Post-Traumatic Stress Disorder (PTSD)

What is Post-Traumatic Stress Disorder?
Post-Traumatic StressPost-Traumatic Stress Disorder (PTSD) is a form of psychological trauma which develops in response to actual or threatened extreme danger or trauma. Examples include wartime experiences, natural disasters, rape, incest, or even psychotic episodes (including placement in psychiatric hospitals). Torture almost always results in PTSD. Symptoms include nightmares, dissociative states, vivid flashback memories of the traumatic event, loss of control, emotional detachment (psychic numbing), hyper-arousal, and survivor guilt. Typically, symptoms of PTSD consist of recurrent re-experiencing of the trauma, avoidance behaviors or phobias, and chronic physical signs related to hyper-arousal, including sleep disorder, difficulty concentrating, hypervigilance, memory problems, and fatigue. PTSD may be associated with anxiety, depression, substance abuse, alcoholism, or personality disorders. During wartime, PTSD was referred to as “shell-shock” or battle fatigue.  In the press, PTSD has become strongly associated with survivors of military trauma.

What are symptoms of Post-Traumatic Stress Disorder?
People with PTSD repeatedly re-experience their trauma through memories and thoughts of the experience. They often suffer from flashbacks, hallucinations and nightmares. The anxiety associated with the traumatic event can provoke avoidant or isolating behaviors. Persons with PTSD can have feelings of detachment from family and friends, isolation, and loss of social interactions. Severe dissociative symptoms include depersonalization, psychic numbing, or amnesia. Increased arousal can manifest as emotional liability, insomnia, difficulty concentrating, sensitivity to sensory stimuli (startle response), and physical symptoms such as rapid heartbeat, shortness of breath, nausea, dizziness, and gastrointestinal problems.

What causes Post-Traumatic Stress Disorder?
Exposure to a real or threatened traumatic event is the origin of PTSD. Risk factors for development of symptomatic PTSD include a high level of exposure to the traumatic experience, repeated exposures to the traumatic event, severity of the inciting event, emotional and physical state around the time of the event, and the depth of the family and social support structure. Lack of control over the traumatic situation is also associated with a higher likelihood of development of PTSD. Interestingly, persons who have had disaster training or medical training who experience traumatic events have a lower risk of developing PTSD. This protective effect can sometimes be replicated with administration of antidepressants or anti-anxiety medications or beta-blockers.

Frequently Asked Questions about Post-Traumatic Stress Disorder

How is Post-Traumatic Stress Disorder diagnosed?
The diagnosis of Post-Traumatic Stress Disorder is based on three categories: recurrent re-experiencing of the traumatic event, avoidant behavior, and signs of hyper-arousal. These symptoms and signs should be assessed by a mental health professional. For example, a history of exposure to a traumatic event, with a response that involved intense fear, helplessness or horror is pathognomonic for PTSD. Persons with trauma will report recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. PTSD is further characterized as immediate onset versus delayed onset. The PTSD assessment also includes an evaluation of symptoms and behaviors that have interfered with the Client’s everyday living, including negative effects on family, friends, work or school. Drug or alcohol abuse and self-medication are also common and can interfere with treatment.

What is the Prognosis for Post-Traumatic Stress Disorder?
The prognosis for Post-Traumatic Stress Disorder varies widely, depending on the severity of trauma exposure, duration and severity of symptoms, and co-existing psychological problems or substance or medication abuse. While PTSD can be managed with psychological treatment and medication, it requires perseverance, dedication and commitment. Symptoms of PTSD may be extremely distressing and the person suffering from it may have difficulty seeking help or staying in treatment. Persons with PTSD may be predisposed to other conditions, including anxiety disorders, depression or substance abuse, which complicates treatment and adversely affects the overall prognosis.

What factors affect recovery?
Persons with severe Post-Traumatic Stress Disorder may isolate themselves and refuse treatment. Substance abuse (especially alcohol, marijuana or cocaine) or self-medication and co-occurring psychological problems may also be prevalent among persons with trauma. Concurrent substance abuse dramatically interferes with effective psychological and medical treatment. Persons with PTSD may be separated from family or loved ones, thus lacking an effective social support structure that is important for their recovery. Family and friends can educate themselves about PTSD to understand when the person requires intervention. They can be a valuable resource in monitoring medications and being vigilant in watching for symptoms as well as avoidant or isolating behaviors. Family members can encourage a person with PTSD to seek definitive help by entering a treatment facility, while providing emotional support and financial resources.

When Should a Client enter a treatment center?
When a person with Post-Traumatic Stress Disorder is in crisis, they require immediate psychological support. This is a time for an immersive treatment program, rather than routine outpatient therapy. Furthermore, when problems are continually or severely impacting daily school or work life and personal and family relationships, an intensive treatment program is an appropriate option. Oftentimes, once per week psychotherapy or medication is ineffective at managing serious symptoms of PTSD. PCH Treatment Center is a more effective option than simple outpatient therapy, especially when the person with PTSD is in crisis or not fully compliant or invested in their current treatment arrangement.

How does PCH Treatment Center treat Post-Traumatic Stress Disorder?
PCH Treatment Center has extensive experience with PTSD and psychological trauma. Dr. Jeff Ball, the Executive and Clinical Director, has been working with Clients with psychological trauma for over 25 years. He has assembled a clinical staff of doctoral level therapists who also have a deep understanding of PTSD and the devastating effects it can have on a person’s well-being. When a Client is admitted to PCH Treatment Center, a doctoral level psychologist performs a thorough initial evaluation.  Individual psychodynamic psychotherapy is the core of our treatment program. Clients with trauma also undergo Somatic Experiencing therapy and Eye Movement Desensitization and Reprocessing, which have been specifically shown to effectively treat PTSD. Additionally, Dialectical Behavioral Therapy (DBT), anger management, sleep management, psycho-education, and neurofeedback are incorporated into the treatment schedule. Holistic therapies including yoga, mindfulness meditation, acupuncture and massage therapy also promote healing and recovery. Optional family therapy groups are available, which incorporate family members or significant others into the Client’s treatment environment. Clients may choose our Intensive program with residence or Day Treatment Program, depending on the severity of their problems, their schedule, and their treatment goals.  The PCH Family Treatment Program may also be coordinated with the individual treatment plan.

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