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December 2001
Vol. 4, No. 12, p 56.
diseases and disorders
CHAD E. McFARLANE
Posttraumatic stress disorder
As a result of the September 11 terrorist attacks, posttraumatic stress disorder (PTSD) may become a problem of near-epidemic proportions in America. In response, many medical organizations are enhancing their mental health departments and facilities. However, mental health professionals have been aware of PTSD for a long time. Years ago, it was called “shell shock” and was commonly thought to be a soldier’s syndrome because of the many war veterans diagnosed with the disorder. After combat military personnel, rape victims are the next-largest group affected. Police officers and firefighters also are at high risk for PTSD because of their elevated daily stress levels. The disorder occurs in men and women, and from childhood to old age.

According to the Trinity Pages, a Web site devoted to PTSD, “Posttraumatic stress disorder is an acquired mental condition that is manifested following a psychologically distressing event outside the range of usual human experience. This disorder presumes that the person experienced a traumatic event or events involving actual or threatened death or injury to themselves or others, and where they felt fear, helplessness, or horror. Symptoms of PTSD may be delayed, or may become evident at any time following the original trauma(s), including years after the fact” (www.mentalhealth.com). The symptoms of PTSD fall into three categories: intrusion, avoidance, and hyperarousal.

Intrusion symptoms are usually unexpected recurring memories of the trauma, commonly called “flashbacks”. They occur as sudden, vivid memories accompanied by painful emotions that take over the person’s attention. In severe instances, people re-experience the trauma by seeing it happen again before their eyes or in a nightmare.

Avoidance symptoms begin with a feeling of numbness or diminished emotions. The victim can complete only activities of a routine or mechanical nature. Soon, close emotional ties with family, colleagues, and friends are severed in order to avoid any stimuli related to the trauma. Revisiting the traumatic experience can have one of two effects. Victims can experience either a flood of emotions (often painful) or no emotion at all. Either way, victims often cannot work out their grief or anger over the trauma; and depression frequently ensues, which is sometimes severe enough to lead to suicide.

Hyperarousal takes the form of acts of sudden irritability or explosiveness, often without provocation. Victims also may have trouble concentrating or have poor short-term memory due to terrifying flashbacks or nightmares. They also may become jumpy or overly alert and have exaggerated startle reflexes.

Since the September 11 tragedies, many people have continued to be anxious, have nightmares, and feel sad. Although not every instance can be diagnosed as PTSD, the number of people with this disorder has dramatically increased. From the rescue workers and injured victims at ground zero to the families and friends who lost loved ones, America has experienced a great trauma. Organizations such as the PTSD Alliance (composed of the American College of Obstetrics and Gynocology, Anxiety Disorders Association of America, International Society for Traumatic Stress, and Sidran Traumatic Stress Foundation) and the American Psychiatric Association are now updating pamphlets, Web sites, and newsletters to alert Americans to the warning signs of PTSD and how the disorder can be treated.

Research and treatment have focused on anxiety reduction and stress coping techniques. Self-hypnosis and cognitive psychotherapy have proven helpful in getting trauma survivors to learn new ways of reacting to traumatic memories. Behavior therapy and family therapy are also used. And advances in pharmacology have helped trauma survivors deal with the more physical effects of this mental condition.

The message that psychiatrists and other mental health professionals are giving to the American people during this time of uncertainty is that although PTSD is classified as an anxiety disorder, it is a very real psychosis that should not go untreated. Recognize the symptoms in your friends and family, and get help. Treatment can allow you to alleviate the life-crippling effects of PTSD.

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