Post traumatic stress disorder (PTSD) is a psychological condition triggered by experiencing or witnessing a traumatic event such as war, assault, or a natural disaster. Symptoms include re-experiencing the trauma through flashbacks or nightmares, avoiding reminders of the event, increased anxiety, and emotional numbness. Treatment involves trauma-focused cognitive behavioral therapy which exposes patients to traumatic memories and thoughts, as well as medication such as antidepressants and anti-anxiety drugs. Group therapy can also help PTSD sufferers process their trauma by sharing their experiences.

1. Post traumatic
stress disorder
By
Aastha Bhat, Group 9624Ma, IV course (Medicine); Dr. Natalia

2. Definition
PTSD is a pathological anxiety
that usually occurs after an
individual experiences or
witnesses severe trauma that
constitutes a threat to the
physical integrity or life of the
individual or of another person
It is a debilitating psychological
condition trigged by a traumatic
event, such as rape, war, a
terrorist act, sudden or violent
death of a loved one, natural
disaster, or catastrophic accident

3. Traumas leading to PTSD
include,
 War
 Natural disasters
 Car or plane crash
 Terrorist attack
 Childhood neglect
 Kidnapping
 Assault
 Rape
 Physical abuse
 Sudden death of a loved one
 Sexual abuse

4. Signs and symptoms
 Symptoms of PTSD: Re-experiencing the traumatic event
 Intrusive, upsetting memories of event
 Flashbacks
 Nightmares
 Feelings of intense distress, when reminded of trauma
 Intense physical reactions, as reminders of event (pounding heart, rapid
breathing, nausea, muscle tension, sweating)

5. Signs and symptoms
Symptoms of PTSD: Avoidance and numbing
 Avoiding activities, places, thoughts, or feelings 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 and emotionally numb
 Sense of a limited future (you don’t expect to live a normal life span, get
married, have a career)

6. Signs and Symptoms
Symptoms of PTSD: Increased anxiety and emotional arousal
 Difficulty falling or staying asleep
 Irritability or outbursts of anger
 Difficulty concentrating
 Hypervigilance (on constant “red alert”)
 Feeling jumpy and easily startled

8. Other common
symptoms
 Anger and irritability
 Guilt, shame or self blame
 Substance abuse
 Feelings of mistrust
 Depression and hopelessness
 Suicidal thoughts and feelings
 Feeling alienated and alone
 Physical aches and pains

9. Diagnostic criteria

10. DSM-5 Criteria for PTSD
Criterion A: Stressor
 You directly experienced the
event.
 You witnessed the event
happen to someone else, in
person.
 You learned of a close
relative or close friend who
experienced an actual or
threatened accidental or
violent death.
 You had repeated indirect
exposure to distressing
details of the event
Criterion B: Intrusion
 Recurrent, involuntary, and
intrusive memories
 Traumatic nightmares or
upsetting dreams with
content related to the event
 Dissociative reactions, such
as flashbacks, in which it
feels like the experience is
happening again.
 Intense or prolonged
distress
 increased heart rate
Criterion C:
Avoidance
Persistent effortful avoidance
of distressing trauma-related
reminders after the event as
evidenced by the following:
 Avoidance of trauma-
related thoughts or feelings.
 Avoidance of trauma-
related external reminders,
such as people, places,
conversations, activities,
objects, or situations.

11. DSM-5 Criteria for PTSD
Criterion D: Neg mood
alterations
 Inability to recall key
features of the traumatic
event
 distorted negative
beliefs and expectations
about oneself or the world
 distorted blame of self or
others for causing the
traumatic event
 Feeling alienated, detached
or estranged from others.
 inability to experience
positive emotions, such as
happiness, love, and joy.
Criterion E: Alterations
in arousal and
reactivity
 Irritable or aggressive
behavior
 Self-destructive or reckless
behavior
 Feeling constantly "on
guard" or like danger is
lurking around every corner
(hypervigilance)
 Exaggerated startle
response
 Problems in concentration
 Sleep disturbance
Criterion F: Functional
significance
 Significant symptom-related
distress or impairment of
different areas of life, such
as social or occupational.

12. DSM-5 Criteria for PTSD
 The disturbance is not due to
medication, substance use, or other
illness.
Criterion H: Exclusion
Criterion G: Duration
 Persistence of symptoms in Criteria B,
C, D, and E for more than one month.

14. Trauma focused
cognitive
behavioral
therapy
2. PSYCHOSOCIAL TREATMENT
It involves carefully and gradually “exposing”
yourself to thoughts, feelings, and situations
that remind you of the trauma
Exposure therapy
It involves gradually facing the
thoughts and memories of traumatic
event or situations (places where
the event occurred) that make one
anxious.
Done by using imaging techniques
or by actually returning to the place
where one had an accident.
Cognitive
restructuring
therapy
It involves identifying irrational
patterns of thought, feeling and
behavior that emerges after a
traumatic event.
It replaces dysfunctional
thoughts with realistic and
helpful ones.
Eye movement
desensitization
and reprocessing
The patient is asked to concentrate
on an image connected to the
traumatic event and the related
negative emotions, sensations and
thoughts
Patient is encouraged to let go of the
memories and discuss the images
and emotions he experienced during
the eye movements
Group
psychotherapy
Telling one’s story (the “trauma
narrative”) and directly facing the
grief, anxiety and guilt related to
trauma enables many survivors to
go on with their lives rather than
getting stuck in unspoken despair
and helplessness.
TREATMENT
1. PHARMACOLOGICAL TREATMENT
 Anti-depressants
SSRIs- Sertraline, Fluoxetine; TCAs- Imipremine
 Anti-anxiety drugs
Lorazepam

16. Self help in
PTSD
 PTSD self-help tip 1: Reach out to
others for support
 PTSD self-help tip 2: Avoid alcohol and
drugs
 PTSD self-help tip 3: Challenge your
sense of helplessness

17. Thank
you
AASTHA BHAT