WHAT IS POST-TRAUMATIC STRESS DISORDER?

This page was last updated on: March 17, 2002


WHAT IS POST-TRAUMATIC STRESS DISORDER?




You have experienced a traumatic event, or a series of traumatic events.
The event may be over, but you may now be experiencing or may experience
later some strong emotions or physical reactions. It is very common, in
fact, quite normal for people to experience emotional shocks when they
have passed through a horrible event.




Sometimes the emotional aftershocks (or stress reactions) appear
immediately after the traumatic event. Sometimes they may appear a few
hours or a few days later. And, in some cases, weeks or months may pass
before the stress reactions appear.




The signs and symptoms of a stress reaction may last a few days, a few
weeks, or a few months and occasionally longer depending on the severity
of the traumatic event. With the understanding and the support of loved
one　s, stress reactions usually pass more quickly. Occasionally, the
traumatic event(s) is so painful that professional assistance from a
counselor may be necessary. This does not imply craziness or weakness. It
simply indicates that the particular trauma was just too powerful to
manage without help.




Here are some very common signs and signals of a stress reaction:




(* Definite indication of the need for medical eval　uation!)




Physical Signs




Fatigue
Muscle tremors
Twitches
Chest pain*
Difficulty breathing*
Elevated blood pressure
Rapid heart rate
Thirst
Visual difficulties
Vomiting
Nausea
Grinding of teeth
Weakness
Dizziness
Profuse sweating
Chills
Shock symptoms*
Fainting




Cognitive Signs




Blaming someone
Confusion
Poor attention
Poor decisions
Heightened or lowered alertness
Hyper-vigilance
Poor concentration
Memory problems
Poor problem solving
Difficulty identifying familiar objects or people
Increased or decreased awareness of surroundings
Loss of time, place, or person orientation
Disturbed thinking
Nightmares
Intrusive images
Poor abstract thinking




Emotional Signs




Anxiety
Guilt
Grief
Denial
Uncertainty
Severe panic (rare)
Emotional shock
Fear
Agitation
Depression
Apprehension
Irritability
Inappropriate emotional response
Intense anger
Feeling overwhelmed
Loss of emotional control
etc.




Behavioral Signs




Change in activity
Change in speech patterns
Emotional outbursts
Suspiciousness
Withdrawal
Inability to rest
Change in usual communications
Hyper-alert to environment
Loss or increase of appetite
Alcohol consumption
Antisocial acts
Non-specific bodily complaints
Startle reflex intensified
Pacing
Erratic movements
Change in sexual functioning
etc.




Source:
Los Angeles County Department of Mental Health



PTSD Characteristics In Veterans:








INTRUSIVE THOUGHTS AND FLASHBACKS:
Replaying military experiences in their minds, searching for alternative
outcomes. Flashbacks triggered by everyday experiences: helicopters, the
smell of urine, the smell of diesel fuel, the smell of mold, the smell of
Asian food cooking, green tree lines, popcorn popping, rainy days, and
refugees.




ISOLATION:
He has few friends. Isolates family emotionally and sometimes
geographically. Fantasizes about being a hermit, moving away from his
problems. Believes no one　 can understand and no one　 would listen if he
tried to talk about his experiences. Isolates himself from his partner,
family, and others with a "leave me alone" attitude. He needs no one　.




EMOTIONAL NUMBING:
Cold, aloof, uncaring, detached. Constant fear of "losing control"... "
I may never stop crying!"




DEPRESSION:
Sense of helplessness, worthlessness, and dejection. Lacks self esteem and
suffers from great insecurity. Feels undeserving of good feelings. Seems
unable to handle it when things are going well, and may appear to try to
be sabotaging the situation.




ANGER:
Quiet, masked rage which is frightening to the veteran and to those around
them. Sublimating the rage against inanimate objects. Unable to handle or
identify frustrations. Unexplainable, inappropriate anger.




SUBSTANCE ABUSE:
Used primarily to numb the painful memories of past experiences. Heavy
use of alcohol, nicotine, caffeine, and other drugs.




GUILT/SUICIDAL THOUGHTS and FEELINGS:




Self-destructive behavior. Hopeless physical fights, single car accidents,
compulsive blood donors. Self inflicted injuries to feel pain - many
accidents with power tools. High suicide rate. Financial suicide. As soon
as things are well off, doing something to lose it all, or walking away
from it. Survivor's Guilt when others have died around them. "How is it
that I survived when others more worthy than I did not?" (more so with
medical personnel)




ANXIETY or NERVOUSNESS:
Uncomfortable when people walk close behind them or sit behind them.
Conditioned suspicion, he trusts no one　. Startled responses.




EMOTIONAL CONSTRICTION:
Unresponsive to self, therefore unresponsive to others. Unable to express
or share feelings, cannot talk about personal emotions. Unable to achieve
intimacy with family, partner, or friends.




DENIAL:
Unable to admit that he has any of the above symptoms or that he may have
PTSD. May deny that his military experience could have anything to do with
his attitude. In extreme cases, will deny that he was even in the
military. Unwilling to seek help. Trusts no one　.




Reprinted from: The Birmingham News
Feb 9. 1998 - Health & Family Section








A MULTITUDE of PHYSICAL PROBLEMS




Wives, Families, and Close Friends:








MEMORIES:
Preoccupation with the veteran. Constant tension and anxiety because she
never "knows what he'll do next". Critical or self-righteous martyr
attitude because of "what he has put me through". Continual manipulation
of veteran and/or circumstances in order to be in control in a situation
that is out of control.




ISOLATION:
May have few friends or be unable to relate to friends as she would like
to because Vet has alienated them with his attitude and actions in the
past. Vet has isolated family and/or is jealous of them. She has alienated
friends because of her constant family hassles. The friends and family she
does have tell her to get rid of him.




EMOTIONAL NUMBING:
Sexual problems. She feels that she cannot be truly intimate with the vet.
Distrust of God, "how could he let this happen?" Low self esteem. Escapes
into fantasy world, TV, thoughts of affairs, compulsive buying, etc. May
lean on children, friends, or mother too heavily for emotional support.




DEPRESSION:
Sense of helplessness and hopelessness, "tired of trying." Low self
esteem, evidenced by poor appearance, dirty home, etc.




ANGER and OTHER RELATED EMOTIONS:
Resentment and bitterness developed over the years not onl　y toward vet,
but others. Withdrawal from vet and family emotionally. Constant fear and
anxiety. May provoke or instigate fights or arguments with vet or take it
out on the kids.




OVER RESPONSIBILITY: (the "Enabler")
In an attempt to keep the family stable, may take over the financial and
other responsibilities as well as the "wife" and "mother" roles leading to
such traits as: think and feel responsible for others, perfectionism,
feels-save when giving, nagging or silence, peace at any price, does
things out of sense of duty, feelings of anxiety, pity, guilt, need to
"help" husband and others, harried and pressured, constant time pressure,
blame the husband or children for spot they are in, feelings of anger,
victimization, feeling a lack of appreciation, and being used.




GUILT:
Guilt for having married a vet as well as guilt for thoughts of leaving
him. Sorry for putting the children through trauma. Constant financial
stress, never knowing how they will be able to pay mounting bills, how
long he will work or fault, if I were a better wife, he would be
different". Feels guilty about spending money on themselves or having a
hard time just having fun. Feels guilty about just about everything. Fears
rejection. Often comes from troubled, dysfunctional family.




STRESS:
Feels that if one　 more thing happens, I'll loose my mind".
Over-commitment leading to constant time pressure.




EMOTIONAL EXPLOSIONS OR PROJECTION:
Take out frustrations on the children. Children may become severely
withdrawn or demanding, hyperactive, and agitated. Children may have less
friends because of a negative home environment leading to their loss of
self esteem. They may try to find fulfillment in other worthy causes,
including getting overly involved in the church, children's activities,
and other "worthy" organizations or projects.




DENIAL:
Denies that she or the children have problems... "after all, in spite of
the circumstances, look how well I keep it together!" Denial that husband
has problem or totally blames vet for ALL the problems. Denial that the
Lord or others can help her husband or her family.









Sites that vets and/or their families might find helpful. They are for
Mental Health and onl　y one　 is VA or military connected (The National
Center for PTSD the last link on the list).
1. Zoloft.com -has info on depression, PTSD (FIRST drug approved for
long-term treatment of PTSD), panic disorder and Obsessive-Compulsive
Disorder

2. NCPTSD - National Center for PTSD - This website is designed to serve
the diverse needs of a large array of interested audiences such as:
veterans and other survivors of traumatic experiences, clinicians,
researchers, journalists, family members, students, policymakers, lawyers,
librarians, and others interested in understanding PTSD.
3. Anxiety Disorders Association of America
4. Anxiety and Depression Resource Organization since 1984 - Freedom From
Fear
5. International Society for Traumatic Stress Studies
6. The National Mental Health Association - Leading the Way for America's
Mental Health
7. PTSD - FACTS FOR HEALTH - A reliable and unbiased public service site
about post traumatic stress disorder. The site provides up-to-date,
factual information, a self-test, and a fully searchable database of
clinicians who treat this disorder. The site also provides a free, on-line
consulting medical education course for medical professionals.
8. The Sidran Traumatic Stress Institute
9. National DMDA - National Depressive and Manic-Depressive Association
10. AFSP - American Foundation for Suicide Prevention is dedicated to
advancing knowledge of suicide and ability to prevent it.
11. Obsessive-Compulsive Foundation
12. Coping.org - Tools for Coping with Life's Stressors
14. Depression-screening.org
15. NAMI (National Alliance for the Mentally Ill) - The Nation's Voice on
Mental Illness

16. National Library Service for the Blind & Physically Handicapped -
Other useful web site