Tag Archives: PTSD

Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd kids

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

ptsdpic
Review this previous Straight, No Chaser post for a review of PTSD signs, symptoms and those at risk.
Fortunately, not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.

PTSD cognitive-behavioral-therapy

PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated, and get the help you need.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

ptsd-1

Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imagine having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.
ptsd2

  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

ptsd-dv

  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Civilian & Police Officer Murders, Community Stress & PTSD

ptsd Veteran-504x200

Just a month ago, Straight, No Chaser discussed Mass Trauma, Community Stress and Post-Traumatic Stress Disorder. If you’ve been following the news, it may have occurred to you that recent events involving shooting of civilians and police officers could either be the result of or the precipitant of individual and community stress rising to the level of post-traumatic stress disorder (PTSD). As a reminder, episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others.

ptsd murdered-by-the-police

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or a seemingly senseless death within the community, many within the community can subsequently develop signs of post-traumatic stress disorder (PTSD). Although it is most correct to note that symptoms tend to develop in the first few weeks after the episode, victims are likely to be hyperreesponsive to subsequent stimuli long into the future. New stimuli can then trigger abnormal responses. In many ways, what is happening now is a normal, expected and shared community response to serious trauma.
Now with all due respect to our veterans, PSTD is not limited to those who have participated in wars (although it is of note that those involved in the execution of police officers both had military backgrounds). Would it be easier to accept, understand and empathize with those involved if these events had happened immediately after having served in the arena of war? Why hasn’t there been a discussion of these issues through this prism? More importantly, why hasn’t support and solutions been fashioned for involved communities accordingly?
Take a breath, and conceptualize the cumulative effect on a community of slavery, Jim Crow, all the various forms of oppression and institutional racism that have come with that and now the ongoing senseless, avoidable and largely unpunished loss of life at the hands of those meant to “Serve and Protect?” One could argue that remarkable restraint has been shown, all things considered.

ptsd officers dead in flag gettyimages-486498406_custom-8fa02d097b26d219e1cd92d316d28c4693d0e4de-s900-c85ptsd lead_large

How can anyone question the multitude of stimuli that have been present of late, poised to affect someone affected by PTSD? How can we be blind to the notion that communities (most notably the African-American community) and the “fraternity” of police officers are both (not to be confused with equally) addressing an abnormal level of stress and fear? That’s right. Now the police are involved. Whether or not the recipients of the initial affronts, or whether or not you believe it to be reasonable, when a community (of police officers) begin being besieged by random killings of officers, they will respond a certain way. However, the involvement of the police comes with a different consideration: they are empowered to strike back. Officers can shoot to kill if confronted with subsequent dangerous situations in which they believe there lives are in danger. Has there been any discussion about the inherent danger of leaving in place such power to individuals under this level of stress without specific, additional cultural sensitivity training and counseling on PTSD?
Traditionally, when communities suffer mass trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Reinforcing contacts with loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

ptsd Screen-Shot-2015-01-09-at-3.33.22-PM-1-860x450

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
It is time to add these considerations to the current conversation. Fear, retaliation and conversation isn’t enough and will only contribute to a never-ending spiral of death. Our leadership needs to begin implementation of services and support to address the broad factors in play.

ptsd_brain-705x380

If you are interested in the other posts in the Straight, No Chaser series on Post-Traumatic Stress Disorder (PTSD), they are listed below.

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

ptsddisasters

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

A woman cries while sitting on a road amid the destroyed city of Natori, Miyagi Prefecture in northern Japan March 13, 2011, after a massive earthquake and tsunami that are feared to have killed more than 10,000 people. Picture taken March 13, 2011. REUTERS/Asahi Shimbun (JAPAN - Tags: DISASTER ENVIRONMENT) JAPAN OUT. NO COMMERCIAL OR EDITORIAL SALES IN JAPAN. FOR EDITORIAL USE ONLY. NOT FOR SALE FOR MARKETING OR ADVERTISING CAMPAIGNS
Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd kids

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

ptsdpic
Review this previous Straight, No Chaser post for a review of PTSD signs, symptoms and those at risk.
Fortunately, not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.

PTSD cognitive-behavioral-therapy

PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated, and get the help you need.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 
 
 
 
 
 
 
 

Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

ptsd-1

Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imagine having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.
ptsd2

  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

ptsd-dv

  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Civilian & Policer Officer Murders, Community Stress & PTSD

ptsd Veteran-504x200

Just a month ago, Straight, No Chaser discussed Mass Trauma, Community Stress and Post-Traumatic Stress Disorder. If you’ve been following the news, it may have occurred to you that recent events involving shooting of civilians and police officers could either be the result of or the precipitant of individual and community stress rising to the level of post-traumatic stress disorder (PTSD). As a reminder, episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others.

ptsd murdered-by-the-police

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or a seemingly senseless death within the community, many within the community can subsequently develop signs of post-traumatic stress disorder (PTSD). Although it is most correct to note that symptoms tend to develop in the first few weeks after the episode, victims are likely to be hyperreesponsive to subsequent stimuli long into the future. New stimuli can then trigger abnormal responses. In many ways, what is happening now is a normal, expected and shared community response to serious trauma.
Now with all due respect to our veterans, PSTD is not limited to those who have participated in wars (although it is of note that those involved in the execution of police officers both had military backgrounds). Would it be easier to accept, understand and empathize with those involved if these events had happened immediately after having served in the arena of war? Why hasn’t there been a discussion of these issues through this prism? More importantly, why hasn’t support and solutions been fashioned for involved communities accordingly?
Take a breath, and conceptualize the cumulative effect on a community of slavery, Jim Crow, all the various forms of oppression and institutional racism that have come with that and now the ongoing senseless, avoidable and largely unpunished loss of life at the hands of those meant to “Serve and Protect?” One could argue that remarkable restraint has been shown, all things considered.

ptsd officers dead in flag gettyimages-486498406_custom-8fa02d097b26d219e1cd92d316d28c4693d0e4de-s900-c85ptsd lead_large

 
How can anyone question the multitude of stimuli that have been present of late, poised to affect someone affected by PTSD? How can we be blind to the notion that communities (most notably the African-American community) and the “fraternity” of police officers are both (not to be confused with equally) addressing an abnormal level of stress and fear? That’s right. Now the police are involved. Whether or not the recipients of the initial affronts, or whether or not you believe it to be reasonable, when a community (of police officers) begin being besieged by random killings of officers, they will respond a certain way. However, the involvement of the police comes with a different consideration: they are empowered to strike back. Officers can shoot to kill if confronted with subsequent dangerous situations in which they believe there lives are in danger. Has there been any discussion about the inherent danger of leaving in place such power to individuals under this level of stress without specific, additional cultural sensitivity training and counseling on PTSD?
Traditionally, when communities suffer mass trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Reinforcing contacts with loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

ptsd Screen-Shot-2015-01-09-at-3.33.22-PM-1-860x450

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
It is time to add these considerations to the current conversation. Fear, retaliation and conversation isn’t enough and will only contribute to a never-ending spiral of death. Our leadership needs to begin implementation of services and support to address the broad factors in play.

ptsd_brain-705x380

If you are interested in the other posts in the Straight, No Chaser series on Post-Traumatic Stress Disorder (PTSD), they are listed below.

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

ptsddisasters

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

A woman cries while sitting on a road amid the destroyed city of Natori, Miyagi Prefecture in northern Japan March 13, 2011, after a massive earthquake and tsunami that are feared to have killed more than 10,000 people. Picture taken March 13, 2011. REUTERS/Asahi Shimbun (JAPAN - Tags: DISASTER ENVIRONMENT) JAPAN OUT. NO COMMERCIAL OR EDITORIAL SALES IN JAPAN. FOR EDITORIAL USE ONLY. NOT FOR SALE FOR MARKETING OR ADVERTISING CAMPAIGNS
Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd kids

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

ptsdpic
Review this previous Straight, No Chaser post for a review of PTSD signs, symptoms and those at risk.
Fortunately, not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.

PTSD cognitive-behavioral-therapy

PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated, and get the help you need.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

ptsd-1

Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imaging having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.
ptsd2

  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

ptsd-dv

  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd kids

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

ptsdpic
Review this previous Straight, No Chaser post for a review of PTSD signs, symptoms and those at risk.
Fortunately, not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse, or other anxiety disorders.

PTSD cognitive-behavioral-therapy

PTSD is typically treated with either psychotherapy (“talk” therapy), medications, or both. Mental health professionals will review and discuss all treatment options with you prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft), and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger, and the feeling of numbness inside. Taking these medications often make it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex.

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, it’s very simple. Please get evaluated, and get the help you need.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

ptsd-1

This is Mental Health Awareness Month. Straight, No Chaser has done multiple posts on depression and suicide, the components of health and happiness, and many other mental health topics. It’s important that you appreciate the ways events in your life and even the way you live your life impact you over the long term. I deal with disease and death everyday as an Emergency Physician, and it’s dehumanizing on many levels. Imaging having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.
ptsd2

  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

ptsd-dv

  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
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Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment

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Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Straight, No Chaser has reviewed various aspects of post-traumatic stress disorder. Today’s post is a review of diagnosis and treatment, and we will link you to other Straight, No Chaser posts on the topic. We thank all of our veterans for their service.

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD in communities, click here.
  • For a review of PTSD in children, click here.

Not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:

  • At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
  • At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
  • At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)

Additionally, PTSD is often accompanied by depression, substance abuse or other anxiety disorders.
PTSD is typically treated with either psychotherapy (“talk” therapy), medications or both. Mental health professionals will review and discuss all treatment options prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft) and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger and the feeling of numbness inside. Taking these medications often makes it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:

  • Headache
  • Nausea (feeling sick to your stomach)
  • Sleeplessness or drowsiness
  • Agitation (feeling jittery)
  • Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex

Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, please get evaluated and get the help you need.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack or the effects of war, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

Unfortunately, some just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid”. This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Click here for a related Straight, No Chaser on Mass Trauma, and here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
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Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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