Post Traumatic Stress Disorder

What is Post Traumatic Stress Disorder?

Post-traumatic stress disorder occurs as a delayed and / or prolonged reaction to a stressful event or situation (short or long) of an exclusively threatening or catastrophic nature, which in principle can cause general distress in almost any person (for example, natural or artificial disasters, battles, serious unfortunate cases, monitoring the violent death of others, the role of the victim of torture, terrorism, rape or another crime). Predisposing factors, such as personality traits (for example, compulsive, asthenic) or previous neurotic disease, can lower the threshold for the development of this syndrome or aggravate its course, but they are not necessary and insufficient to explain its occurrence.

Causes of Post Traumatic Stress Disorder

It develops in people who have experienced emotional or physical stress (hostilities, disasters, bandit attacks, rape, house fire).

Pathogenesis during Post Traumatic Stress Disorder

The onset of this disorder occurs after an injury after a latent period, which can vary from several weeks to months (but rarely more than 6 months). The course is undulating, but in most cases recovery can be expected. In a small part of cases, the condition can detect a chronic course over many years and a transition to a persistent personality change after experiencing a catastrophy.

Symptoms of Post Traumatic Stress Disorder

Typical signs include episodes of re-experiencing trauma in the form of intrusive memories (reminiscences), dreams or nightmares, while in the imagination the picture of the trauma can be objective and lively. Characterized by the emergence of a chronic feeling of “numbness” and emotional dullness, estrangement from other people, a lack of reaction to the environment, anhedonia (lack of pleasure from life and its manifestations) and evasion of activities and situations reminiscent of trauma. Typically, an individual is afraid and avoids what he is reminded of the initial trauma. Rarely, there are dramatic, sharp outbreaks of fear, panic or aggression provoked by stimuli that trigger an unexpected memory of the injury or the initial reaction to it. Usually, there is a state of increased vegetative excitability with an increase in the level of wakefulness, an increase in the reaction of fright and insomnia.

Anxiety and depression are usually combined with the above symptoms and signs, a suicidal ideation is not uncommon, excessive consumption of alcohol or drugs can be a complicating factor. Children and old people suffer harder stress. The duration of the disorder is more than 1 month.

Diagnosis of Post Traumatic Stress Disorder

This disorder is diagnosed if there is evidence that it occurred within 6 months after a severe traumatic event. A “presumptive” diagnosis is possible if the interval between the event and the onset is more than 6 months, but the clinical manifestations are typical and there is no possibility of an alternative qualification of the disorder (for example, anxiety or obsessive-compulsive disorder or a depressive episode). Evidence of injury should be supplemented by recurring obsessive memories of the event, fantasies, and daytime views. Noticeable emotional alienation, numbness of feelings and avoidance of stimuli that could trigger memories of trauma are common, but are not necessary for diagnosis. Autonomic disorders, mood disorders, and behavioral disorders may be included in the diagnosis, but are not of paramount importance.

The long-term chronic effects of devastating stress, manifested decades after stressful exposure, should be classified as a persistent personality change after experiencing a catastrophe.

Treating Post Traumatic Stress Disorder

Antidepressants, sleeping pills, if necessary antipsychotics. Group and family psychotherapy.