Everyone has stress; we all get nervous; things can weigh on us and we may toss and turn going over details in our mind. This is normal and most of us move past it and continue with our daily lives. In some cases, these feelings become incredibly intense and can last longer than expected or recur even decades later. This is when a person may be dealing with Post-Traumatic Stress Disorder (PTSD).
PTSD is a disorder that occurs in some people who have experienced a shocking, scary, or dangerous event. This may be something that happens directly to them, or it may be an event they have witnessed such as in first responders who witness traumatic events routinely. The symptoms usually occur within the first three months but may begin years later and greatly impact a person’s relationships and ability to perform tasks such as working.
There are four clusters or types of symptoms that are diagnostic of PTSD:
- Re-experiencing (flashbacks, recurrent dreams);
- Avoidance (staying away from people, places or events that remind the person of the traumatic experience);
- Arousal and Reactivity (angry outbursts, trouble sleeping, feeling ‘on edge’);
- Negative Cognition and Mood (negative feelings of oneself or the world, loss of interest in daily activities, distorted feelings of guilt or blame).
The symptoms of PTSD vary from person to person. However, doctors usually make their diagnosis when someone has symptoms from all four clusters that last more than one month and cannot be explained by other conditions such as injury or substance abuse.
The main treatments for PTSD are medication and/or psychotherapy. Antidepressants (Zoloft, Paxil, Prozac, Effexor) have been used to alleviate some of the symptoms and are generally considered first line. It usually takes two to four weeks to see the effects of these medications, which are safe with minimal side effects. Other medications are used for specific symptoms such as nightmares or severe anxiety. I recommend a careful review of medications with your doctor and/or psychiatrist with regular follow up and evaluation. Take care of yourselves and each other.