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PTSD In Civilians

Post-traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur after a traumatic experience. Many people think of military combat and war veterans when they think about PTSD since PTSD has been portrayed as a combat issue from what we could find, dating back to ancient Greek warriors. Homer Iliad’s stories from the battles and events between King Agamemnon and the warrior Achilles are still used today for military men and women transitioning back into civilization. The truth is, PTSD is not only a military issue. PTSD can develop from experiences with natural disasters, serious accidents, life-threatening illnesses, physical abuse, and sexual assault during childhood or adulthood. Therapists and researchers have developed PTSD symptoms into four subgroups: intrusive symptoms, avoidance symptoms, negative alterations in cognition and mood, and alterations in arousal and reactivity. Most individuals with PTSD have reported experiencing at least one intrusion symptom, one avoidance symptom, two cognition and mood symptoms, and two arousal and reactivity symptoms. It is also common for people with PTSD to express symptoms of depression.

Intrusion Symptoms:

  • Unwanted, distressing memories of the traumatic event(s)
  • Recurring trauma-related nightmares
  • Flashbacks – involuntary and vivid re-experienceing of the traumatic experience(s)
  • Intense emotional distress and/or noticeable physiological reactions to trauma reminders

Avoidance Symptoms:

  • Persistent avoidance of thoughts and memories related to the trauma
  • Persistent avoidance of external reminders of the trauma (e.g. the location at which the trauma occurred or people that remind you of the trauma)

Negative Alterations in Cognitions and Mood:

  • A complete lapse in memory of or a feeling of blacking out for parts of the trauma
  • Perpetual negative expectations of the world
  • Continuous, misattributed blame of self or others about the traumatic event
  • Persistent negative emotional state and/or the inability to experience positive emotions
  • Loss of interest or participation in significant activities or activities once interested in
  • Feelings of detachment from others, as well as feeling like others cannot relate or understand the trauma and emotional burden

Alterations in Arousal and Reactivity

  • Easily irritable or angry
  • Reckless or self-destructive behavior
  • More alert
  • Easily startled
  • Problems with concentration
  • Difficulties sleeping, including falling asleep and/or staying asleep

Treating and coping with traumatic experiences is undoubtedly difficult. Talking about one of the most disturbing experiences of an individual’s past can be extremely difficult. Seeking help takes courage and willingness for them to vulnerable, which may be difficult for some. Three common types of therapy have proven to help with PTSD.

  1. Prolonged Exposure Therapy (PE) is the gold-standard for PTSD treatment. Generally it consists of 10-15 therapy sessions. The two core components are imaginal exposures (repeated confrontation with the traumatic memories) and vivo exposures (systematic confrontation with avoided trauma-related situations). Other components include processing of the imaginal exposure experience, education about common reactions to trauma, and anxiety management (controlled breathing).
  2. Cognitive Processing Therapy (CPT) targets irrational thinking and cognitive distortions in therapy to help patients process their trauma memories. The four main components of CPT are learning about your PTSD symptoms, becoming aware of thoughts and feelings, learning skills to manage the thoughts and feelings, and understanding the changes in beliefs that occur because of the traumatic experience. Self-blame and feeling powerless against all danger are two common examples of distorted thinking. Patients will write out their trauma narrative and work with a therapist to uncover cognitive distortions.
  3. Eye Movement Desensitization and Reprocessing (EDMR) exposes an individual to traumatic memories with varying stimuli, such as eye movements.

There are other treatment options available, but these three are more frequently used for PTSD patients. Whether you are a veteran, military service member, elementary school student, or salesperson PTSD can develop in any of us. If it does please know that help is available and you don’t have to face it alone.

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