FREE ESSAY ON POST TRAUMATIC STRESS DISORDER

POST TRAUMATIC STRESS DISORDER

Post Traumatic Stress Disorder 
After experiencing a traumatic event, the mind has been known to horde away the details
and memories and then send them back at unexpected times and places, sometimes after
years have passed. It does so in a haunting way that makes the recall just as disturbing
as the original event. Post Traumatic Stress Disorder is the name for the acquired mental
condition that follows a psychologically distressing event outside the range of usual
human experience (Bernstein, et al). There are five diagnostic criteria for this disorder
and there are no cures for this affliction, only therapies which lessen the burden of the
symptoms.
The root of the disorder is a traumatic event which implants itself so firmly in the mind
that the person may be shackled by the pain and distress of the event indeinately,
experiencing it again and again as the mind stays connected with the past rather than the
present, making it difficult to think of the future. 
The research on this topic is all rather recent as the disorder was only added to the
Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in the last twenty years.
Yet, the disorder is quite common, threatening to control and damage the lives of
approximately eight percent of the American population [5% of men and 10% of women]. Any
person is a potential candidate for developing PTSD if subject to enough stress. There is
no predictor or determining factor as to who will develop PTSD and who will not. Although
all people who suffer from it have experienced a traumatic event, not all people who
experience a traumatic event will develop PTSD. Each persons individual capacity for
coping with catastrophic events determines their risk of acquiring PTSD. And not everyone
will experience the same symptoms; some may suffer only a few mild symptoms for a short
period of time, others may be completely absorbed, still others who experience great
trauma may never develop any symptoms at all (Friedman).
More than any other psychological problem, symptoms are a reaction to an overwhelming
external event, or series of events. From a historical perspective, the concept of PTSD
made a significant change in the usual stipulation that the cause of a disorder could be
outside of the self, rather than some inherent individual weakness (Friedman).
There are many situations that may lead to developing PTSD, including: serious threats to
one's life or well being, or to children, spouse or close friends/relatives; sudden
destruction of home or community; and witnessing the accidental or violent death or
injury of another (Bernstein, et al).
Characteristic symptoms include re-experiencing the event, avoidance of stimuli
associated with the event or numbing of general responsiveness, increased arousal not
present before the event, and duration of the disturbance for at least one month
(Johnson). 
When a bomb exploded the Oklahoma Federal building in 1996, hundreds of lives were
affected. Not only are the people who were in the explosion in danger of re-experiencing
it over and over, but so are the people who witnessed the aftermath, from bystanders to
the rescue workers on scene. The surviving employees not only were physically injured in
the blast, but saw the deaths of their coworkers and children. Surviving a horrific
trauma that many others did not is enough to cause serious emotional harm. For the rescue
workers who arrived, many of them saw death and people who they could not help; feeling
helpless and guilty may manifest into intrusive recollection and nightmares.
To explain further, the first criteria is that the person was at one time exposed to a
traumatic event involving actual or threatened death or injury, where the response was
marked by intense fear, horror or helplessness (Pfefferbaum). This event may have taken
place only weeks ago, or as far back in memory as forty years. The disorder is most
commonly found among survivors of war, abuse and rape. It also occurs after assorted
crime and car accidents, as well as after community disasters such as hurricanes and
floods. Workers of rescue missions are subjected to situations of severe stress
frequently. Many emergency response workers (police, nurses, and medics) may become
overwhelmed by the trauma they see so many people go through and end up with intrusive
recollections themselves.
Secondly, the trauma is re-experienced in the form of nightmares, flashbacks, intrusive
memories and/or unrest in situations that are similar to the traumatic experience by an
associated stimuli (Pfefferbaum). Auditory or visual stimuli can evoke panic, terror,
dread, grief or despair. Commonly, in the case of war veterans, the patient may be
mentally sent back to the time and location of the original traumatic experience. A
veteran who hears a startling noise like a car backfiring may hear gunfire and it will
trigger flashbacks. These flashbacks can last a little as a few seconds, minutes, or up
to days where the person behaves and reacts to everything as if they are in that original
traumatizing setting.
Thirdly, there is a numbing of the emotions and reduced interests in others and the
outside world. The person is attempting to reduce the likelihood that they will either
expose themselves to traumatic stimuli or if exposed will minimize the intensity of their
psychological response (Pfefferbaum). For this reason, it is extremely difficult for
people with PTSD to participate in meaningful interpersonal relationships.
Forth, there are random associated symptoms including insomnia, irritability,
hypervigilance and outbursts of rage. The natural startle inhibitor may be dulled and the
patient is easily surprised or upset by unexpected stimuli.
Lastly, symptoms of each category must show significant affect on the person's
social/vocational abilities or other important areas of life. Which appears to be an
unavoidable effect if a person is in fact experiencing the symptoms listed. All of these
symptoms must persist for at least one month
An example from the textbook Psychology introduces a 33-year-old nurse named Mary who
suffered severe trauma in the weeks following an attack in her apartment by an intruder
who raped her at knife point (Criterion one). In the weeks after the attack Mary suffered
from an immense fear of being alone in her apartment (the second criterion), and
preoccupied with attack, she feared it could happen again. Her worry developed in to an
obsession with protection and she installed numerous locks on all her windows and doors,
eventually Mary became so overly preoccupied with the attack that she could no longer go
out socially or even return to work (Criterion three and five). She became repelled by
the idea of sex. Her associated behaviors encompass criterion four.
In the seven years since the Gulf War, three percent of United States Soldiers have so
far been diagnosed as having Posttraumatic Stress Syndrome. Those with greatest exposure
to combat are the most likely sufferers, which lends to the idea that the more severe a
traumatic event are more difficult it is to overcome. Additionally it develops
predominantly in soldiers who were categorized as having the least stress resistant
personalities coupled with low levels of social support. Essential to recovery of any
stressful event is the knowledge that the sufferer is not alone or unique in the grief
and that others care about his or her recovery. Those soldiers who returned from war with
no one to share their experiences with are likely to re experience warfare in the form of
nightmares and flashbacks. After witnessing the deaths of both enemies and comrades those
without social support are likely to internalize their pain which have a good chance of
escaping out of the body in the symptoms listed (Bernstein).
Acute PTSD occurs within six months of the traumatic event, while Delayed On-set PTSD
occurs anytime afterwards. In some instances, patients have developed symptoms decades
later. Holocaust survivors, experiencing terrifying nightmares of events they thought
they had buried so long ago, have been diagnosed forty and fifty years after the
attempted genocide of the Jews with PTSD. 
PTSD can become a chronic psychiatric disorder that can persist for decades and sometimes
a lifetime. Chronic patients go through periods of remission and relapse like many
diseases. 
Some problems associated with leaving PTSD untreated are clinical depression and
addictions, such as alcoholism, drug abuse, and compulsive gambling. Addictions are a
common way of self-medicating.
There are instances when a person suffers from involuntary recall of events that they
cant quite place or understand. Sometimes adults who were abused in some form as children
do not fully know what is tormenting them but still struggle with similar symptoms. For
these people hypnosis in a controlled environment is beneficial. After hypnosis the
patient and doctor will discuss what has come out and together deal with what has been
learned. Drugs in general are not a cure for Post Traumatic Stress Disorder, but they can
calm the patient long enough to rationally discuss what is torturing them. Also it is
possible that children who survived the Oklahoma bomb blast may not be told for some time
what they lived through. Their first recollections may be hazy pictures that only hint as
to what happened. Hypnosis may bring out the details that the mind isn't willingly
sharing. When the details are known the patient then has the opportunity to accept them
and develop an understanding and an acceptance (if they are lucky enough to get that far)
of what they have survived (Foy). 
Therapy is the only known method of treatment, but there have not been substantial gains
in this field for recovery of patients. After four months of intensive treatment, Vietnam
veterans showed no long term effects of their therapy in a study conducted by the
National Center for Post-Traumatic Stress Disorder in New Haven. The men received
individual and group psychotherapy and behavior therapy as well as family therapy and
vocational guidance. Although they left reporting increased hope and self-esteem, a year
and a half later their psychiatric symptoms had actually worsened. They had made more
suicide attempts and their substance abuse was dramatically increased (Johnson).
The Harvard Mental Health Letter published February/March of 1991 asserts the important
result of therapy (of any kind) is the enabling of the patient to think about the trauma
without it taking over and being able to control their feelings without systematically
avoiding or diverting their attention. People who are afflicted with PTSD never feel safe
because they are controlled by their fears; nightmares and flashbacks only confirm their
perceived helplessness and remind them of how they were unable to protect themselves from
the event. Healing has taken place only when the person can invoke and dismiss the
memories at will, instead of suffering the intrusive involuntary recall (Johnson).
Bibliography
Bernstein, Douglas A., Alison Clarke-Stewart, Edward Roy, Christopher D. Wickens.
Psychology. Boston: Houghton Mifflin Company, 1997
Bower, Bruce. Exploring trauma's cerebral side. Science News. 149.20 (1996) : 315
Foy, David W., ed. Treating PTSD : cognitive-behavioral strategies. New York: Guilford
Press, 1992.
Friedman, Matthew J. Post Traumatic Stress Disorder: An Overview. National Center for
PTSD. Dartmouth Medical School, 1997. 
Johnson, David R., Robert Rosenheck, Alan Fontana. Post-traumatic treatment failure.
Harvard Mental Health Letter. 13.9 (1997) : 7
Matsakis, Aphrodite. I Can't Get Over It : a handbook for trauma survivors. Oakland.: New
Harbinger Publications, Inc., 1996.
Pfefferbaum, Betty. Posttraumatic stress disorder in children: a review of the past ten
years. Journal of the American Academy of Child and Adolescent Psychiatry. 36.11 (1997) :
1503-12
The Harvard Mental Health Letter. Feb./Mar. 1991. Online. Internet. 14 Oct 1998.
Available. http://www.mentalhealth.com/mag1/p5h-pts2.html