HistoryFirst described as shell shock(Kardina 1941)Formally recognised as a condition after collective descriptors and research with Vietnam veterans (Beck 1967)
Since then it has become recognised as a condition that arises in other situations outside of combat, such as: Fire-fighters (Mcfarlane 1988) Police (Gersons 1989)
Symptoms• Flashbacks• Anxiety• Avoidance• Hyper Vigilance• Live in Past• Loss of Sleep• Feeling of Helplessness• Utter Despair
These symptoms can be triggered by a memory by any ofthe senses. Sight , Sound and Smell. Sometimes bysomething very small where the connection is seeminglyquite distant.The flashback particularly is effected by memory. Thismeans that the sufferer relives the actual experience.The implications are far reaching and the sufferer will go toextreme lengths to avoid any chance of a familiarsensation.Their life’s can become restricted any chance of a normalday to day life is ended.Post Traumatic Stress Disorder has an expectedface, There are assumptions made within society of whatthe precursors are. Sufferers who are outside of thisperceived norm find it difficult to obtain help or bediagnosed
Precursors Threat of Death or Serious Injury No Control over Situation Response of Extreme Fear and Helplessness (Damasio 1989)
Victims of rape, accidents, or witness to an extreme event such as 9/11, or a tsunami (Heltzer, Robbins, 1987)
Sex differences for PTSD have been looked at, and prevalence rates have shown:5/1000 in men, (yehuda 2001)25/1000 in women.
Main Precursors for Women Physical Attack, Rape, Sexual Abuse, Harm to Family, Murder, Natural Disasters. (Kessler 2002)
Main Precursors for Men Combat, Traumatic Accidents, Fire, Murder, Natural Disasters. (Kessler 2002)
Factors that can attributeto PTSD Some people have risk factors which make them more prone to develop PTSD when they are exposed to a traumatic event. These include: Previous mental health problems. Being female. Coming from a poor background. Lack of education. Coming from an ethnic minority. Being exposed to trauma in the past. A family history of mental illness.
So the Face of PDSD...http://vimeo.com/8682583
One in every 200 births within the UKresults in some form of PTSD http://www.youtube.com/watch?v=M0LrtVUe GfU
Post Traumatic Stress Aftera Traumatic BirthBirth is seen as a natural process. There is social pressure from society and peers. Birth is seen as a happy event.The experience to most is seen as incomparable to war, major accidents, and so forth.There is little or marked empathy for women, who experience this.
Effect on family’s The mood swings and irrational behaviour can cause problems within the family unit. Even when understanding that there is a genuine reason for the behaviour it can be hard to act in an understanding manner when it impacts on day to day family life . Quite often the loved one can become unrecognisable. Sufferers quite often become isolated within the family unit compacting their symptoms. In some case’s it can become dangerous to live within the family unit until the symptoms are more under control . Many family’s find the reasons beyond their true understanding having not the same perception of the event. If undiagnosed it can go on for years and can often manifest into another illness or behaviour , i.e. drug/alchol abuse ( Van de Kolk 2005)
Treatment Talking treatments and other nondrug treatments Cognitive behavioural therapy (CBT) may be advised. Briefly, CBT is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as PTSD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and false ideas or thoughts. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. It may help especially to counter recurring distressing thoughts, and avoidance behaviour. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks. You have to take an active part, and are given homework between sessions. Eye movement desensitisation and reprocessing (EMDR) is a treatment that seems to work quite well for PTSD. Briefly, during this treatment a therapist asks you to think of aspects of the traumatic event. Whilst you are thinking about this you follow the movement of the therapists moving fingers with your eyes. It is not clear how this works. It seems to desensitise your thought patterns about the traumatic event. After a few sessions of therapy, you may find that the memories of the event do not upset you as much as before. Other forms of talking treatments such as anxiety management, counselling, group therapy, and learning to relax may be advised. Self-help. Joining a group where members have similar symptoms can be useful. This does not appeal to everyone, but books and leaflets on understanding PTSD and how to combat it may help
Treatment cont...... Medication Antidepressant medicines are often prescribed. These are commonly used to treat depression, but have been found to help reduce the main symptoms of PTSD even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing symptoms. Antidepressants take 2-4 weeks before their effect builds up, and can take up to three months. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give an antidepressant time to work. If one does help, it is usual to stay on the medication for 6-12 months, sometimes longer. There are several types of antidepressants. However, selective serotonin reuptake inhibitor (SSRI) antidepressants are the ones most commonly used for PTSD. There are various types and brands of SSRI. Paroxetine has been found particularly useful for general use. Non-SSRI drugs sometimes used by specialists include mirtazipine and phenelzine. Benzodiazepines such as diazepam are sometimes prescribed for a short time to ease symptoms of anxiety, poor sleep, and irritability. The problem is, they are addictive and can lose their effect if you take them for more than a few weeks. They may also make you drowsy. Therefore, they are not used long-term. A short course of up to 2-3 weeks may be prescribed now and then if you have a particularly bad spell of anxiety symptoms. Other medicines such as betablockers, mood stabilisers, and anticonvulsants are being studied. These are normally used to treat other conditions but there is some evidence that they may help some people with PTSD. Further research is needed to clarify their role. A combination of treatments such as cognitive behavioural therapy and an SSRI antidepressant may work better in some cases than either treatment alone.
PTSD is often misdiagnosed and mistreated after traumatic birth.Suicide is known as the single largest cause or maternal death in the UK.Full numbers are unknown and under estimated as the UK only deals with death up to a year after birth. (Weiss et al 2005)
References Kardiner, A. (1941). The traumatic neuroses of war. New York: Hoeber Beck AT. Depression: Clinical, Experimental, and Theoretical Aspects. New York,Harper and Row 1967. Yehuda R. Immune neuroanatomic neuroendocrine gender differences in PTSD. Program and abstracts of the 154th Annual Meeting of the American Psychiatric Association; May 5-10, 2001; New Orleans, Louisiana. Symposium 12A. GERSONS B., CARLIER I. Post-Traumatic Stress Disorder: The history of a Recent Concept British Journal of Psychiatry, vol. 161, 742-748. , 1992 HELZER J.E., ROBINS L.N., McEVOY L. Post-Traumatic Stress Disorder in the General Population The New England Journal of Medicine, vol. 317, n° 23, 1630-1634, 1987
REF cont...... Kessler RC. Posttraumatic stress disorder: The burden to the individual and to society. J Clin Psychiatry. 2002;61 suppl 5:4–12. McFarlane AC: Vulnerahility to posttraumatic stress disorder, in Posttraumatic Stress Disorder: Etiology Phenomenology and Treatment. Edited by Wolf ME, Mosnaim AD. Washington, DC, American Psychiatric Press, 1990. Damasio, A. (1994). Descartes error: Emotion, reason, and the human brain. New York: Putnam Robbinson J Holditch-Davis, D., Bartlett, T.R., Blickman, A.L., & Shandor Miles, M. (2000). Posttraumatic stress symptoms in mothers JOGNN, 32, 161–171. Van der Kolk, B. A. (1996b). Trauma and memory. In BA van der Kolk, AC MacFarlane, & L Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society (pp. 279-302). New York: Guilford Press. Weiss D, Marmar CR: The Impact of Event Scale—Revised, in Assessing Psychological Trauma and PTSD: A Practitioner’s Handbook. Edited by Wilson JP, Keane TM. New York, Guilford, 2005 pp 399–411