Post Traumatic Stress Disorder

Post-Traumatic Stress Disorder is a reaction to psychological trauma which develops in response to actual or threatened extreme danger or personal injury. Examples include wartime experiences, natural disasters, sexual assault, bodily injury, incest, or even psychotic episodes (including placement in psychiatric hospitals). Torture almost always results in Post Traumatic Stress Disorder. During wartime, Post Traumatic Stress Disorder was referred to as “shell-shock” or battle fatigue. In the press, Post Traumatic Stress Disorder has become strongly associated with survivors of military trauma. In the current era of war, more and more soldiers are surviving bodily injuries – most of them develop Post Traumatic Stress Disorder. Interestingly, persons who have had disaster training or medical training who experience traumatic events have a lower risk of developing the disorder. This protective effect can sometimes be replicated with administration of antidepressants or anti-anxiety medications or beta-blockers.

People with Post Traumatic Stress Disorder 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 Post Traumatic Stress Disorder can have feelings of detachment from family and friends, isolation, and loss of social interactions. Typically, symptoms also consist of chronic physical signs related to hyper-arousal. These physical signs include insomnia, difficulty concentrating, hypervigilance, memory problems, and fatigue. Post Traumatic Stress Disorder may be associated with depression, substance abuse, alcoholism, or personality disturbances.

The diagnosis of Post Traumatic Stress Disorder is based on three categories of symptoms:
1) Recurrent re-experiencing of the traumatic event
2) Avoidant behavior
3) 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 involves intense fear, helplessness or horror is pathognomonic for Post Traumatic Stress Disorder. Persons with trauma will report recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Post Traumatic Stress Disorder is further characterized as immediate onset versus delayed onset. The Post Traumatic Stress Disorder 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.

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 Post Traumatic Stress Disorder can be managed with psychological treatment and medication, it requires perseverance, dedication and commitment. Symptoms may be extremely distressing and persons suffering from it may be predisposed to other conditions including anxiety disorders, depression or substance abuse, which complicates treatment and adversely affects the overall prognosis.

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.

When a Client is admitted to PCH Treatment Center for Post Traumatic Stress Disorder, a doctoral level psychologist performs a thorough initial evaluation. Individual psychodynamic psychotherapy and cognitive behavioral therapy are available to all clients. Clients with trauma also participate in Somatic Experiencing or sensorimotor therapy and Eye Movement Desensitization and Reprocessing (EMDR), which have been specifically shown to effectively treat Post Traumatic Stress Disorder.

Additionally, Dialectical Behavioral Therapy (DBT), mentalization, mindfulness-based stress reduction, anger management, sleep management, psycho-education, and neurofeedback are incorporated into the Post Traumatic Stress Disorder treatment schedule. Holistic therapies including yoga, mindfulness meditation, acupuncture and massage therapy also promote healing and recovery. Optional family Post Traumatic Stress Disorder therapy groups are available in the L.A. area, which incorporate family members or significant others into the Client’s treatment environment (when appropriate).