Anxiety Disorders, Panic, Phobias and Fear Part 10: Understanding PTSD: Diagnosis, Treatment, and Alternative Terminology
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after an individual experiences or witnesses a traumatic event. Last week, I wrote about how my father fought in World War 2, and our Office Manager, Erica’s father fought in The Vietnam War. Both our fathers experienced some of the symptoms you see listed below, and yet because PTSD hadn’t been identified in WWII and hadn’t been destigmatized until well after the Vietnam war, neither one of our fathers wound up seeking treatment.
Nowadays, we know that events including combat, natural disasters, accidents, or personal assaults can all cause victims of these traumatic events and even people who witness these events to experience different degrees of PSTD. Despite the growing awareness of PTSD, there is still a significant amount of stigma surrounding the diagnosis, perhaps due to the word "disorder." This stigma can deter people from seeking the help they need as it did with Erica’s father. In this post, we'll explore the diagnosis and treatment of PTSD and discuss alternative terminology that might help reduce the associated stigma.
What is PTSD?
PTSD is characterized by a set of symptoms that can develop after exposure to a traumatic event. These symptoms are generally grouped into four categories:
1.) Intrusive Memories: This includes flashbacks, nightmares, and severe anxiety related to the trauma. Individuals might feel as though they are reliving the event, and certain triggers can cause a sudden onset of these memories.
2.) Avoidance: People with PTSD may go out of their way to avoid reminders of the trauma. This might involve steering clear of places, activities, or even thoughts that could bring back memories of the event.
3.) Negative Changes in Thinking and Mood: Individuals might experience feelings of hopelessness, emotional numbness, memory problems, or detachment from loved ones. They may also struggle with maintaining positive relationships and have a diminished interest in activities they once enjoyed.
4.) Changes in Physical and Emotional Reactions: Hyperarousal symptoms like being easily startled, feeling tense, having difficulty sleeping, or experiencing angry outbursts are common. These symptoms can lead to destructive behaviors, such as substance abuse or self-harm.
Diagnosis of PTSD
Diagnosing PTSD typically involves a comprehensive evaluation by a mental health professional. This assessment may include:
1.) Clinical Interviews: These are conducted to understand the individual’s trauma history, the onset of symptoms, and the impact on daily functioning.
2.) Diagnostic Criteria: The professional uses criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which outlines the symptoms and duration necessary for a PTSD diagnosis.
3.) Physical Examination: Sometimes, physical exams are conducted to rule out other conditions that could be contributing to the symptoms.
4.) Psychological Testing: Standardized assessments might be used to measure the severity and impact of PTSD symptoms.
It is important to note that PTSD can manifest differently in different people. While one individual might experience all the typical symptoms, another might only have a few. This variability highlights the need for a personalized approach to both diagnosis and treatment.
Treatment of PTSD
There are several evidence-based treatments for PTSD, many of which can be tailored to an individual's specific needs:
1.) Psychotherapy:
- Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for PTSD. CBT helps individuals identify and change negative thought patterns that contribute to their symptoms. A specific form of CBT, called Cognitive Processing Therapy (CPT), is particularly effective for trauma-related disorders.
- Prolonged Exposure Therapy (PE): This approach involves gradually confronting trauma-related memories, feelings, and situations to reduce their power over time.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR involves recalling distressing memories while performing specific eye movements, which can help process and integrate these memories more healthily.
2.) Medication:
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) and paroxetine (Paxil) are commonly prescribed to help manage symptoms of PTSD.
- Prazosin: This medication can be used to reduce nightmares and improve sleep quality, although its effectiveness varies among individuals.
- Anti-Anxiety Medications: These are sometimes prescribed for short-term relief, though they are not typically recommended for long-term use due to the risk of dependence.
3.) Lifestyle and Self-Care:
- Mindfulness and Meditation: Techniques like mindfulness meditation can help individuals stay grounded and reduce anxiety. These practices promote present-moment awareness and can serve as valuable tools in managing PTSD symptoms.
- Physical Activity: Regular exercise has been shown to reduce symptoms of depression and anxiety, both of which are common in individuals with PTSD. Activities like yoga, running, or even walking can be particularly beneficial.
4.) Support Systems: Engaging with a strong support network, whether through friends, family, or support groups, can provide a sense of community and understanding. Group therapy is also an option that allows individuals to connect with others who have experienced similar traumas.
Reducing Stigma with Alternative Terminology
The term "Post-Traumatic Stress Disorder" carries with it the implication of a dysfunction or defect, which can contribute to the stigma that prevents people from seeking help. Some experts and advocates suggest alternative terminology that might help reduce this stigma, making it easier for individuals to discuss their experiences and seek treatment.
- Post-Traumatic Stress Injury (PTSI): The term "injury" implies a condition that can be healed rather than a permanent disorder. This reframing can encourage individuals to view their experiences as a challenge they can overcome, rather than a lifelong condition they must endure.
- Post-Traumatic Stress Syndrome (PTSS): "Syndrome" suggests a collection of symptoms without the negative connotations associated with the word "disorder." This term can be more approachable and less stigmatizing.
- Post-Traumatic Growth (PTG): Although this concept is not a direct replacement for PTSD, it emphasizes the potential for positive psychological change following trauma. This idea can empower individuals to focus on resilience and recovery.
These alternative terms are gaining traction among some clinicians and mental health advocates as a way to lessen the stigma around PTSD, making it more accessible for those who might otherwise avoid seeking help.
Conclusion
PTSD is a serious and potentially debilitating condition, but with proper diagnosis and treatment, recovery is possible. By exploring alternative terminology like PTSI or PTSS, we can begin to reduce the stigma that often surrounds this condition. This shift in language, combined with evidence-based treatments and strong support networks, can create a more compassionate and understanding environment for those who have experienced trauma.
This is part ten in a series about anxiety: How to identify the different forms of anxiety and what you can do to lessen its effects.
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James Porter
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