| Imagine, if you will, that you are walking | | | | is beginning the initial medication treatment |
| alone at night in an unfamiliar neighborhood. | | | | within two weeks of the trauma. Then the goal |
| You think you hear footsteps behind you so | | | | of therapy, breaking the pattern of |
| you walk a little faster. Suddenly someone | | | | self-defeat by reexamining the traumatic |
| steps out from behind a bush. You turn around | | | | event and the patient responses to it, can |
| but someone is behind you as well. They are | | | | begin. Education about the disease and |
| both bigger than you and you are scared to | | | | recognition of cues or situations that |
| death. Possibly you are mugged or raped. | | | | trigger symptoms are invaluable. Complete |
| Maybe you escape harm, but you've still had a | | | | education and healing consists of:* |
| harrowing experience. You could end up | | | | ExposureExposure to the event via imagery |
| suffering from Posttraumatic Stress Disorder | | | | allows you to reexperience the event in a |
| (PTSD) if you have an experience like this or | | | | safe, controlled environment where your |
| have exposure to any real or a perceived | | | | reactions can be monitored.* |
| life-threatening trauma where you responded | | | | ExaminingExamining feelings such as anger, |
| with intense fear.PTSD is a medically | | | | shame, guilt, etc. allows you to work on |
| recognized anxiety disorder that occurs in | | | | resolving these feelings.* New Coping |
| normal individuals under extremely stressful | | | | SkillsNew coping skills teach you how to |
| situations. Symptoms may appear immediately | | | | handle reminders, reactions and feelings |
| and then disappear after several months. At | | | | without becoming overwhelmed or emotionally |
| other times symptoms may take up to 6 months | | | | numb. This can help foster your relationships |
| to emerge and may never completely go away. | | | | with others. Some of the techniques used |
| Half of those who meet the DSM-IV criteria | | | | are:* Relaxation (i.e. breathing techniques, |
| for PTSD will still suffer from symptoms a | | | | visualization)* Biofeedback* Cognitive |
| year after diagnosis and 1/3 will still have | | | | restructuring* Managing Anger* Preparing for |
| weekly symptoms ten years after the | | | | stress reactions* Addressing urges to use |
| trauma.CRITERIA FOR PTSD* Exposure to a | | | | alcohol or drugs* Communications and relating |
| traumatic event marked by intense fear, | | | | effectively with peopleGroup treatment has |
| helplessness or horror* Symptoms from each of | | | | also proven to be quite helpful for PTSD |
| the three symptom clusters:* Intrusive | | | | sufferers. This type of setting allows you to |
| recollections (evoke panic, fear, dread, | | | | share with others who are more empathetic to |
| nightmares, grief, despair, daytime | | | | your feelings. Being able to share instills |
| fantasies, etc.)* Avoidant/numbing symptoms | | | | more confidence and helps you to trust again. |
| (avoidance of trauma related stimuli, trouble | | | | After being allowed to share your trauma you |
| leaving the house, cannot tolerate strong | | | | are freer to engage proactively in current |
| emotions, etc.)* Hyperarousal symptoms | | | | relationships.Eye Movement Desensitization |
| (symptoms resemble panic attacks, generalized | | | | and Reprocessing (EMDR)This is a relatively |
| anxiety, insomnia, irritability, startle | | | | new treatment that combines elements of |
| response, hypervigilance that may come across | | | | exposure therapy, cognitive behavior therapy |
| as paranoia)You may also use the mnemonic | | | | and then uses techniques (eye movements, hand |
| "DREAMS"D = DETACHMENTR = REEXPERIENCING THE | | | | taps, sounds, etc.), which creates an |
| EVENTE = EVENT HAD EMOTIONAL EFFECTSA = | | | | alteration of attention back and forth across |
| AVOIDANCEM = MONTH IN DURATIONS = | | | | the person's midline. Fourteen controlled |
| SYMPATHETIC, HYPERACTIVITY OR | | | | studies have been done on EMDR. The last five |
| HYPERVIGILANCESTATISTICSCertain populations | | | | done on trauma patients (abuse, rape, |
| are more at risk than others. Here are just a | | | | accident victims, etc.) have found that |
| few examples:* 2% in post-partum women* 18% | | | | 84-90% of the individuals suffered no PTSD |
| in professional fire fighters* 34% in | | | | after only three sessions. In a study for |
| adolescent survivors of car accidents* 48% in | | | | combat veterans, 77% showed no PTSD symptoms |
| female rape victims* 67% in prisoners of | | | | after twelve sessions. Like all therapy the |
| warUp to 80% of patients with PTSD will have | | | | progress rate depends on the individual and |
| a comorbid psychological or psychiatric | | | | the type of trauma. To administer EMDR, |
| disorder. The most common diseases that occur | | | | therapists must undergo special |
| with PTSD are:* major depression* substance | | | | training.Although PTSD manifests itself in a |
| abuse* dysthymia* bipolar disorder* | | | | wide variety of symptoms there is a common |
| generalized anxiety disorder* panic disorder* | | | | factor. If you have lived through any type of |
| phobias* dissociative | | | | experience that has caused you to feel |
| disordersTREATMENTSMedicationsTypical first | | | | threatened by death (either real or |
| line treatment is with selective serotonin | | | | perceived) or threatened serious physical |
| reuptake inhibitors (SSRI's) such as Prozac, | | | | injury to yourself or to others, and you felt |
| Paxil, Zoloft or Lescol. Trazadone and | | | | intense fear, horror or helplessness, you |
| nefazadone (Serzone) are being re-studied | | | | could be suffering from PTSD and may not even |
| since the have SSRI properties and they also | | | | be aware of it. If you have experienced a |
| reduce or suppress REM sleep, thus reducing | | | | traumatic event, lived an abused life, or |
| or eliminating nightmares. Tricyclic | | | | cannot deal with something that you were |
| antidepressants and MAOI's have been tried | | | | confronted with, please seek the help of a |
| but there is no proven efficacy for these | | | | professional. No one should have to live a |
| types of medications.Benzodiazepines were | | | | life in constant fear or helplessness.Terry |
| once the first line of treatment but the | | | | J. Coyier is a 37-year-old college student |
| efficacy has not been proven in controlled | | | | studying for an Associates of Applied |
| studies. They can also cause dependency | | | | Sciences degree. She is also a freelance |
| problems for people who must deal with | | | | writer who writes about bipolar disorder and |
| substance abuse issues. These types of | | | | other mental illnesses. Terry was diagnosed |
| medications also come with a variety of | | | | with bipolar ten years ago. She lives with |
| discontinuation problems.PsychotherapyOnce | | | | her son in the Dallas/Ft. Worth Metroplex. |
| medications relieve the most distressing | | | | Terry is an author on which is a site for |
| symptoms a patient can then concentrate on | | | | Writers and her personal portfolio can be |
| psychotherapy. A key element to success here | | | | viewed here. |