Diagnosis And Management Of Post
BRADLEY D. GRINAGE, M.D., University of Kansas School of MedicineWichita, Wichita, Kansas
Am Fam Physician. 2003 Dec 15 68:2401-2409.
Although post-traumatic stress disorder is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient’s symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.
What Kind Of Trauma Leads To Ptsd
1. Exposure to:
2. Exposure can be:
The Symptoms Of A Generalized Anxiety Disorder
There are a host of symptoms of GAD.
Pathological Symptoms
- Nausea
The Treatment for Anxiety Disorders
The treatment for anxiety disorders will depend entirely on the type of anxiety disorder you have and your individual specifications.
Reduce Stress and Triggers
Even GAD will have its triggers. If stress at work is resulting in an anxiety disorder, then a change in duties performed at work, or even a change in working environments, is necessary. You will not be able to get better if the source of your stress is still prevalent in your life.
Get Help From a Mental Health Professional
Cognitive Behavioral Therapy is a very effective treatment for GAD. Support groups and other types of therapy have proven to be extremely valuable, as well.
Stick to Your Medication Regimen
It can be tempting to stop taking the medication once you feel you are in remission. This is a mistake. It is recommended when you have GAD to continue with your medication regimen for six to twelve months afterward. The medication you will likely take would be serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors.
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Fear Is A Critical Construct For The Development Of Ptsd
Across the main theoretical models for understanding the development of PTSD is the centrality of classical conditioning of fear as a necessary, but not sufficient, mechanism for the development of PTSD. This emphasis is consistent with key models across the anxiety disorders and, in fact, underlies the DSM linkage of trauma exposure to subsequent PTSD symptoms. Empirical evidence also strongly supports this, with one of the best predictors of PTSD being if the person thought they would be killed or seriously injured. In many respects, PTSD is the quintessential anxiety disorder, where of all the anxiety disorders, PTSD consistently shows an empirical pattern of anxiety disorder-defining characteristics. Namely, self-reported symptoms of anxiety and fear, heightened anxiety and fear responding to threat/no threat signaling cues, elevated stress reactivity to threat-related stimuli, attentional biases to threat-relevant stimuli, and threat-based appraisals of ambiguous stimuli and elevated amygdala responses to threat-relevant stimuli. Based on years of research, this is a compelling evidence base arguing that PTSD is an anxiety disorder.
What Is The Difference Between Ptsd Vs Anxiety
Unfortunately, determining the difference between an anxiety disorder and posttraumatic stress disorder can be difficult, since they usually co-occur. PTSD and anxiety typically go hand-in-hand and are known to share similar symptoms. Although PTSD is also an anxiety disorder, people with PTSD have developed this disorder due to the previous experience of a traumatic event.
For those suffering from an anxiety disorder, there often isnt a trigger, scenario, or reason for you to feel anxious, and yet you will. Anxiety disorders come with a host of symptoms that you will feel both pathologically and physically.
If you think you suffer from PTSD, depression, or anxiety or worry and it is beginning to interfere with your daily activities, it is important that you visit a mental health professional to be evaluated accurately and start on a treatment plan to help you live a healthy life.
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What Is Post Traumatic Stress Disorder
One of the things that may indicate that a person is suffering from PTSD symptoms is when theyve experienced a natural disaster, a serious accident, a terrorist act, a war/combat, a personal injury, or sexual violence and have been a victim of that act.
The experience of traumatic events and PTSD symptoms may not only last long after they have occurred but bring up intense, troubling thoughts and feelings that last long after they have stopped.
They may feel as if they are passing through a flashback or a nightmare reminding them of the event, experiencing feelings of sadness, fear, or anger, and being isolated from other people.
A person with PTSD symptoms may avoid situations or people that remind them of the traumatic event and may react to even routine events like loud noises or an accident touch strongly.
Traumatic events may occur indirectly rather than directly, so PTSD symptoms may be a result of witnessing a close relative or friend die violently. Witnessing horrifying details of trauma can also be enough to trigger PTSD symptoms in individuals such as police officers witnessing child abuse cases.
Additional Contributors To The Comorbidity Section
Gordon Asmundson10, Larry J. Klassen11, Raymond W. Lam12, Roger S. McIntyre13, Isaac Szpindel14
10Department of Psychology, University of Regina, Regina, S4S 0A2, Canada 11Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, R3T 2N2, Canada 12Department of Psychiatry, University of British Columbia, Vancouver, V6T 2A1, Canada 13Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, M5S 1A1, Canada 14Attention and Learning Related Disorders, START Clinic, Toronto, M4W 2N4, Canada
Email: Gordon Asmundson – gordon.asmundson@uregina.ca Larry J. Klassen – larryjklassen@hotmail.com Raymond W. Lam – r.lam@ubc.ca Roger S. McIntyre – roger.mcintyre@uhn.ca Isaac Szpindel – iszpindel@startclinic.ca
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The Relationship Between Ptsd And Gad
Some research suggests that roughly one in six people with PTSD experience GAD at some stage in their condition.
While the reasons for their coexistence are not entirely clear, we do know that worry is a common feature of PTSD. Because emotional responses are typically hyper-aroused in people with PTSD, worries can also be extended and exaggerated to the point where they can no longer be controlled. In some individuals, worry may even be used as a coping mechanism.
It is not unusual to hear people with PSTD say that worrying about other events or troubles distracts them from the things that are more upsetting to them.
Worry can provide people with distance from the thoughts and feelings they are unable to face. Another possible explanation is that PTSD and GAD have similar origins. While trauma is the innate cause of PTSD, it can also be the trigger that leads to GAD.
How Ptsd Relates To Trauma
Anyone can develop PTSD at any age. Not every person who experiences trauma develops PTSDin fact, most people will manage to process a traumatic event and move on without developing the disorder. Others will exhibit some behaviors or transient symptoms of PTSD but never develop the disorder.
Certain factors can increase a persons likelihood of developing PTSD following traumathese can include the type of trauma, number of traumas experienced, prior problems with anxiety and depression, poor social support, and genetic predisposition.
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Healthy Ways Of Coping With Ptsd Anxiety
Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.
People with post-traumatic stress disorder often struggle with frequent and intense symptoms of anxiety. These strong symptoms of anxiety often lead people with PTSD to rely on unhealthy ways of coping, such as through drug or alcohol use.
Fortunately, there are a number of healthy ways of coping with anxiety. These strategies may help reduce the intensity of anxiety, lessen its frequency, and/or make it more tolerable.
Post Traumatic Stress Disorder
When we hear the word “trauma” we often think of a being hurt or involved in an accident, yet this word covers a broader spectrum of events which can be physical, psychological or both. Traumatic experiences can cause long term complications with anxiety, isolation, depression and in some cases suicidal thoughts. Complications such as these, following a traumatic event are often referred to as post traumatic stress disorder .PTSD is often associated with war veterans, military personnel and first responders of emergency services. Sadly this condition is not limited to work related experiences and affects people throughout the UK for various reasons.
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Understanding Generalized Anxiety Disorder
Generalized anxiety disorder goes well beyond the normal worrying and fretting that most people experience. It is defined as the excessive worry about subjects or events that persist at least six months.
The anxiety is something the person cant seem to control with the object of worry often switching from one thing to the next. The worrying ultimately takes up a lot of a persons day with little relief and to the point where relationships and work are affected.
A person is diagnosed with GAD in the presence of at least three of the following physical or cognitive symptoms:
- Edginess or restlessness
- Impaired concentration or feeling as if ones mind suddenly goes blank
- Irritability, either internalized or externalized
- Increased muscle tension
- Difficulty sleeping or unsatisfying sleep
In order to confirm a diagnosis, the symptoms cannot be explained by any other causes or conditions including prescription medications, alcohol use, illicit drug use, neurological problems, or another medical condition.
Do I Have Ptsd Or Anxiety
Do you experience feelings of panic, nightmares, chronic worries or nervousness? If so, you may be suffering from anxiety. Anxiety is a common but very serious problem that can affect every aspect of your life. Posttraumatic stress disorder is a type of anxiety problem that can lead to even greater levels of anxiety and problems over time.
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When It Is Ptsd
As you probably noticed, there are many symptoms of PTSD, and very few people have all of them. Also, not everyone who experiences a trauma will develop PTSD. So how do you know if you might have PTSD? Here are 2 tips that might be helpful:
Tip #1: If you have at least 1 symptom in each of the 4 categories, and your symptoms only started AFTER a traumatic event, then you might have PTSD. If your anxiety symptoms were already present before the trauma, then it is probably not PTSD.
Tip #2: It is normal to feel more anxious right after a trauma. But over time, these anxious feelings will settle down. If these symptoms do not settle down then you might have PTSD.
How Is Anxiety Different Than Ptsd
When the average person hears anxiety, we start thinking pre-existing issues like Generalized Anxiety Disorder among others. Unlike PTSD, traumatic events dont necessarily have to happen for a person to experience anxiety symptoms. The difference between PTSD and anxiety can be tricky to pinpoint, especially when soldiers with history of mental health issues like anxiety are then exposed to extremely traumatic experiences in their military service. Their symptoms may be re-aggravated or made worse. Because every person is different and reacts differently to situations based on their coping skills, morals, values, and experiences in life reactions to those events will be different as well. Where one person may not have any lasting mental health condition to an event, another may develop PTSD. We do not know what causes one person to develop certain conditions and others to not, but we continue to try to understand and treat them.
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Where Can I Find Support
Having an under-recognized condition like CPTSD can be isolating. If you feel like you need some extra support, the National Center for PTSD has several resources, including a PTSD coaching app for your phone. While many of these resources are geared toward people with PTSD, you may still find them helpful for many of your symptoms.
The nonprofit organization Out of the Storm also has many online resources, including a forum, information sheets, and book recommendations, specifically for CPTSD.
What Are The Risk Factors For Ptsd
There are many risk factors for developing PTSD. Recognizing and addressing them can help prevent PTSD, when possible. These risk factors include:
- Lack of family or social support resources
- Repeated exposure to traumatic circumstances
- Personal history of trauma or of an acute stress or anxiety disorder
- Family history of mental health disorders
- Personality traits of vulnerability and a lack of resilience
- History of childhood trauma
- Personality disorder or traits including borderline personality disorder, paranoia, dependency, or antisocial tendencies
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Demographic And Descriptive Characteristics
The study was completed with a total of 447 adolescents, 171 men and 276 women . The mean age of participants was 15.06 years. 27.3% of the participants live in rural areas and 72.7% in urban areas. The participants were asked whether they, their family members or those in their environment were infected with COVID-19 and death due to COVID-19 in the family or environment. According to the answers, 3.4% of the participants stated that they were infected with COVID-19 and 3.8% stated that their family members or individuals in their environment were infected. None of the participants reported death due to COVID-19 in their family or environment. Descriptive data are shown in Table .
- Abbreviations: 95% CI, 95% confidence interval COVID-19, 2019 Coronavirus disease PTSD, post-traumatic stress disorder.
Ptsd And Other Anxiety Disorders
Besides PTSD, mental health disorders that are classified as anxiety disorders are acute stress disorder, social anxiety disorder, panic disorder , and obsessive-compulsive disorder.
People with PTSD have been found to be at greater risk of having all of these disorders. This overview provides the rates of these anxiety disorders among people with PTSD.
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Ptsd Symptoms: Difficult But Totally Normal
Maybe you experience nightmares or flashbacks. The anxiety they bring can show up without warning, like the worst kind of surprise houseguest. And you might find yourself sucked into quicksand-like swamps of anger or guilt.
The good news: All of those symptoms are normal. You might be thinking, Thats supposed to be good news? But understanding where your symptoms are coming from is the first step toward healing. And you can heal and recover from PTSD it will just take some time, says psychiatrist Molly Wimbiscus, MD.