blockers and alpha adrenergic agonists- to reduce symptoms of increased activity of the nervous system.
5. - for the treatment of nervous regulation disorders.

How can it all end?

The prognosis of PTSD depends on various factors. In this regard, the severity of the injury, the general condition of the victim’s nervous system, and the environment in which he is located during the rehabilitation period are also important.

The disorder is fraught with the following complications that can occur as a result of lack of treatment:

• development of dependence on alcohol, drugs or medications;
• suicide attempts;
• the appearance of persistent phobias, obsessions;
• antisocial behavior, which usually serves to isolate a person from society and also leads to the breakdown of families;
• an irreversible change in a person’s character traits, which makes it difficult for him to adapt to society.

Post-traumatic stress disorder can significantly affect a person’s mental state, even to the point of changing his personality.

Timely and adequate therapy, which will take quite a long time, can still correct the patient’s condition and return him to life within society, coming to terms with the difficult experiences of the past.

PTSD (Post-Traumatic Stress Disorder) is a special set of psychological problems or painful behavioral abnormalities dictated by a stressful situation. Synonyms for PTSD are PTSS (Post-traumatic stress syndrome), “Chechen syndrome”, “Vietnamese syndrome”, “Afghan syndrome”. This condition occurs after a single traumatic or multiple repeated situations, for example, physical trauma, participation in hostilities, sexual violence, threat of death.

Features of PTSD include the manifestation of characteristic symptoms for more than a month: involuntary recurrent memories, high levels of anxiety, avoidance or loss of memory of traumatic events. Statistics show that most people do not develop PTSD after traumatic situations.

PTSD is the most common psychological disorder in the world. Statistics say that up to 8% of all inhabitants of the planet experience this condition at least once during their lives. Women are susceptible to this disorder 2 times more often than men due to reactivity and physiological instability to a stressful situation.

Causes of PTSD

This condition is caused by the following traumatic influences: natural disasters, terrorist acts, military actions, which include violence, hostage-taking, torture, as well as severe long-term illnesses or death of loved ones.

In many cases, if the psychological trauma is severe, it is expressed in feelings of helplessness, intense, extreme horror. Traumatic events include service in law enforcement agencies, domestic violence, where he witnesses serious crimes.

People develop post-traumatic stress disorder due to post-traumatic stress. The features of PTSD are expressed in the fact that the individual, having managed to adapt to various life circumstances, has changed internally. The changes that happen to him help him survive, no matter what conditions he finds himself in.

The degree of development of the pathological syndrome depends on the level of the individual’s participation in a stressful situation. Also, the development of PTSD can be influenced by the social and living conditions in which the individual finds himself after the trauma he has experienced. The risk of developing a disorder is greatly reduced when there are people around who have experienced a similar situation. Often, individuals with poor mental health and increased reactivity to environmental stimuli are susceptible to PTSD.

In addition, there are other individual characteristics that provoke the occurrence of the disorder:

— hereditary factors (mental illness, close relatives, alcoholism, drug addiction);

- childhood psychological trauma;

— nervous, concomitant mental pathologies, diseases of the endocrine system;

— difficult economic and political situation in the country;

- loneliness.

One of the most common causes of PTSD is participation in combat. A war situation develops in people a neutral mental attitude towards difficult situations, but these circumstances, remaining in memory and emerging in peacetime, cause a strong traumatic effect. The majority of participants in hostilities are characterized by disturbances of internal balance.

What are the signs of PTSD? The criteria for PTSD are events that go beyond normal human experience. For example, war horrors have an impact due to their intensity, as well as their frequent repetition, which does not help a person to come to his senses.

The other side of PTSD affects the inner world of the individual and is associated with his reaction to experienced events. All people react differently. A tragic incident may cause irreparable trauma to one person, but little to no impact on another.

If the injury is relatively minor, then increased anxiety and other signs will disappear within a few hours, days, weeks. If the trauma is severe or traumatic events are repeated many times, the painful reaction persists for many years. For example, for combat veterans, an explosion or the rumble of a low-flying helicopter can cause an acute stressful situation. At the same time, the individual strives to feel, think, and act in such a way as to avoid unpleasant memories. The human psyche with PTSD develops a special mechanism to protect itself from painful experiences. For example, an individual who has experienced the tragic death of loved ones will subconsciously avoid a close emotional connection with anyone in the future, or if a person believes that at a crucial moment he showed irresponsibility, then in the future he will not take responsibility for anything.

“Combat reflexes” do not seem unusual to a person until he finds himself in peacetime and makes a strange impression on people.

Help with PTSD for participants in tragic events includes creating an atmosphere so that people can rethink everything that is happening to them, analyze their feelings and internally accept and come to terms with the experience. This is necessary in order to continue to move forward in life and not get stuck on your experiences. It is very important for people who have experienced military events or violence that they are surrounded by love, harmony, and understanding at home, but often this is not the case and at home people are faced with misunderstanding, lack of a sense of security and emotional contact. Often people are forced to suppress their emotions, not allowing them to come out, at the risk of losing them. In these situations, nervous mental tension does not find a way out. When an individual for a long time does not have the opportunity to relieve internal tension, his psyche and body themselves find a way to get along with this state.

PTSD symptoms

The course of PTSD is expressed in repeated and obsessive reproductions of traumatic events in the mind. Often the stress experienced by the patient is expressed in extremely intense feelings, causing suicidal thoughts to stop the attack. Characteristic nightmares and recurring dreams and involuntary flashbacks are also noted.

Features of PTSD are expressed in increased avoidance of feelings, thoughts, conversations associated with traumatic events, as well as actions, people and places that initiate these memories.

Signs of PTSD include psychogenic amnesia, which is the inability to recall a traumatic event in detail. People have constant vigilance, as well as a constant state of anticipation of a threat. This condition is often complicated by diseases and somatic disorders of the endocrine, cardiovascular, nervous and digestive systems.

The “trigger” of PTSD is an event that causes an attack in the patient. Often the “trigger” is only part of a traumatic experience, for example, the noise of a car, a crying child, an image, being at a height, text, a TV show, etc.

Patients with PTSD usually do their best to avoid encounters with factors that provoke this disorder. They do this subconsciously or consciously, trying to avoid a new attack.

PTSD is diagnosed when the following symptoms are present:

- exacerbation of psychopathological experiences that cause serious harm through mental trauma;

- the desire to avoid situations reminiscent of the trauma experienced;

— loss of traumatic situations from memory (amnestic phenomena);

- a significant level of generalized anxiety during the 3rd - 18th week after the traumatic incident;

- manifestation of exacerbation attacks after meeting with factors that provoke the development of this disorder - anxiety triggers. Triggers are often auditory and visual stimuli - a gunshot, squeaking brakes, the smell of some substance, crying, the hum of an engine, etc.;

- dullness of emotions (a person partially loses the ability to express emotions - friendship, love, there is a lack of creative enthusiasm, spontaneity, playfulness);

- impaired memory, as well as concentration when a stress factor appears;

- with accompanying feelings, a negative attitude towards life and nervous exhaustion;

- general anxiety (concern, worry, fear of persecution, fear, guilt complex, lack of self-confidence);

— (explosions similar to a volcanic eruption, often associated with the influence of alcohol and drugs);

— abuse of medicinal and narcotic substances;

- uninvited memories that emerge in ugly, terrible scenes associated with traumatic events. Unbidden memories surface both while you are awake and while you sleep. In reality, they appear in cases where the environment resembles what happened during a traumatic situation. They are distinguished from ordinary memories by a feeling of fear and anxiety. Uninvited memories that come in a dream are classified as nightmares. The individual wakes up “broken,” wet with sweat, with tense muscles;

- hallucinatory experiences, which are characterized by behavior as if the person is reliving the traumatic event;

- insomnia (intermittent sleep, difficulty falling asleep);

- thoughts of suicide due to despair, lack of strength to live;

- a feeling of guilt due to the fact that he survived difficult trials, while others did not.

Treatment for PTSD

Therapy for this condition is complex; at the beginning of the disease, medication is provided, and then psychotherapeutic assistance.

All groups of psychotropic drugs are used in the treatment of PTSD: hypnotics, tranquilizers, antipsychotics, antidepressants, and in some cases, psychostimulants and anticonvulsants.

The most effective in treatment are antidepressants of the SSRI group, as well as tranquilizers and drugs that act on MT receptors.

An effective treatment technique is one in which the patient, at the beginning of an attack, concentrates attention on a distracting, vivid memory, which over time contributes to the formation of the habit of automatically moving to positive or neutral emotions, bypassing the traumatic experience when a trigger appears. A psychotherapeutic method in the treatment of PTSD is the method, as well as processing using eye movements.

For patients with severe symptoms, psychedelic psychotherapy is prescribed using serotonergic psychedelics and psychostimulants of the phenylethylamine group.

Psychological assistance for PTSD is aimed at teaching patients to accept the reality of their lives and create new cognitive models of life.

Correction of PTSD is expressed in gaining true mental and physical health, which does not consist of meeting someone else's standards and norms, but of coming to an agreement with oneself. To do this, on the path to true recovery, it is not so important to behave as is customary in society, but you need to be extremely honest with yourself, assessing what is currently happening in life. If life circumstances are influenced by: way of thinking, disturbing memories, behavior, it is important to honestly acknowledge their existence. Complete relief from PTSD can be obtained by seeking help from specialists (psychologist, psychotherapist).

It is quite normal for a person to be filled with fear, fright, and sadness that appear after a traumatic experience. But if these symptoms persist and you constantly experience feelings of danger and painful memories, then you may have Post-Traumatic Stress Disorder (PTSD). You may feel like you'll never cope with what's happening to you or that you'll never get back to normal. But treatment, psychotherapy, support will help you cope with PTSD (Post-Traumatic Stress Disorder) and return to normal life.

Post-traumatic stress disorder (PTSD) - what is it?

Post-traumatic stress disorder (PTSD) develops as a result of a traumatic event in which you felt helpless or in danger.

Most people associate PTSD with wounded, battle-maimed soldiers, and combat (military) actions are the most common cause of it. However, any life event that can affect a person's life (take away life) can trigger PTSD (Post Traumatic Stress Disorder), especially if the person could not control and/or predict it.

Post-traumatic stress disorder (PTSD) can occur in people who have experienced a disaster, witnessed a disaster, and those involved in the aftermath of a disaster, including emergency workers and law enforcement. PTSD can also develop in friends or family members of people who have experienced traumatic experiences.

Post-traumatic stress disorder/PTSD can develop differently in different people. Although symptoms of PTSD (Post-Traumatic Stress Disorder) usually develop within hours or days after a traumatic event, in some cases symptoms may appear weeks or months after the traumatic event.

Difference between PTSD (Post Traumatic Stress Disorder) and the normal response to a traumatic event

The traumatic event that results in Post-Traumatic Stress Disorder/PTSD is usually so overwhelming and frightening that it will affect anyone. As a result of such a traumatic event, almost anyone will experience at least some symptoms of PTSD. When you don't feel safe, it's normal to feel like you're going crazy, disconnected from the world (derealization). You have nightmares very often, you feel fear, you practically cannot stop thinking about the event that happened. These symptoms are a normal reaction to a traumatic/traumatic situation.

However, for most people, these symptoms go away quickly. Symptoms may last for several days or weeks, but they will eventually go away. But if you have Post-Traumatic Stress Disorder (PTSD), then these symptoms will not go away. You do not feel these symptoms getting better. You may feel them getting worse.

A normal reaction to a traumatic event can develop into PTSD (Post Traumatic Stress Disorder)

After a traumatic (psychotraumatic) situation, both the mind and body are in a state of shock. Once you understand what happened and cope with your emotions, you come out of this state. However, if you have Post Traumatic Stress Disorder/PTSD you continue to experience psychological shock. Your memories of what happened and your feelings about the event are disconnected. In order to get out of this state, it is very important to meet and experience your memories and emotions.

Traumatic/Psychotraumatic events that can lead to the development of PTSD (Post Traumatic Stress Disorder)

• War/combat (military) actions;
• Natural disasters;
• Car accidents (car accidents);
• Plane crash;
• Act of terrorism;
• The unexpected death of a loved one;
• Rape;
• Kidnapping;
• Attack;
• Sexual and/or physical (physiological) violence;
• Other.

Or any other disruptive event that leaves you feeling helpless and/or hopeless.

Post-traumatic stress disorder / PTSD - symptoms and signs

Symptoms of PTSD (Post Traumatic Stress Disorder) may appear suddenly, gradually, or come and go over time. Sometimes PTSD symptoms appear suddenly. In other cases, PTSD symptoms may be triggered by something that reminds you of the traumatic event that happened, such as a sound, image, certain words, or smell.

Symptoms of PTSD (Post Traumatic Stress Disorder) vary widely from one person to another, and there are three main groups of symptoms:

• Reliving a traumatic event;
• Avoiding things that remind you of the traumatic event;
• Increased restlessness, anxiety and emotional arousal.

Symptoms of PTSD - Reliving a traumatic event

• Intrusive, upsetting memories of the event;
• Replaying (you feel and/or behave as if the traumatic event is happening again right now);
• Nightmares (or memories of a traumatic event or other frightening things);
• Feelings of extreme stress and tension when you remember the traumatic event;
• Intense physiological reactions when you remember the traumatic event (accelerated heart rate, rapid breathing, nausea, muscle tension, increased sweating, etc.).

Symptoms of PTSD - avoidance of reminders of the traumatic event

• Avoidance of actions, places, things, thoughts and/or sensations that remind you of the traumatic event;
• Inability to remember important moments of a traumatic event;
• Loss of interest in life, apathy;
• Feeling of separation from other people and emotional exaltation;
• A feeling of limitation in the future (you don’t think that you will live a normal life, start a family, have a career, etc.).

Symptoms of PTSD are increased restlessness, anxiety, and emotional arousal.

• Sleep problems (difficulty falling asleep; waking up in the middle of the night, etc.);
• Irritability and/or angry outbursts;
• Difficulty concentrating/focusing;
• Hypervigilance/hypercontrol;
• Feeling of nervousness and rapid excitability.

Post-traumatic stress disorder (PTSD) - other symptoms that occur

• Anger and/or irritability;
• Guilt, shame and/or self-blame (self-blame);
• Abuse of harmful substances (alcohol, nicotine, drugs);
• Feelings of mistrust and/or betrayal by others;
• Depression and/or hopelessness;
• Thoughts and/or feelings about suicide;
• Feelings of loneliness and/or disconnection from the world;
• Physiological (physical) pain and/or tension.

Post-traumatic stress disorder (PTSD) in children and adolescents - symptoms

• Fear/fear of being separated from parents;
• Loss of previously acquired skills/abilities (eg, learning to go to the toilet);
• Sleep problems and nightmares;
• Pessimistic, repetitive games in which the theme or aspects of the traumatic event are repeated;
• New fears/phobias/anxiety that, at first glance, are not associated with a traumatic event (for example, fear of monsters);
• Acting out, replaying psychological trauma in games, stories or drawings;
• Pain for no apparent reason;
• Irritability and aggression;
• Other.

Post-traumatic stress disorder (PTSD) according to ICD-10 F43.1

Post-traumatic stress disorder (PTSD) occurs as a delayed and/or prolonged reaction to a stressful event or situation (short-term or long-term) of an extremely threatening or catastrophic nature, which can cause severe stress in almost anyone. Factors that may contribute to the appearance are individual personality traits (for example, obsessive or asthenic), previously manifested neurotic disorders, which can lower the threshold for the onset of the disorder or worsen its course, but in themselves they are not necessary or sufficient for the occurrence of the disorder. Common manifestations include recurrent intrusive memories of the traumatic event, nightmares or fantasies, resulting in feelings of emotional insensitivity or emotional dullness, alienation from other people, indifference to others, indifference to situations that brought joy, avoidance of activities and/or or situations that may bring back memories of the traumatic event. A state of hyperarousal and hypervigilance usually occurs, which may be exacerbated by severe fear and insomnia. Anxiety and depression may present with the symptoms and signs listed above, and suicidal ideation may also occur. The disorder begins after a traumatic event, and the latency period between the traumatic event and the onset of the disorder lasts from several weeks to months (usually no more than 6 months). The course of the disorder is wave-like, but recovery can be expected in most cases. In a small number of cases, the disorder may become chronic, lasting for many years, with the possibility of developing into chronic personality changes after experiencing a catastrophe (f62.0).

Risk Factors That May Trigger PTSD/Post-Traumatic Stress Disorder

Although it is impossible to predict in advance who will develop PTSD in response to a traumatic event, there are certain risk factors that increase this possibility.

A large number of risk factors come from the nature of the traumatic event. A traumatic/psychotraumatic event is much more likely to lead to the onset of PTSD (Post-traumatic stress disorder) is associated with a threat to your life and health: the more intense and prolonged the threat, the greater the risk of developing PTSD. Intentional harm to a person, for example rape, beatings, torture, are also more traumatic events than natural disasters, accidents or catastrophes that are not aimed at a specific person. The extent to which the traumatic event was unexpected, uncontrollable, and inevitable is also a risk factor.

Other risk factors for PTSD

• Previous traumatic events, especially at a young age;
• If anyone in the family has had PTSD or depression;
• Earlier episodes of physiological or sexual abuse;
• When the person has previously abused substances;
• If the person has previously had depression, anxiety, or other psychological and emotional difficulties;
• Intense daily stress;
• Lack of support after a traumatic event;
• Lack/inadequacy of abilities to overcome psychological difficulties;
• others.

Post-traumatic stress disorder (PTSD) and family

If your loved one suffers from PTSD, it is important that you take care of yourself and get additional support from others. PTSD can be a heavy burden on your family. It is very difficult to understand why a loved one does not want to open up to you, why he shows less attention and warmth, why he has become more emotionally unstable. In some cases, PTSD can lead to job loss, substance abuse, and a variety of other problems.

Allowing a family member with PTSD to dominate your life and ignoring your own needs will lead to emotional exhaustion and burnout. You need to understand that in order to care for your loved one with PTSD, you first need to take care of yourself. It is also very important that you learn everything you can about PTSD (Post Traumatic Stress Disorder). The more you know about symptoms and treatment, the more effectively you can help your loved one.

Basic rules for helping a loved one with Post-Traumatic Stress Disorder (PTSD):

Be patient and understanding. You need to understand that treating PTSD takes time. Be patient during the treatment process and listen to your loved one if necessary. A person with post-traumatic stress disorder (PTSD) may need to talk about the traumatic event over and over again. This is part of the treatment, so you should avoid telling your loved one to leave the past behind and move forward.

Try to predict and prepare for those triggers that will provoke PTSD. Common examples of triggers: anniversaries of a traumatic event; people or places that are associated with the traumatic event; certain sights, sounds or smells. If you can anticipate what triggers might trigger a PTSD reaction, you will be prepared to help your loved one.

Don't assume that PTSD symptoms are directed towards you. Common symptoms in people diagnosed with Post-Traumatic Stress Disorder/PTSD include emotional exaltation, irritability, anger, withdrawal, and others. If you see that your loved one is withdrawn, irritable, or withdrawn, you should remember that these manifestations may have nothing to do with you or your relationship.

Don't force your loved one to talk. People experiencing PTSD/Post Traumatic Stress Disorder find it very difficult to talk about a traumatic event. For some this may make things worse. Don't try to force your loved one to open up to you completely. However, make it clear that you are there anyway and will listen if necessary.

PTSD / Post-traumatic stress disorder - treatment

Treatment for PTSD is aimed at teaching you how to cope with the trauma you have experienced, which will result in relief from the symptoms of PTSD. Rather than avoiding the traumatic event and any memories of it, treatment for PTSD aims to allow you to remember and relive the emotions and feelings you felt at the time of the traumatic event. Treatment for PTSD (Post Traumatic Stress Disorder) is not only about allowing you to release emotions that you have previously bottled up and kept bottled up, but also about helping you regain a sense of control and reduce the intensity of lingering memories of the traumatic event.

Treatment of PTSD (Post-Traumatic Stress Disorder) includes the following steps:

• Exploring your thoughts and feelings about the traumatic event;
• Changes in feelings of guilt, self-blame and mistrust;
• Learning methods on how to cope and manage, control intrusive, unwanted memories;
• Addressing the problems that PTSD has caused in your life and relationships.

Treatment Methods for PTSD (Post Traumatic Stress Disorder)

Treating PTSD - Trauma-Focused Cognitive Behavioral Therapy

Cognitive behavioral therapy for PTSD (Post-Traumatic Stress Disorder) and traumatic events involves gently and gradually exposing the person to their own thoughts, feelings, and situations that remind them of the traumatic event. Also, cognitive behavioral therapy focuses on identifying and becoming aware of thoughts about the traumatic event, especially if these thoughts are distorted and/or irrational, and replacing these thoughts with more adaptive ones.

Treatment of PTSD (Post-Traumatic Stress Disorder) - Family Psychotherapy

Because post-traumatic stress disorder (PTSD) affects both the person suffering and those close to them, family therapy has a powerful effect. Family therapy can help your loved ones understand more clearly what you are going through. Family therapy can also help all family members communicate and interact better, despite relationship problems caused by PTSD.

Post-traumatic stress disorder (PTSD) - medication treatment

Sometimes people diagnosed with Post-Traumatic Stress Disorder (PTSD) are given medication to reduce secondary symptoms. Antidepressants such as Prozac or Zoloft are the most commonly used medications for PTSD. Although antidepressants may help you feel less sad, they do not treat the causes of PTSD to reduce anxiety.

Post-traumatic stress disorder (PTSD) - treatment with Eye Movement Desensitization and Reprocessing (EMDR)

(PTSD) - occurs as a delayed or protracted reaction to a stressful event or situation of an exceptionally threatening or catastrophic nature, which can cause distress in almost any person (disasters, wars, torture, terrorism, etc.).

Post-traumatic stress disorder usually occurs after a latency period that can vary from several weeks (on average about four) to months (usually no more than six). The development of PTSD may be preceded by a stage of acute stress reaction.

In peacetime, PTSD occurs in 0.5% of cases in women and 1.2% of cases in men. Over the course of a lifetime, PTSD is diagnosed in 1% of the population, and 15% may experience isolated symptoms. The most vulnerable groups are children, adolescents and the elderly. In addition to specific biological and psychological characteristics, coping mechanisms in this group of people are not formed (in children) or are already weakened (in older people).

Causes of Post-Traumatic Stress Disorder are as follows:

• psychological trauma - occurring suddenly, with radical aggression or the threat of death (potential risk of physical destruction); This also includes any emotional trauma combined with intense stress; presence of psychological trauma in the anamnesis.
• social trauma - wars, revolutions, natural and man-made disasters, terrorism, violence and other events; stages of the above-mentioned incidents of a threatening and catastrophic nature that go beyond the usual human experience; such stress is pathogenic for all participants in the events;
• ethical-cultural traumas - understanding the problem of life and death, the severity of sin and the severity of punishment and other existential issues resolved by a person depending on his mentality, religious and ideological worldview; play a leading role in the perception of a stressful situation;
• characteristic features - emotional instability, increased anxiety, immaturity of personality; in children these are usually asthenic traits; the moral climate that accompanies a stressful situation.
• personality and behavioral disorders - for example, dependent behavior, personality accentuation with a predominance of anxious-suspicious, sensitive, hyperthymic, unstable, conformal or epileptoid types;
• medical factors - the presence of relatives with mental disorders and alcoholism, a history of mental disorder, organic diseases of the central nervous system (in particular skull trauma or neuroinfections), somatic pathology, a weakened body (due to malnutrition, sleep deprivation).

It has been found that the number of people with post-traumatic stress disorder is lower among participants in military and other traumatic situations who were convinced of the justice of the cause for which they fought, believed in their commanders and leaders, and made a clear choice between basic moral values. Contribute to the formation of PTSD:

• moral injury and moral shock that arise in the event of the loss of a comrade, the need to fight with children and women, loss of trust in commanders, etc.;
• psychological reactions in the form of a feeling of guilt towards the dead (“survivor syndrome”);
• feeling of guilt about what you have done;
• the collapse of old ideals and ideas about people, the world and power;
• destruction of norms, hierarchy of values ​​and self-esteem of the individual, on the basis of which the idea of ​​oneself and one’s place in the world is built.

Factors limiting the development of PTSD.

• the ability to timely integrate the traumatic experiences of others into one’s life;
• a person’s ability to exercise emotional self-control;
• presence of adequate self-esteem;
• availability of good social support.

At the initial stage of the formation of PTSD, anxiety-phobic states appear with tearfulness, nightmares, attacks of derealization and depersonalization. Patients experience influxes of unpleasant memories associated with psychotrauma, often of an obsessive nature, usually without any external reasons. In the patient’s mind, these memories are very vivid and evoke in him the same sensations as a real tragedy. Various reminders of the past, for example in films, television shows, and stories from others, also cause very strong feelings.

These repeated experiences develop against the background of emotional depression, social alienation, and reduced reaction to the environment. Patients try to avoid situations and thoughts that could even remotely resemble the tragedy they experienced. They develop insecurity due to the fear of influxes of difficult memories, as a result of which patients become less sociable, insecure and delay making various decisions. Sleep deteriorates, memory and concentration decrease, irritability and short temper appear.

There are acute (less than 3 months) and chronic (more than 3 months) course of PTSD, as well as a variant with delayed onset (6 months after the stress factor). In a significant proportion of people, PTSD becomes chronic.

How to treat post-traumatic stress disorder?

Treatment of Post-Traumatic Stress Disorder is gradual:

• Immediate initiation of treatment is carried out after psychological trauma to prevent the development of a chronic form of PTSD;
• complex, long-term treatment includes pharmacotherapy and psychotherapy.

It is necessary to carry out combined treatment with antidepressants, tranquilizers, sleeping pills, thymostabilizers, beta-blockers, antipsychotics, etc., with antidepressants playing the main role.

In the initial period, when specialized care is needed for patients who have suffered a catastrophe or natural disasters, psychopharmacological therapy should also be prescribed. In these cases, tranquilizers or antidepressants in low doses are most indicated in order to normalize sleep and reduce emotional stress. Among antidepressants, preference is given to selective serotonin reuptake inhibitors (primarily Zoloft), both for adults and for children and adolescents.

The prescription of tranquilizers is symptomatic. They are used to quickly reduce the severity of asthenoneurotic, asthenodepressive, anxiety-phobic manifestations. Due to the fact that long-term use of most tranquilizers can cause dependence, their use should last no more than 3 weeks.

Of the group of drugs that produce a hypnotic effect, the most widely used are non-benzodiazepine hypnotics (imovan, ivadal). Thymoisoleptics are used as mood stabilizers.

If necessary, patients are prescribed antipsychotic drugs. It is advisable to use antipsychotics that have a balanced antipsychotic, psychostimulant and tranquilizing effect: sulpiride, periciazine, thioridazine.

In the presence of resistance to treatment, it is advisable to prescribe atypical antipsychotic drugs. The prescription of nootropics in the treatment of patients with PTSD is due to their cerebroprotective, vegetative-stabilizing effect and positive effect on neurometabolic processes. The most widely used are noolgropil, lucetam, phenibut, and cogitum.

The purpose of beta-blockers is due to the fact that they produce a rapid anti-anxiety, vegetative-stabilizing effect; they do not cause the effect of sedation. As a rule, beta blockers are used in combination with antidepressants

The most common methods of psychotherapy are:

• behavioral (behavioral);
• cognitive (or cognitive-behavioral);
• psychodynamic.

The following types of psychotherapy are used:

• individual psychotherapy - helps the patient understand the true nature of his problem, resolve internal conflicts and life crises; consists of six components:
  • correcting misconceptions about the stress response that most often occur;
  • providing the patient with information about the general nature of the stress response;
  • focusing on the role of excessive stress in the development of the disease;
  • developing the patient’s ability to recognize the manifestations of a stress reaction and the characteristic symptoms of PTSD;
  • developing the patient’s ability for self-analysis to identify stressors characteristic of him;
  • The clinician's education of the patient about the active role he or she plays in the treatment of excessive stress.
• group psychotherapy - helps the patient cope with feelings of guilt, a state of helplessness and powerlessness, emotional alienation, irritability, anger and gain a lost sense of control over others, a state of helplessness and powerlessness;
• family psychotherapy - provides relatives with information about the clinical signs of PTSD, the patient’s experiences and feelings, the principles of behavior of relatives in this situation, it is necessary to inform them about the duration of treatment for this disease and the possible effect; psychotherapeutic sessions are also conducted with close relatives;
• marital psychotherapy - the main task is to help spouses adapt to the changes that have occurred for both.

What diseases can it be associated with?

Patients experience difficulty communicating with others, even with relatives, become distant, withdrawn, sometimes angry, and external unmotivated outbursts of aggression appear. At work, these patients cannot maintain subordination and fulfill the requirements of labor discipline. In families, they cannot share the experiences of loved ones, and often lose their jobs and family.

Many begin to abuse alcohol, drugs, and toxic substances, which only increases their social maladjustment.

These behavioral features resemble the picture of a psychopathic-like syndrome. However, patients with PTSD are characterized by anxiety, melancholy, feelings of guilt, the uselessness of their lives, and suicidal thoughts. They suffer from recurring memories of the tragedy they experienced, which often appear suddenly in the form of vivid figurative representations, lasting up to several hours and accompanied by severe autonomic disturbances. Many patients have a fear of falling asleep, because often in their sleep they “experience a tragedy” - this is how insomnia and other sleep disorders develop.

In addition, in the case of PTSD, comorbid disorders are often diagnosed - depression, signs of generalized anxiety disorder, phobias, alcohol dependence.

Psychoorganic changes caused by various vascular disorders often develop. The results of follow-up observation indicate that complete recovery occurs only in 30% of cases, residual mild disorders are observed in 40% of patients, moderate impairment occurs in 20%, and deterioration occurs in 10% of patients.

Treating Post-Traumatic Stress Disorder at Home

Survivors of post-traumatic stress disorder often do not seek medical help because they believe that people who have not experienced such a tragedy are not able to understand and help them. In the case of a favorable family atmosphere and favorable social conditions, the majority of patients recover.

At certain stages of PTSD, patients usually do not go to doctors because they do not assess their condition as painful and are afraid that visiting psychiatric institutions may affect their social status.

It is necessary to note the extreme importance of the problem of socio-psychological adaptation in people who have suffered PTSD: it remains relevant not only in the first years after a traumatic event, but also decades later.

What medications are used to treat post-traumatic stress disorder?

Exclusively only as prescribed by a specialized specialist for treatment of post-traumatic stress disorder may be applicable:

antidepressants:

• zoloft
• framex portal,
• Paxil,
• rextil,
• cipramil;

tranquilizers:

• phenazepam,
• gidazepam,
• grandaxin;

non-benzodiazepine hypnotics:

neuroleptics:

nootropics:

beta blockers:

The dosage and duration of the course are prescribed by the psychotherapist after a face-to-face consultation.

Treatment of post-traumatic stress disorder with traditional methods

Folk remedies in treatment of post-traumatic stress disorder are not considered sufficiently effective, and therefore are taken only at the request of the patient. Doctors compare their effect in most cases with the placebo effect.

Treatment of PTSD during pregnancy

Rehabilitation of pregnant women with post-traumatic stress disorder is practically no different from the general strategy. However, some potent medications may be contraindicated. In this case, a psychotherapist works with the woman, and the participation of relatives in the rehabilitation process is important.

After childbirth and the lactation period, a psychotherapist also works with long-term consequences of injury, whose capabilities have already been expanded due to the permissibility of the use of pharmacological drugs.

Which doctors should you contact if you have post-traumatic stress disorder?

Diagnostic criteria for DTSD:

• the location of the traumatic event in the patient’s life;
• the onset of the disorder after a latent period following the injury (from several weeks to 6 months, and sometimes later);
• Flashes of memories in which traumatic events are repeated;
• actualization of psychotrauma in ideas, dreams, nightmares;
• social withdrawal, distancing and alienation from others, including loved ones and relatives;
• changes in behavior, explosive outbursts, irritability or aggression; possible antisocial behavior or illegal activities;
• alcohol and drug abuse, especially to relieve painful experiences, memories or feelings;
• depression, suicidal thoughts or attempts;
• acute attacks of fear, panic;
• autonomic disorders and nonspecific somatic complaints (eg, headache).

Psychological correction is extremely important for such patients; they need to be convinced of the need to receive therapy. The patient should be taught to treat his disorders as a normal reaction to a traumatic situation.

The patient should not avoid everything associated with mental trauma, in particular memories of it, it is important to help him understand it rationally and overcome it emotionally. This work requires great tact and patience from the psychotherapist; it must be carried out taking into account the cultural and national characteristics of people who survived the disaster.

The provision of psychological assistance should last from several months to 1-2 years.

Treatment of other diseases starting with the letter - p