ptsd

1. AMBIKA GAUR
SENIOR NURSING TUTOR
HIN POUNTA SAHIB

2. Post traumatic stress disorder
 Shell shock or Battle fatigue syndrome
 Can happen to anyone at any age
 Occurs as a response to chemical and neuronal
changes in the brain after exposure to threatening
events.

3. Introduction
 Post traumatic stress disorder defined as individual
who have been exposed to traumatic event in which
one person experienced witnessed with actual or
threatened death or serious injury or threat to the
physical integrity of self or others.
 ( DSM-IV)

4. Traumatic event that can lead to
PTSD
 War
 Natural disasters
 Car or plane crashes
 Rape assault
 Physical abuse
 Kidnapping
 Sexual abuse
 Sudden death of loved ones
 Childhood neglect

5. Factors for PTSD include
 Women are at greater risk than males.
 Previous traumatic experiences especially in early life
 Family history of PTSD or depression
 History of substance abuse
 History of depression, anxiety or another mental
illness
 High level of stress in everyday life

6.  Lack of support after the trauma
 Lack of coping skills
 Education

7. Sign and Symptoms
 Symptoms of PTSD into four groups:
 Intrusion
 Avoidance
 Arousal and reactivity
 Cognition and mood

8. Other common Sign and
Symptoms-
 Anger and irritability
 Guilt shame or self blame
 Substance abuse
 Feeling of mistrust
 Depression and hopelessness
 Suicidal thought and feelings
 Feeling alienated and alone
 Physical aches and pains
 Agitation
 in addition people with PTSD may experience depression
and panic attacks

9. Intrusion
 Flashback where you feel like you relive the event over
and over
 Unpleasant memories of the event
 Frequent nightmares about the event
 Intense mental or physical distress when you think
about event

10. Symptoms' in children &
adolescents
 Fear of being separated from parents
 Losing previously acquired skills such as toilet training
 Sleep problem and nightmares without recognizable
content
 Compulsive play in which themes or aspects of trauma
are repeated
 New phobias and anxieties that seem unrelated to the
trauma( fear of monster)

11. Conti…….
 Acting out the trauma through play stories or drawing
 Ache irritability and pains with no apparent cause

12. Anxiety and emotional arousal
 Difficulty falling or staying asleep
 Irritability or outburst of anger
 Difficulty concentrating
 Hypervigilence can constant red alert
 Feeling grumpy

13. Avoidance
 Avoiding activity places,
 Thoughts or feeling that remind the trauma
 Inability to remember important aspects of the trauma
 Loss of interest in activities and life in general
 Feeling detached from others & emotionally numb
 Sense of a limited future ( don’t have to expect to live a
normal life span get married have a career)

14. Cognition and mood
 Negative thoughts about self
 Distorted feeling of guilt worry or blame
 Trouble remembering important parts of the event
 Reduced interest in activities once loved

15. Types of PTSD
 Acute stress disorder
 Dissociative ptsd
 Uncomplicated ptsd
 Comorbid ptsd

16.  Acute ptsd- cluster of symptoms like anxiety and
avoidance that develops within a month after
traumatic event

17.  Dissociative ptsd-
 Is when patient detach himself from trauma

18.  Uncomplicated ptsd-
 Is when ptsd symptoms like the re experiencing the
traumatic event and avoiding people and places
related to the trauma. Don’t have other medical issues
such as depression.

19.  Comorbid ptsd-
 Involves symptoms of ptsd along with another mental
health disorder like depression, panic disorder
substance abuse .

20. Screening patient for ptsd
 DREAMS
 D- detachment
 R- experiencing the event
 E- event had emotional effects
 A- avoidance
 M- month in duration
 S- sympathetic hyperactivity or hyper vigilance

21. Pharmacological treatment
 Antidepressants
 SSRIS- sertraline, fluvoxetine
 TCAs- imipramine
 Ant anxiety drugs
 lorazepam

22. Psychological treatment
 Trauma focused cognitive behavioral therapy
 It involves carefully and gradually exposing patient to
thoughts, feeling, and situation that remind patient of
the trauma

23. Exposure therapy
 It involves gradually facing the thoughts and memories
of the traumatic event or situation ( places where the
event occurred) that makes one anxious
 This can be done by using imaging technique or by
actually returing to the places where one had an
accident

24. Cognitive restructuring therapy
 Involves identifying irrational pattern of thoughts,
feeling and behavior
 Aim is to replacing dysfunctional thoughts with more
realistic and helpful ones .

25. Eye movement desensitization
and reprocessing (EMDR)
 Patient is asked to concentrate on image connected to
the traumatic event and the related negative emotions
sensations and thoughts

26. Family therapy
 Can help the loved once understand what you are
going through

27. Group psychotherapy
 Telling the story of that event and directly facing the
grief anxiety and guilt related to trauma enables many
survivors' to go with life

28. Positive ways of coping with PTSD
 Learn about trauma and PTSD
 Practice relaxation techniques
 Spend time with positive people
 Avoid alcohol and drugs
 Join a PTSD support group

29. ….Thank you………