Post-Traumatic Stress Disorder

1. Post-Traumatic Stress Disorder National Institute of Medical Health

2. What is PTSD ?

3. What is PTSD ? • Anxiety disorder • Get after seeing or living through a dangerous event • “fight-or-flight” response • This reaction is changed or damaged • Even no longer in danger

4. Who gets PTSD? • At any age • War veterans • Survivors of physical and sexual assault, abuse • Accidents • Disasters… • Not everyone with PTSD has been through a dangerous event.

5. What are the symptoms of PTSD? • Re-experiencing symptoms • Avoidance symptoms • Hyperarousal symptoms

6. Re-experiencing Symptoms • Flashbacks • Bad dreams • Frightening thoughts. • Words, objects, or situations

7. Avoidance symptoms • Staying away from … • Strong guilt, depression, or worry • Losing interest in activities • Having trouble remembering the dangerous even • Change personal routine

8. Hyperarousal symptoms • Being easily startled • Feeling tense or “on edge” • difficulty sleeping, angry outbursts • Constant • Trigger by things that remind th traumatic event • Hard to do daily tasks (Sleep, eat, concentrate)

9. ASD Vs. PTSD • ASD (Acute stress disorder) • Detachment • Being in a daze • Derealization • Depersonalization • Dissociative amnesia Sustain at lesast 2 days - 4week Within 4 week post accident • PTSD Duration: Over 1 month

10. Do children react differently than adults? • Bedwetting • Forgetting how or being unable to talk • Acting out the scary event during playtime • Unusually clingy with… • The older children • Likely in adults • Disrespectful or destructive behaviors • Guilty • Thought of revenge

11. How is PTSD detected? • All of the following for at least 1 month • At least one re-experiencing symptom • At least three avoidance symptoms • At least two hyperarousal symptoms • Hard to go about daily life

12. Why do some people get PTSDand other people do not? Risk factors • Living through dangerous events and traumas • History of mental illness • Getting hurt • Seeing people hurt or killed • Feeling horror, helplessness, or extreme fear • Having little or no social support after the event • Dealing with extra stress after the event (loss of a loved one, pain and injury, loss job or home)

13. Why do some people get PTSDand other people do not? Resilience factors • Seeking out support from other people( friends, family) • Finding a support group after a traumatic event • Feeling good about one’s own actions in the face of danger • Having a coping strategy, or a way of getting through the bad event and learning from it • Act and respond effectively despite feeling fear.

14. How is PTSD treated? • Psychotherapy • Medications • Other ongoing problems • Panic disorder • Depression • Substance abuse • Feeling suicidal

15. Psychotherapy • “talk” therapy • 6 to 12 weeks and more • Family and friends • Cognitive behavioral therapy (CBT) • Exposure therapy :Face and control, safe way • Cognitive restructuring :What happen in a realistic way • Stress inoculation training :How to reduce anxiety

16. Medications FDA approved • Sertraline (Zoloft) • Paroxetine (Paxil) Control PTSD symptom • Sadness, worry, anger, feeling numb in side, easier to go through • Side effect: Headache, nausea, sleeplessness, agitation, sexual problem.

17. Other medications • Benzodiazepines:Relax, sleep • Antipsychotics:with other mental disorder • Other antidepressants

18. Treatment after mass trauma • 911 terrorist attacks • Hurricane Katrina • 921 earthquake • 88 floods

19. Treatment after mass trauma • Some PTSD symptoms • Basic support • Getting to a safe place • Seeing a doctor if injured • Getting food and water • Contacting loved ones or friends • Learning what is being done to help.

20. What efforts are under way to improve thedetection and treatment of PTSD? • brain imaging and the study of genes what leads to PTSD, when it happens, and who is most at risk. • Why some people get PTSD and others do not. Knowing this can help • Focusing on ways to examine pre-trauma, trauma, and post-trauma risk and resilience factors all at once. • Looking for treatments that reduce the impact traumatic memories have on our emotions. • Improving the way people are screened for PTSD, given early treatment, and tracked after a mass trauma. • Developing new approaches in self-testing and screening • Testing ways to help family doctors detect and treat PTSD or refer people with PTSD to mental health specialists.

21. How can I help a friend orrelative who has PTSD? To help a friend or relative, you can: • Offer emotional support • Learn about PTSD • Talk to your friend or relative, and listen carefully. • Listen to feelings your friend or relative expresses • Situations that may trigger PTSD symptoms. • Positive distractions (walks, outings, and other activities ) • With time and treatment, he or she can get better.

22. How can I help myself? To help yourself: • Talk to your doctor about treatment options. • Mild activity or exercise to help reduce stress. • Set realistic goals for yourself. • Break up large tasks into small ones ( priorities, and do what you can as you can) • Confide in a trusted friend or relative. • Tell others about things that may trigger symptoms. • Expect your symptoms to improve gradually, not immediately. • Comforting situations, places, and people.

23. Thank you for your listening