PTSD

Post-traumatic stress disorder (PTSD) is a mental health disorder that is caused by an extremely stressful or terrifying event, series of events or set of circumstances – either being a part of it or witnessing it.  An individual may experience this emotionally or physically harmful or life-threatening and may affect mental, physical, social, and/or spiritual well-being.  Examples include natural disasters, serious accidents, terrorist acts, war/combat, rape/sexual assault, historical trauma, intimate partner violence and bully. 

PTSD can occur in all people, of any ethnicity, nationality or culture, and at any age.  Women are reportedly twice as likely as men to have PTSD.  People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended.  Often, patients will relive the event through flashbacks or nightmares, often feeling sadness, fear or anger.  These feelings can make you feel detached, or estranged from other people in your life, especially loved ones that want to help.  People with PTSD often avoid situations, people, and places that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.

Andrea conducts a thorough psychiatric diagnostic evaluation during your PTSD screening. She reviews your medical and mental health history, as well as your family history. She also asks about your childhood, academic performance, work, and social interactions, looking for symptoms of acute stress and PTSD.

New Patient Intake/Diagnostic Evaluation appointments are typically 60-75 minutes long.

Follow up visits are 15-25 minutes.

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illnesses.

The course of the disorder varies. Although some people recover within 6 months, others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things as an outsider rather than experiencing them. As a mental health care clinician, Andrea can determine whether your symptoms meet the criteria for PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

• At least one re-experiencing symptom

• At least one avoidance symptom

• At least two arousal and reactivity symptoms

• At least two cognition and mood symptoms

Re-experiencing symptoms

• Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating

• Recurring memories or dreams related to the event

• Distressing thoughts

• Physical signs of stress

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

Avoidance symptoms

• Staying away from places, events, or objects that are reminders of the experience

• Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

Arousal and reactivity symptoms

• Being easily startled

• Feeling tense, on guard, or on edge

• Having difficulty concentrating

• Having difficulty falling asleep or staying asleep

• Feeling irritable and having angry or aggressive outbursts

• Engaging in risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating.

Cognition and mood symptoms

• Trouble remembering key features of the traumatic event

• Negative thoughts about oneself or the world

• Exaggerated feelings of blame directed toward oneself or others

• Ongoing negative emotions, such as fear, anger, guilt, or shame

• Loss of interest in previous activities

• Feelings of social isolation

• Difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members.

It is important to note that not everyone who experiences trauma will develop PTSD, and not everyone who develops PTSD requires psychiatric treatment.  Some people have symptoms that subside or disappear over time.  Others may get better with the help of their support system without formal treatment.  But many with PTSD need professional treatment to recover from psychological distress that can be intense and debilitating daily.  The earlier a person gets treatment, the better overall chance of recovery. 

Evidence based treatment includes both psychotherapy and/or medication management.  These are the most common types of therapy used for PTSD- cognitive behavioral therapy (CBT), prolonged exposure therapy, trauma focused cognitive behavioral therapy, eye movement desensitization and reprocessing (EMDR) and group therapy.  Other psychotherapies such as interpersonal, supportive, and psychodynamic therapies focus on the emotional and interpersonal aspects of PTSD. 

Medications can help to control the symptoms noted earlier in PTSD.  Some antidepressants such as SSRIs and SNRIs are commonly used and FDA approved to treat the core symptoms of PTSD.  They may be used alone, or in combination with therapy.

Ketamine is a newer medication showing promise to treat PTSD.  Please note that Andrea/Total Clarity Psychiatry does not prescribe Ketamine. 

Complementary and alternative therapeutic approaches such as acupuncture, yoga, meditation, animal-assisted therapy, and/or peer support group therapy can be helpful to treat PTSD symptoms.

PTSD is a long-term disorder that can take over your life. Don't wait any longer, let Andrea help you live your best life and start managing your symptoms.

Psychopharmacological genetic testing (PGT) can be order and is covered by some insurance carriers to determine how you metabolize certain medications. This can be helpful if you have failed or had serious side effects on medications in the past. If you have questions, or want to order this test, ask Andrea for more details.