PsychMD.info - Post Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD)

What is Post-Traumatic Stress Disorder?

Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include:

violent personal assaults
military combat
natural or human-caused disasters
accidents

Some people at risk for developing PTSD include:

rape victims
survivors of accidents, physical and sexual abuse, and other crimes
military troops who served in the Vietnam and Gulf Wars
rescue workers involved in the aftermath of disasters like the terrorist attacks on New York City and Washington, D.C.
immigrants fleeing violence in their countries
survivors of the Oklahoma City bombing
survivors of the 1994 California earthquake, the 1997 North and South Dakota floods, and hurricanes Hugo and Andrew

Signs and Symptoms:

persistent frightening thoughts and memories of traumatic event or ordeal
flashback episodes with intrusive images
feeling emotionally numb or detached
feeling easily startled or jumpy
nightmares, sleep disturbance
depression, anxiety, and irritability or outbursts of anger
feelings of intense guilt
avoidance of reminders or thoughts of the ordeal

How common is PTSD?

About 3.6% of U.S. adults ages 18 to 54 (= 5.2 million people) have PTSD during the course of a given year.

Treatment (combination of psychotherapy and medication(s) may be helpful):

cognitive-behavioral therapy (CBT): learning how to identify, evaluate and modify distorted cognition by changing thoughts and behaviors can help the patient manage anxiety more effectively
group therapy: talking about the traumatic experience very soon afterwards may reduce some of the symptoms of PTSD
exposure therapy: the patient gradually and repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma
medications: some of the medications that have been used to treat PTSD include:
- fluoxetine (Prozac)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- citalopram (Celexa)
- escitalopram (Lexapro)
- venlafaxine (Effexor)
- amitriptyline (Elavil)
- nortriptyline (Pamelor)
- imipramine (Tofranil)
- desipramine (Norpramin)
- phenelzine (Nardil)
- alprazolam (Xanax)
- clonazepam (Klonopin)
- carbamazepine (Tegretol)
- valproic acid (Depakote)
- propanolol (Inderal)
- clonidine (Catapres)

Before taking medication for PTSD:

Ask your doctor to tell you about the effects and side effects of the medication he or she is prescribing.
Tell your doctor about any alternative therapies or over-the-counter medications you are using.
Ask your doctor when and how the medication will be stopped. Some medications cannot safely be discontinued abruptly; they have to be tapered slowly under a physician's supervision.
Be aware that some medications are effective only as long as they are taken regularly, and symptoms may occur again when the medications are discontinued.
Work together with your doctor to determine the right dosage of the right medication to treat PTSD.

Reference: National Institute of Mental Health