Understanding Post Traumatic Stress Disorder

Posttraumatic stress disorder (or PTSD) is a type of anxiety problem caused by exposure to one or more terrifying events that threatened or caused grave physical harm to the patient.  It is also a severe and ongoing reaction to an extreme psychological trauma. 

These events may involve someone’s actual death, a threat to the life of the patient or of someone else, serious physical injury, sexual assault, natural disasters, or anything else that would cause one’s psychological defenses to be overwhelmed. 

Note that PTSD is distinct from "traumatic stress," which has less intensity and duration, as well as "combat stress reaction," which is only temporary.  PTSD is also known as "shell shock" or "traumatic war neurosis," and can also be spelled as "post-traumatic stress disorder." 

However, the recent version of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) spells "posttraumatic" when referring to this disorder.

History

Battle-related stress has been reported as early as 6th Century BC.  Symptoms similar to PTSD have been reported through centuries, but it was only in the 1970s when the modern understanding of PTSD took hold, largely as a result of the problems that were being experienced by the American veterans of the Vietnam War.

One of the first descriptions of PTSD was made in 490 BC by Herodotus, a Greek historian, who wrote that during the Battle of Marathon, an Athenian soldier who suffered no injury from war became permanently blind after witnessing the death of a fellow soldier.

The term "post-traumatic stress disorder" was coined in the mid-1970s, which was also used in a working group finding presented to the Committee of Reactive Disorders.

Signs and symptoms

PTSD is diagnosed according to the following factors: 

– exposure to a traumatic event;
– persistent re-experience such as nightmares and flashbacks;
– persistent avoidance of stimuli associated with the trauma, such as avoiding to talk about anything related to the experience;
– increased arousal, such as difficulty of falling asleep and hypervigilance; significant impairment in social, occupational,
– other important areas of functioning; and that all of these symptoms should last for more than one month.

How the patient dissociates himself after the trauma predicts the severity of PTSD.  For instance, members of the Marines and Army are much more likely to develop PTSD than Air Force and Navy personnel because the former group witness more traumatic situations. 

Treatment

Different forms of psychotherapy have advocated in treating trauma-related problems such as PTSD.  This includes education about the condition, as well as providing safety and support.  Cognitive therapy and group therapy may be helpful in reducing social stigma and isolation. 

Another school of treatment involves exposure therapy, which involves assisting patients to therapeutically confront those distressing trauma-related memories and reminders, aiming to facilitate habituation and successful emotional processing of the trauma memory.