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Stress-related Problems

 

Post-traumatic Stress Disorder

Post-traumatic Stress Disorder (PTSD) is a delayed or prolonged response to a traumatic event or situation. This event may have been either brief or long in duration but the person will have either been at risk themselves of harm, either perceived or real, or witnessed catastrophic events. The following symptoms may occur from a few weeks to months after the event:
Repeated reliving of the trauma in the form of intrusive memories (“flashbacks”)

  • Dreams or nightmares about the event
  • A sense of emotional “numbness”
  • Detachment from other people
  • Unresponsiveness to surroundings
  • Inability to experience pleasure
  • Avoidance of activities and situations reminiscent of the trauma
  • “Hyper-arousal” – a state of increased physical and psychological tension
  • “Hyper-vigilance” – being particularly aware of potential threats
  • Becoming more easily startled
  • Insomnia
  • Anxiety and depression
Causes

Clearly the primary cause of PTSD is the event itself but not everybody who experiences a trauma will go on to suffer with PTSD symptoms. Therefore, other factors are likely to be relevant, including:

  • Genetic – there is evidence that some people are more vulnerable to stress whereas others have greater resilience. It is thought that genes play a part in these differences.
  • Brain chemistry – PTSD symptoms are thought to be explained by a lack of regulation between areas of the brain involved with the processing of emotional memories. This means that the event is not fully processed and the brain therefore responds as if it is still at risk, releasing chemicals such as adrenaline.
  • Psychological factors – traumatic events can undermine a person’s belief about the world being safe, or confirm beliefs that it is unsafe. This then impacts upon their strategies to cope. Avoidance of activities or places that remind a person of the trauma prevents them from processing the event and has a negative effect on their mood.
Treatment
  • Cognitive behavioural therapy (CBT) involves learning strategies to manage the symptoms of PTSD as well as processing the memory of the trauma and addressing the avoidance that keeps the symptoms going.
  • Eye Movement Desensitisation and Reprocessing (EMDR) works by helping a person to make sense of the traumatic memory whilst also using eye movements in order to help the brain processes involved in doing so.
  • Medication – some anti-depressant medications, in particular SSRIs and Venlafaxine, can help reduce the PTSD symptoms as well as the negative effects on a person’s mood. Pregabalin may also be of benefit.

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