C ptsd physical symptoms

Symptoms, Tests, Treatment, and Finding Support

What is complex post-traumatic stress disorder?

Most people are familiar with post-traumatic stress disorder (PTSD), an anxiety disorder that results from a traumatic event, such as a natural disaster or car accident.

However, a closely related condition called complex post-traumatic stress disorder (CPTSD) is becoming more widely recognized by doctors in recent years. CPTSD results from repeated trauma over months or years, rather than a single event.

The symptoms of CPTSD usually include those of PTSD, plus an additional set of symptoms.

Symptoms of PTSD

Reliving the traumatic experience

This can include having nightmares or flashbacks.

Avoiding certain situations

You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.

Changes in beliefs and feelings about yourself and others

This can include avoiding relationships with other people, not being able to trust others, or believing the world is very dangerous.

Hyperarousal

Hyperarousal refers to constantly being on-alert or jittery. For example, you might have a hard time sleeping or concentrating. You might also be unusually startled by loud or unexpected noises.

Somatic symptoms

These refer to physical symptoms that don’t have any underlying medical cause. For example, when something reminds you of the traumatic event, you might feel dizzy or nauseated.

Symptoms of CPTSD

People with CPTSD typically have the above PTSD symptoms along with additional symptoms, including:

Lack of emotional regulation

This refers to having uncontrollable feelings, such as explosive anger or ongoing sadness.

Changes in consciousness

This can include forgetting the traumatic event or feeling detached from your emotions or body, which is also called dissociation.

Negative self-perception

You may feel guilt or shame, to the point that you feel completely different from other people.

Difficulty with relationships

You might find yourself avoiding relationships with other people out of mistrust or a feeling of not knowing how to interact with others. On the other hand, some might seek relationships with people who harm them because it feels familiar.

Distorted perception of abuser

This includes becoming preoccupied with the relationship between you and your abuser. It can also include preoccupation with revenge or giving your abuser complete power over your life.

Loss of systems of meanings

Systems of meaning refer to your religion or beliefs about the world. For example, you might lose faith in some long-held beliefs you had or develop a strong sense of despair or hopelessness about the world.

It’s important to note that symptoms of both PTSD and CPTSD can vary widely between people, and even within one person over time. For example, you might find yourself avoiding social situations for a period of time, only to start seeking potentially dangerous situations months or years later.

If you’re close to someone with CPTSD, it’s also important to remember that their thoughts and beliefs might not always match up with their emotions. They might know that, logically, they should avoid their abuser. However, they might also hold onto a sense of affection toward them.

Researchers are still trying to figure out exactly how traumatic stress affects the brain and leads to conditions like CPTSD. However, studies on animals suggest that trauma can have lasting effects on the amygdala, hippocampus, and prefrontal cortex. These areas play a big role in both our memory function and how we respond to stressful situations.

Any type of long-term trauma, over several months or years, can lead to CPTSD. However, it seems to appear frequently in people who’ve been abused by someone who was supposed to be their caregiver or protector. Examples include survivors of human trafficking or ongoing childhood sexual abuse by a relative.

Other examples of long-term trauma include:

ongoing physical, emotional, or sexual abuse
being a prisoner of war
living in an area of war for long periods of time
ongoing childhood neglect

While anyone can develop CPTSD, some people may be more likely to develop it than others. Aside from having past traumatic experiences, risk factors include:

underlying mental illness, such as anxiety or depression, or a family history of it
inherited personality traits, which is often referred to as temperament
how your brain regulates hormones and neurochemicals, especially in response to stress
lifestyle factors, such as not having a strong support system or having a dangerous job

CPTSD is still a relatively new condition, so some doctors aren’t aware of it. This can make it hard to get an official diagnosis, and you might be diagnosed with PTSD instead of CPTSD. There’s no specific test for determining whether you have CPTSD, but keeping a detailed log of your symptoms can help your doctor make a more accurate diagnosis. Try to keep track of when your symptoms started as well as any changes in them over time.

Once you find a doctor, they’ll start by asking about your symptoms, as well as any traumatic events in your past. For the initial diagnosis, you likely won’t need to go into too much detail if it makes you uncomfortable.

Next, they may ask about any family history of mental illness or other risk factors. Make sure to tell them about any medications or supplements you take, as well as any recreational drugs you use. Try to be as honest as you can with them so they can make the best recommendations for you.

If you’ve had symptoms of post-traumatic stress for at least a month and they interfere with your daily life, your doctor will likely start with a diagnosis of PTSD. Depending on the traumatic event and whether you have additional symptoms, such as ongoing relationship problems or trouble controlling your emotions, they may diagnose you with CPTSD.

Keep in mind that you may need to see a few doctors before you find someone you feel comfortable with. This is very normal, especially for people dealing with post-traumatic stress.

There are several treatment options for CPTSD that can both reduce your symptoms and help you better manage them.

Psychotherapy

Psychotherapy involves talking with a therapist either alone or in a group. It also includes the use of cognitive behavioral therapy (CBT). This type of treatment helps you identify negative thought patterns and gives you tools to replace them with more healthy, positive thoughts.

Your doctor might also recommend dialectical behavioral therapy, a type of CBT that helps you better respond to stress and build stronger relationships with others.

Eye movement desensitization and reprocessing (EMDR)

EMDR is commonly used to treat PTSD, and it can be helpful for CPTSD as well. You’ll be asked to briefly think about a traumatic moment while moving your eyes from side to side. Other techniques include having someone tap on your hands instead of moving your eyes. Over time, this process may help to desensitize you to traumatic memories and thoughts.

While there’s some debate within the medical community over its use, the American Psychological Association conditionally recommends it for PTSD. This means that they recommend it but additional information is still needed due to insufficient evidence.

Medication

Medications traditionally used to treat depression can also help with symptoms of CPTSD. They tend to work best when combined with another form of treatment, such as CBT. Common antidepressants used for CPTSD may include:

sertraline (Zoloft)
paroxetine (Paxil)
fluoxetine (Prozac)

While some people benefit from using these medications long term, you may only need to take them for a short period of time while you learn new coping strategies.

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.

Symptoms, Tests, Treatment, and Finding Support

What is complex post-traumatic stress disorder?

Most people are familiar with post-traumatic stress disorder (PTSD), an anxiety disorder that results from a traumatic event, such as a natural disaster or car accident.

The symptoms of CPTSD usually include those of PTSD, plus an additional set of symptoms.

Symptoms of PTSD

Reliving the traumatic experience

This can include having nightmares or flashbacks.

Avoiding certain situations

You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.

Changes in beliefs and feelings about yourself and others

This can include avoiding relationships with other people, not being able to trust others, or believing the world is very dangerous.

Hyperarousal

Hyperarousal refers to constantly being on-alert or jittery. For example, you might have a hard time sleeping or concentrating. You might also be unusually startled by loud or unexpected noises.

Somatic symptoms

These refer to physical symptoms that don’t have any underlying medical cause. For example, when something reminds you of the traumatic event, you might feel dizzy or nauseated.

Symptoms of CPTSD

People with CPTSD typically have the above PTSD symptoms along with additional symptoms, including:

Lack of emotional regulation

This refers to having uncontrollable feelings, such as explosive anger or ongoing sadness.

Changes in consciousness

This can include forgetting the traumatic event or feeling detached from your emotions or body, which is also called dissociation.

Negative self-perception

You may feel guilt or shame, to the point that you feel completely different from other people.

Difficulty with relationships

Distorted perception of abuser

This includes becoming preoccupied with the relationship between you and your abuser. It can also include preoccupation with revenge or giving your abuser complete power over your life.

Loss of systems of meanings

Other examples of long-term trauma include:

ongoing physical, emotional, or sexual abuse
being a prisoner of war
living in an area of war for long periods of time
ongoing childhood neglect

While anyone can develop CPTSD, some people may be more likely to develop it than others. Aside from having past traumatic experiences, risk factors include:

underlying mental illness, such as anxiety or depression, or a family history of it
inherited personality traits, which is often referred to as temperament
how your brain regulates hormones and neurochemicals, especially in response to stress
lifestyle factors, such as not having a strong support system or having a dangerous job

Keep in mind that you may need to see a few doctors before you find someone you feel comfortable with. This is very normal, especially for people dealing with post-traumatic stress.

There are several treatment options for CPTSD that can both reduce your symptoms and help you better manage them.

Psychotherapy

Your doctor might also recommend dialectical behavioral therapy, a type of CBT that helps you better respond to stress and build stronger relationships with others.

Eye movement desensitization and reprocessing (EMDR)

Medication

sertraline (Zoloft)
paroxetine (Paxil)
fluoxetine (Prozac)

While some people benefit from using these medications long term, you may only need to take them for a short period of time while you learn new coping strategies.

The nonprofit organization Out of the Storm also has many online resources, including a forum, information sheets, and book recommendations, specifically for CPTSD.

PTSD

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Variant of Acrobat Samana Gaze | Acrobat Reader Samana Download

PTSD is a normal response
for severe traumatic events.
This booklet deals with signs,
symptoms and treatments for PTSD.

New York State
Department of Mental Health

Have you experienced a terrible and dangerous event? Note please, those cases in which you recognize yourself.

Sometimes, out of the blue, everything that happened to me is happening again. I never know when to expect it again.
I have nightmares and memories of the terrible incident which I have experienced.
I avoid places that remind me of that incident.
I jump on the spot and feel uneasy at any sudden movement or surprise. I feel alert all the time.
It's hard for me to trust someone and get close to someone.
Sometimes I just feel emotionally drained and deaf.
I get angry very easily.
I am tormented by guilt that others died, but I survived.
I sleep poorly and experience muscle tension.

PTSD is a very serious condition that needs to be treated.

Many people who have experienced terrible events suffer from this disease.

It is not your fault that you fell ill, and you should not suffer from it.

Read this booklet to find out how you can be helped.

You can get well and enjoy life again!

What is post-traumatic stress disorder (PTSD/PTSD)?

PTSD is a very serious condition. PTSD symptoms may occur in a person who has experienced a terrible traumatic event. This disease is susceptible medical and therapeutic treatment.

PTSD can occur after you:

Have been a victim of sexual abuse
Have been a victim of physical or emotional domestic violence
Victim of a violent crime
Been in a car accident or plane crash
Survived a hurricane, tornado, or fire
Were at war
Survived a life-threatening event
Witnessed any of the above events

If you have post-traumatic stress disorder, you often have nightmares or memories associated with the event. you try to hold on away from anything that might remind you of the experience.

You are bitter and unable to trust or care for others. You are always on your guard and see a hidden threat in everything. You become not by itself, when something happens suddenly and without warning.

When does PTSD start and how long does it last?

In most cases, post-traumatic stress manifests itself approximately three months after the traumatic event. In some cases, signs Post-traumatic stress symptoms only show up years later. Post-traumatic Stress affects people of all ages. Even children are not immune from it.

Some get better after six months, others may suffer from it illness for much longer.

Am I the only one with this disease?

No, you are not alone. Every year, 5.2 million Americans suffer from PTSD.

Women suffer from this disease two and a half times more often than men. The most common traumatic events that cause PTSD in men are: rape, participation in hostilities, abandonment and abuse in childhood. The most traumatic events in women are rape, sexual molestation, physical assault, threat weapons and childhood abuse.

What other conditions can accompany PTSD?

Common depression, alcoholism and drug addiction, or other anxiety disorders. The likelihood of successful treatment increases if these comorbidities to identify and treat in time.

Frequent headaches, gastroenterological problems, problems with the immune system, dizziness, chest pain or discomfort in other parts of the body. It often happens that a doctor treats physical symptoms, unaware that their cause lies in PTSD.

The National Institute of Mental Health (NIMH) recommends therapists to learn from patients about experiences of violence, recent losses and traumatic events, especially when symptoms persist are returning. After diagnosing PTSD, it is recommended to refer patient to a mental health specialist who has experience in the treatment of patients with PTSD.

What should I do to help myself in this situation?

Talk to your doctor and tell him about your experience, and how you feel. If you are visited by terrible memories, overcomes depression and sadness if you have trouble sleeping and constantly embittered - you should tell your doctor about all this. Tell him Are any of these conditions preventing you from doing your daily activities? lead a normal life. You may want to show this booklet to your doctor. This may help explain to him how you feel. Ask your doctor examine you to make sure there are no physical illnesses.

Ask your doctor if he has had patients with post-traumatic stress. If your doctor does not have a special preparation, ask him for directions to doctor with relevant experience.

How can a doctor or psychotherapist help me?

Your doctor may prescribe medicine to help reduce your fear or tension. However, it should be borne in mind that usually several weeks before the medicine starts to work.

Many PTSD sufferers benefit from talking with a professional or other people who have experienced traumatic events. This is called "therapy". Therapy will help you get over your nightmare.

One man's story:
"After I was attacked, I He constantly felt fear and depression, became irritable. I couldn't sleep well and lost my appetite. Even when I tried not think about what happened, I was still tormented nightmares and terrible memories.

“I was completely at a loss and didn't know what to do. one buddy advised to see a doctor. My doctor helped me find a specialist in post-traumatic stress."

“I needed a lot of strength, but after medication and a course of therapy, I gradually come to my senses. It’s good that I called my doctor then.”

PTSD and the military

If you are in the military, you have probably been in combat. You, probably got into terrible and life-threatening situations. They shot at you you have seen your friend shot, you have seen death. experienced you events can cause PTSD.

Experts say that PTSD occurs:

Nearly 30% of Vietnam War veterans
Nearly 10% of Gulf War veterans (Operation Desert Storm)
Almost 25% of veterans of the war in Afghanistan (operations "Introducing freedom") and veterans of the war in Iraq (operations "Iraqi Freedom")

Other factors of the military situation can serve as an additional stress to and so stressful situation and can contribute to the development of PTSD and other mental problems. Among these factors are the following: your military specialty, the political aspects of the war, where the battle takes place and who your enemy is.

Another reason that contributes to PTSD in military personnel can be Military Sexual Assault (MST) – any form of sexual harassment or sexual abuse while serving in the military. MST can happen with men and women, and can occur in peacetime, during war training or during the war.

Veterans Affairs (VA) health care approximately:

23 out of 100 women (23%) report sexual violence during military service
55 out of 100 women (55%) and 38 out of 100 men (38%) were exposed to sexual harassment while serving in the army

Although the trauma of sexual assault is more common in the military among women, more than half of veterans who have experienced sexual trauma violence in the army - it's men.

Remember, you can get the help you need right now:

Tell your doctor about your experience and how you feel. If your doctor does not have special training in the treatment of PTSD, ask him for a referral to a doctor who has relevant experience.

PTSD research

To help those suffering from PTSD, the National Institute of Conservation Mental Health (NIMH) supports research into the study of PTSD, as well as other thematically related to PTSD research on problems anxiety and fear. The challenge for research is to find new ways to help people cope with trauma, as well as find new treatment options and, The main thing is to prevent disease.

Research on possible risk factors for PTSD

Today, the attention of many scientists is focused on genes that play a role in having terrible memories. Understanding the mechanism of "creation" of scary memories can help improve or find new ways to alleviate symptoms of PTSD. For example, PTSD researchers have identified genes that are responsible for:

Statmin is a protein involved in the formation of terrible memories. During one experiment, mice were placed in environment designed to instill fear in them. In this situation mice lacking the statmin gene, in contrast to normal mice were less likely to "freeze" - i.e. exercise natural defensive response to danger. Also in the environment designed to evoke innate fear in them, they demonstrated it to a lesser extent than normal mice, more willingly mastering the open "dangerous" space. ¹

GRP (gastrin-releasing peptide/GRP) - signal substance brain released during emotional events. At in mice, GWP helps control the fear response, and lack of GWP can lead to a longer memory of fear. ²

Scientists have also discovered a variant of the 5-HTTLPR gene that controls serotonin (a brain substance associated with mood), which, as it turns out, feeds the fear response. ³ It seems that, like in the case of other mental disorders, in the development of PTSD different genes are involved, each of which contributes to the formation of the disease.

Understanding the causes of PTSD can also be helped by studying different areas brain responsible for fear and stress. One of these areas is cerebellar amygdala, responsible for emotions, learning and memory. It turned out that she plays an active role in the emergence of fear (or other words, "teaches" to be afraid of something, for example, to touch a hot stove), as well as in the early phases of fear repayment (or in other words, "teaches" Do not be scared). ⁴

The retention of faded memories and the weakening of the initial fear reaction are associated with the prefrontal cortex (PFC / PFC) of the brain, ⁴ responsible for decision making, problem solving and situation assessment. Each zone PFC has its own role. For example, when the PFC believes that a stressor is amenable to control, the medial prefrontal zone of the PFC suppresses the anxiety center deeply in the brainstem and controls the response to stress. ⁵ Ventromedial PFC helps maintain long-term fading of fearful memories, and her ability to perform this feature can be affected by its size. ⁶

Individual differences in genes or characteristics of regions of the brain brain can only set the stage for PTSD, but by themselves do not cause no symptoms. environmental factors such as childhood trauma, head trauma or mental illness in family, favor the development of the disease and increase the risk of disease, affecting the brain in the early stages of its growth. ⁷ Except In addition, how people adapt to trauma is likely to be influenced by and characteristics of character and behavior, such as optimism and a tendency to consider problems in a positive or negative way, as well as social factors such as availability and use of social support. ⁸ Further research may show what combination of these factors or what other factors will allow ever predict who has a traumatic event cause PTSD, and who doesn't.

PTSD research

Currently, psychotherapy is used in the treatment of PTSD ("talk" therapy), drugs or drug-therapeutic combination.

Psychotherapy

Cognitive behavioral therapy (CBT) helps you learn differently think and react to frightening events that are the impetus for development PTSD, and can help bring the symptoms of the disease under control. There are several types cognitive behavioral therapy, including:

"Push" method - uses mental images, notes or visiting a place experienced trauma to help those affected face the overwhelming their fear and take control of it.

Behavior restructuring (cognitive restructuring) - encourages survivors of a traumatic event express depressing (often erroneous) thoughts about experienced trauma, challenge these thoughts and replace them with more balanced and appropriate.

Implementation in a stressful situation - teaches ways to reduce anxiety and the ability to cope with it, helping to reduce the symptoms of PTSD, and helps to correct the erroneous train of thought associated with the trauma experienced. NIMH is currently conducting research to study the reaction brain response to cognitive behavioral therapy versus response sertraline (Zoloft) - one of two drugs recommended and approved US Food and Drug Administration funds (FDA) for the treatment of post-traumatic stress. This research may help find out why some people respond better to medications, and others for psychotherapy

Drugs

Recently, in a small study, NIMH scientists found that if patients who are already taking a dose of prazosin (Minipress) at bedtime, add a daily dose, then this weakens the general symptoms of PTSD and stress reaction to reminders of the trauma experienced. ⁹

Another drug of interest is D-cycloserine (Seromycin), which increases the activity of a brain substance called N-methyl-D-aspartate, needed to pay off fear. During the study, which was attended by 28 people suffering from a fear of heights, scientists found that patients who received "push" therapy before a session D-cycloserine, showed lower levels of fear during the session compared to those who did not receive the drug. ¹⁰ Currently scientists study the effectiveness of the combined use of D-cycloserine and therapy for the treatment of post-traumatic stress.

Propranolol (Inderal), a beta-blocker drug, also under study whether it can be used to reduce post-traumatic stress and break the chain of scary memories. First experiments gave consoling results: it was possible to successfully weaken and, it seems, prevent PTSD in a small number of victims of traumatic events. ¹¹

For example, in one preliminary study, scientists created a website self-help, based on the use of a psychotherapeutic method implementation in a stressful situation. First, patients with PTSD meet in person with doctor. After this meeting, participants can go to the site to find more information about PTSD and how to deal with the problem; their doctors may also visit the site to give advice or briefing. In general, scientists believe that therapy in this form - promising treatment for a large number of people suffering from PTSD. ¹²

Scientists are also working to improve methods for testing early treatment and monitoring of survivors of massive trauma, on developing ways to teach them self-assessment skills and introspection and referral mechanism to psychiatrists (if necessary).

Prospects for PTSD research

In the last decade, rapid progress in the study of mental and biological PTSD has led scientists to conclude that there is a need to focus on prevention, as the most realistic and important goal.

For example, in order to find ways to prevent PTSD, with funding NIMH conducts research to develop new and orphan drugs, aimed at combating the underlying causes of the disease. During another research scientists are looking for ways to enhance behavioral, personality and social protective factors and minimizing risk factors for prevent the development of PTSD after trauma. Another study is studying the question of what factors influence the difference in response to one or another method of treatment, which will help in the development of more individual, effective and productive methods of treatment.

Where can I find more information?

MedlinePlus - resource from the American National Library of Medicine (U.S. National Library of Medicine and the National Institutes of Health) - offers the latest information on many health issues. Information about You can find PTSD at: www.nlm.nih.gov/medlineplus/posttraumaticstressdisorder.html.

National Institute of Mental Health
Office of Science Policy, Planning, and Communications
[National Institute of Mental Health
Science Policy Division research, planning and communications]
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513; Fax: 301-443-4279
fax answering system Free answering machine: 1-866-615-NIMH (6464)
Text phone: 1-866-415-8051 toll-free
Email: nimhinfo@nih. gov

National Center for Post-traumatic Stress Disorder
[National PTSD Center]
VA Medical Center (116D)
215 North Main Street
White River Junction, VT 05009
802-296-6300
www.ncptsd.va.gov

NOTES

Shumyatsky GP, Malleret G, Shin RM, et al. Stathmin, a Gene Enriched in the Amygdala, Controls Both Learned and Innate Fear. cell. Nov 18 2005;123(4):697-709.
Shumyatsky GP, Tsvetkov E, Malleret G, et al. Identification of a signal network in lateral nucleus of amygdala important for inhibiting memory specifically related to learned fear. cell. Dec 13 2002;111(6):905-918.
Hariri AR, Mattay VS, Tessitore A, et al. Serotonin transporter genetic variation and the response of the human amygdala.Science. Jul 192002;297(5580):400-403.
Milad MR, Quirk GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. Nov 7 2002;420(6911):70-74.
5 Amat J, Baratta MV, Paul E, Bland ST, Watkins LR, Maier SF. Medial prefrontal cortex determines how stressor controllability affects behavior and dorsal raphe nucleus. Nat Neurosci. Mar 2005;8(3):365-371.
Milad MR, Quinn BT, Pitman RK, Orr SP, Fischl B, Rauch SL. Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory. Proc Natl Acad Sci USA. Jul 26 2005;102(30):10706-10711.
Gurvits TV, Gilbertson MW, Lasko NB, et al. Neurological soft signs in chronic posttraumatic stress disorder.Arch Gen Psychiatry. Feb 2000;57(2):181-186.
Brewin CR. Risk factor effect sizes in PTSD: what this means for intervention. J Trauma Dissociation. 2005;6(2):123-130.
Taylor FB, Lowe K, Thompson C, et al. Daytime Prazosin Reduces Psychological Distress toTrauma Specific Cues in Civilian Trauma Posttraumatic stress disorder. Biol Psychiatry. Feb 3 2006.
Ressler KJ, Rothbaum BO, Tannenbaum L, et al. Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Arch Gen Psychiatry. Nov 2004;61(11):1136-1144.
Pitman RK, Sanders KM, Zusman RM, et al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.Biol Psychiatry. Jan 15 2002;51(2):189-192.
Litz BTWL, Wang J, Bryant R, Engel CC.A therapist-assisted Internet self-help program for traumatic stress. Prof Psychol Res Pr. December 2004;35(6):628-634.

New York State Department of Mental Health expresses thanks to the National Institute of Mental Health for the information, used in this booklet.

Published by the State Department of Mental Health New York, June 2008.

New York State
Andrew M. Cuomo Governor

Mental Health
Head of Department Michael F. Hogan, PhD
For more information about this edition contact:
New York State Office of Mental Health
Community Outreach and Public Education Office
[New York State Department of Mental Health
Public Relations and Community Education Department]
44 Holland Avenue
Albany, NY 12229
866-270-9857 (toll free)
www.omh.ny.gov

For questions and complaints about mental health services Health in New York contact:
New York State Office of Mental Health
Customer Relations
[New York State Department of Mental Health
Customer Service ]
44 Holland Avenue
Albany, NY 12229
800-597-8481 (toll-free)

For information about mental health services in your neighborhood, contact
nearest New York State Department of Mental Health (NYSOMH) regional office:
Western New York Field Office
[Western New York Regional Office]
737 Delaware Avenue, Suite 200
Buffalo, NY 14209
(716) 885-4219

Central New York Field Office
[Central New York Regional Office]
545 Cedar Street, 2nd Floor
Syracuse, NY 13210-2319
(315) 426-3930

Hudson River Field Office
[Hudson River Regional Office]
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Long Island Field Office
[Long Island Regional Office]
998 Crooked Hill Road, Building #45-3
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(631) 761-2508

New York City Field Office
[NYC Regional Office]
330 Fifth Avenue, 9th Floor
New York, NY 10001-3101
(212) 330-1671

PTSD: what it is, symptoms, treatment

Psychological trauma can sit inside us for years and decades, undermining strength and exacerbating pain from time to time. A practicing psychologist talks about the nature of post-traumatic stress disorder and explains what might help to cope with it.

Arkady Volkov, psychotherapist, specialist of the service for the selection of psychologists Alter

Advertising on RBC www.adv.rbc.ru

What is PTSD

Each person has many mechanisms and resources at their disposal to help them cope with difficult events, cope with difficulties, endure grief and loss, overcome disappointments and tragedies. Nevertheless, sometimes we are faced with an event that, for one reason or another, we cannot cope with: it does not fit into our personal experience at all and turns out to be an insurmountable shock. Such events, usually associated with a real or perceived risk to life and health, are usually called traumas, and they can cause post-traumatic stress disorder - a mental disorder as a result of encountering a traumatic situation.

Studies show that almost 4% of people suffer from PTSD at least once during their lives. At the same time, statistics in different countries vary significantly: in China, 0.3% of respondents faced the problem, in the Netherlands — 7.4%, in Canada — 9.2% [1], [2].

Symptoms of PTSD

Two major medical diagnostic guidelines (DSM-5, the American Psychiatric Association's guidelines and ICD-11, the World Health Organization's classification) currently state the following criteria to conclude that a person is suffering from PTSD:

Encounter with a life or limb threatening situation. At the same time, PTSD can develop in a situation where a person has become a victim of such an event, and if he was a witness to it, or if a similar event happened to his loved ones. This criterion also applies to professionals who, by the nature of their work, are faced with the consequences of traumatic events: doctors, firefighters, crisis psychologists, and so on.
Presence of at least one of the symptoms of involuntary intrusive and disturbing memories of the event, nightmares, flashbacks, distressing experiences, or a physical reaction in situations that are reminiscent of the event.
Avoidance of memories and thoughts about the event or anything that can remind of it.
Disturbances in thinking and emotional state due to the experienced event: inability to remember important aspects of what happened, negative thoughts and beliefs about oneself and the world around, blaming oneself or others that the traumatic event occurred, lowered mood and negative emotions, decreased interest in the world around , feelings of isolation and alienation, reduced ability to experience positive emotions.
Changes such as irritability and outbursts of anger, aggressive and dangerous behavior to oneself or others, increased alertness, startle response to minor stimuli, trouble concentrating and sleeping.

To be diagnosed, the listed symptoms must last more than one month and cause significant distress or social difficulties.

It is important to note that PTSD is often accompanied by other disorders, primarily depressive ones.

Diagnosis of PTSD, like any other mental disorder, can only be diagnosed by a qualified specialist, but yes to the following questions may be a reason to seek advice and get help (or just be more attentive to yourself or a loved one).

During your life, have you experienced or witnessed any traumatic event (such as an accident, fire, extreme disaster, physical attack on you or your loved ones)?

During the last month:

Did you return to this event in your thoughts (not wanting it) or dreams?
Did you make an effort not to think about this event and avoid being reminded of it?
Were you more tense than usual?
Have you ever been frightened for minor reasons?
Did you feel alienated from your usual activities and loved ones?
Did you feel guilty or blame yourself or others for the event?

Causes and risk factors

There is still no definite answer to the question of what exactly causes PTSD. But research has led to some important assumptions.

At the physiological level, the development of PTSD can be triggered by:

Increased levels of stress hormones

In case of danger, our body produces stress hormones, such as adrenaline, in order to switch into an active mode and somehow escape from the threat (this reaction is often called "fight or flight"). PTSD victims continue to produce large amounts of stress hormones even when the danger is no longer around. This can cause hyperarousal and emotional changes, and can also cause long-term negative health effects, including migraines, pain, and an increased risk of heart, lung, and digestive problems.

Changes in brain function

Trauma-induced stress can damage the hippocampus, the part of the brain involved in the formation of emotions and memory.

Hippocampal disorders can interfere with the proper processing of memories and dreams, so the anxiety they cause does not decrease over time. Such changes may explain the increased levels of fear and anxiety, memory and recall problems suffered by PTSD victims.

Factors that can increase susceptibility to PTSD:

Previous traumatic experiences. The stress of a trauma can have a cumulative effect, and a new traumatic experience can exacerbate the negative effects of a previous trauma.
Experience of violence. People with a history of physical, emotional or sexual abuse tend to be more susceptible to post-traumatic stress.
PTSD or depression in loved ones.
Substance use experience.
Lack of skills to cope with traumatic situations.
Lack of social support. Good social and family relationships help mitigate the effects of stress and trauma. Conversely, people who lack supportive relationships and environments tend to be more vulnerable to stress and therefore more at risk for PTSD. Being in a social environment that cultivates shame, guilt, stigma, or self-hatred also contributes to the development of post-traumatic stress disorder.
High level of stress in everyday life.

Treatment of PTSD

Approaches to the treatment of PTSD can be divided into two groups: medication and psychotherapy. Often methods of both groups are used in different combinations.

There are currently no medications specifically designed for the treatment of PTSD, but there are many medications that have worked well for other conditions such as depression and anxiety disorders and have been shown to be effective in treating the symptoms of PTSD.

When it comes to psychotherapeutic methods, or "healing with a word", there are several approaches that demonstrate the greatest (and research-supported) effectiveness.

Cognitive Process Therapy

In this approach, the therapist invites the client to talk about the traumatic event and its aftermath and describe the experience in detail in a diary, which allows them to better see how the trauma is reflected in thoughts and find new ways to deal with it [3 ].

EMDR - eye movement desensitization and processing

This approach is based on the notion that trauma disrupts the natural coping mechanisms inherent in each person and cannot be built into his experience and memory. The person is asked to focus on an external stimulus (eye movements from side to side, directed by the therapist) and in parallel work through complex memories, thoughts and emotions associated with the trauma [4].

Body and creativity oriented approaches

Body Oriented Therapy aims to find resources through attention to bodily sensations, as well as gaining the opportunity to relive the traumatic experience from the position of an active actor, not a victim. Similar goals are set by approaches that use dance and participation in theatrical productions to gain the freedom and spontaneity that PTSD often deprives its victims of [5].

Living with PTSD

Trauma has a huge impact on many areas of our lives, but this does not mean that the problem cannot be solved, even if for one reason or another you do not have access to professional help.

Of particular difficulty in working with PTSD is the very pain and severity of the traumatic experience, which often makes it necessary to avoid any reminders of the trauma, excluding the possibility of talking about it, as well as the destructive consequences for the view of oneself and the world around. All this makes it extremely difficult to build close relationships, seek support and help.

What can help you cope with PTSD

The first and most important step is often the recognition of the traumatic experience, which opens up opportunities for conversation and subsequent rethinking. The devastating effect of trauma on the psyche is largely due to the fact that the traumatic event is completely knocked out of the normal course of our life, and it is extremely important to return, build it into our personal history.

Research demonstrates the effectiveness of a simple tool such as writing down your experience: writing down your thoughts and memories of a traumatic event, trying to talk about the impact it had on your life, thinking about the future.

Since trauma affects the body in one way or another, physical exercise, yoga (or regular stretching), meditation, dancing, and even theater classes can be an important help in overcoming its consequences [6].

The support of relatives and friends plays a huge role. It's important to open yourself up and find someone you can talk to about what's bothering you.

However, overcoming PTSD on your own is not easy and can take a long time. Therefore, at the first opportunity, it is worth contacting a psychotherapist.

If your loved one has PTSD

If you notice symptoms of PTSD in a loved one, you can become a support for him and help him. At the same time, it is important to take into account that it can be extremely difficult for him to talk about the trauma and even return to it in his thoughts, so it is important to indicate your willingness to help and be there without exerting any pressure. Your very understanding and supportive presence, your willingness to share activities that bring joy and pleasure, a sense of stability and confidence can be beneficial.

Learn more

C ptsd physical symptoms

Symptoms, Tests, Treatment, and Finding Support

Symptoms of PTSD

Reliving the traumatic experience

Avoiding certain situations

Changes in beliefs and feelings about yourself and others

Hyperarousal

Somatic symptoms

Symptoms of CPTSD

Lack of emotional regulation

Changes in consciousness

Negative self-perception

Difficulty with relationships

Distorted perception of abuser

Loss of systems of meanings

Psychotherapy

Eye movement desensitization and reprocessing (EMDR)

Medication

Suggested reads

Symptoms, Tests, Treatment, and Finding Support

Symptoms of PTSD

Reliving the traumatic experience

Avoiding certain situations

Changes in beliefs and feelings about yourself and others

Hyperarousal

Somatic symptoms

Symptoms of CPTSD

Lack of emotional regulation

Changes in consciousness

Negative self-perception

Difficulty with relationships

Distorted perception of abuser

Loss of systems of meanings

Psychotherapy

Eye movement desensitization and reprocessing (EMDR)

Medication

Suggested reads

PTSD

PTSD: what it is, symptoms, treatment

What is PTSD

Symptoms of PTSD

Causes and risk factors

At the physiological level, the development of PTSD can be triggered by:

Factors that can increase susceptibility to PTSD:

Treatment of PTSD

Cognitive Process Therapy

EMDR - eye movement desensitization and processing

Body and creativity oriented approaches

Living with PTSD

What can help you cope with PTSD

If your loved one has PTSD