LWL | A study on Post Traumatic Stress Disorder (PTSD), its Implication, Management and Treatment

By Eaanya Nirvikar

Abstract

Post traumatic Stress Disorder (PTSD), is multifaceted psychiatric condition can occur in people who have experienced or witnessed a traumatic event. The present few lines of this research paper will explore the complex web of a disorder, PTSD, which includes its etiology, form and symptomology, diagnostic criteria or tests and measures for detection and existence with preventive methodologies business plan in addition to post treatment prognosis in case an individual is suffering from it. It also explores the implications and effects of PTSD on people and a larger society. The objective of this paper is to help identify the resources necessary for diagnosis and, ultimately, clinical practice, while identifying evidence-informed prevention guidelines and effective treatment strategies to provide an understanding of PTSD, as well as available mental health services.

Introduction

Trauma: ‘Psychological trauma is a response to an event that a person finds highly stressful. Written by Jayne Leonard on June 3, 2020 — Fact checked by Timothy J. Legg, PhD, PsyD

The APA defines trauma as "an emotional response to a terrible event like an accident, rape or natural disaster." Trauma is not just one-off memories, but in many cases, trauma is lasting damage such as having lived through a war, being repeatedly abused. It also does not have to be exact event against you, it can happen right in front of you.

One could also develop ‘Post Traumatic Stress Syndrome’ after finding out thataha traumatic event had occurred to a loved one.

Trauma and the Nervous System

If we perceive a human threat (we believe our life to be in danger, it does not matter if the danger is real or imagined), our nervous system will switch on survival mode. Signals are sent from the amygdala, a small region in the brain, which prompt our muscles to prime themselves for action (fight or flight). The freeze response is utilized by the nervous system when fighting and fleeing are not options- as in the 


case of a child experiencing abuse in the home. This means an emotional shutdown and mental shutdown so we do not get too consumed in our psyche. Freeze has its purpose in survival, but it is horrendously maladaptive if it lingers. The nervous system of those who live through chronic trauma gets stuck in this defense and thus comes to experience even safe places, people as threatening.

Trauma comes in all forms, including:

Acute trauma: This occurs after one significant or dangerous event. Acute trauma -This is a trauma caused by a one-time event. The event was so overwhelming that our autonomic nervous system – the portion of the nervous system responsible for survival freezes in its threat response.

Treatment: Acute stress disorder (ASD) Top Line: Trauma-focused CBT is a specific form of cognitive-behavioral therapy (CBT). It is possible that CBT will prevent progression to PTSD.

Chronic trauma: This type of trauma is derived from repeated and highly stressful events that have continued for a long period. Whether it is a case of child abuse, bullying or domestic violence.

Chronic trauma is trauma which developed as a result of an ongoing event, (whereas acute trauma is a one-time event). Those incidences have repeated themselves a number of times, and include phenomena such as:

  • Prolonged child abuse
  • Excessive War and Combat Experiences
  • Repeated sexual abuse Witness to repetitive domestic violence
  • Reoccurring natural disasters - exposure

The most common treatments for chronic trauma, include

  • BeautycounterModern Warfare 8029 EMDR (Eye Movement Desensitization and Reprocessing)
  • Somatic Experiencing
  • Cognitive Behavioral Therapy (for trauma)
  • Medication

Complex trauma: The type of trauma results from exposure to multiple traumatic events.

Treatment for complex PTSD - CBT (trauma-focused or not) and EMDR

Secondary Trauma (a.k.a.Vicarious Trauma) Trauma symptoms arise from being too close to the trauma without ever having experienced it.


Trauma causes stress:

Stress is an emotion or physical feeling. Whether it be feeling upset, pissed off, or anxious over anything. Stress is how your body responds to any kind of demand or threat. It affects a person mentally and physically. This makes it difficult for one to relax and often triggers emotions such as anxiety and irritability. Anxiety and depression, in particular, are the mental health conditions that can be catalyzed or exacerbated by stressful circumstances.

Stress: Chronic and Acute

  • Acute stress : Can occur over minutes to hours after an event. It only sticks around for a few weeks, but hits you hard. This includes stressors to include the following constituents:
  1. Anxiety.
  2. Intense fear or helplessness.
  3. Flashbacks and nightmares.
  4. Numbness or a vague feeling of disconnection from one's body.
  5. Avoiding the painful topic entirely or anything that is even remotely related to the event assassment.
  • Chronic stress: Stress which remains for a long Time or It keeps rebounding. Provided you are always under pressure from all over place and people. Persistent feeling of being rushed and swamped for a long time

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event - either experiencing it or witnessing it. This is a difficult neuropsychiatric problem, includes re-experiencing, avoidance, negative cognitions and emotions and hyper arousal. " A PTSD diagnosis is commonly found alongside neurologic diagnoses, including traumatic brain injury, post-traumatic epilepsy and chronic headaches. While it was first identified in war veterans, PTSD can affect anyone who has experienced or witnessed a traumatic event such as combat, rape, robbery, kidnapping, or natural disaster. This knowledge about PTSD is critical in providing the appropriate treatment and support for those who suffer.



The physical response one has when afraid is the body's way of preparing itself to avoid or repsond to an oncoming danger; this comes as part of a "fight-or-flight" mechanism which exists in everyone. Reactions to trauma can be a spectrum of outcomes and many people may recover over time. When using the CROPS and ongoing symptoms similar to those in PTSD are present, a diagnosis of post-traumatic stress disorder is appropriate.

In the days and weeks following, many people begin to have PTSD-like symptoms as they work through what has happened.

Many people respond to trauma with fear, anxiety, anger, depression, guilt etc. Yet most people who are exposed to trauma do not develop long-lasting post traumatic stress disorder.

Like most mental health problems, PTSD is probably the result of a complex mix of:

  • Stressful events related to the level and intensity of trauma you have endured throughout your life
  • Inherited mental health vulnerabilities (e.g. a family history of anxiety / depression)
  • Your genetic identity including: — Your temperament.
  • Your brain balance and hormones production when your body reacts to stress

Signs / Symptoms:- of Post Traumatic Stress disorder:-

PTSD symptoms may begin within one month of a traumatic event, but sometimes may not appear until years afterward.

These symptoms are severe enough to result in significant problems at work or in social situations and relationships. Symptoms of PTSD fall into 4 categories.

  • Intrusive memories: Memories occur with flashbacks, nightmares or repetitive, involuntary memories of the traumatic event (from U.S. Department of Veteran Affairs).
  • Avoidance behaviors: Not wanting to be reminded of the trauma, including places, people, or activities that might remind you of the traumatic experience.
  • Negative alterations in thinking and mood: Persistent negative emotions, detachment from others, inability to feel positive emotions, and distorted self-image or view of others.
  • Hyperarousal: Hypervigilance, irratibility, difficulty concentrating; an exaggerated startle response; and difficulty falling/staying asleep.


Symptoms may even change over time or be different person to person. Re-experiencing symptoms consist of intrusive thoughts, flashbacks and nightmares. Numbness People with PTSD will avoid other people, places, or activities that remind them of the traumatic event. The adverse effects in cognition and mood can be experienced as depersonalisation, anhedonia, and hyper-responsibility. Arousal/reactivity symptoms such as hypervigilance, irritability, sleep difficulty

  • Physical reactions to a traumatic experience They are:-
  • Fatigue or exhaustion.
  • Disturbed sleep.
  • Nausea, vomiting, and drowsiness.
  • Headaches.
  • Excessive sweating.
  • Increased heart rate.

Exposure to trauma and post-traumatic stress symptoms (PTSS) are related to alterations in emotional face processing. A host of methodological approaches have been adopted in preceding research on hyper-reactivity to threatening cues in post-traumatic stress disorder (PTSD; e.g., fearful faces), but different and conflicting findings were arrived at, such as greatervs. reduced dwell duration on fearful faces in studies to date

Hyper vigilance is well described in PTSD and has been connected with altered threat (fearful faces) processing.

Several conditions that are most associated with PTSD include two:

  1. Acute Stress Disorder, 2. Complex PTSD (CPTSD)

Causes: Etiology and Risk Factors

PTSD Triggers

PTSD is the result of exposure to trauma that involves actual or threatened death, serious injury, or sexual violence. The type and degree of trauma to which one is exposed are essential factors in the development of PTSD.




  • Biological Factors: Genetic predisposition, neurobiological changes (e.g. alterations in brain structure and function, dysregulation of stress hormones), neurotransmitter imbalances play a factor in susceptibility to PTSD.
  • Psychological Factors : Individuals with a pre-existing mental health disorder, past experiences of trauma and loss, coping strategies, resilience and cognitive appraisal of PTSD symptoms hide factors that can predispose the development of PTSD.
  • Social and Environmental Factors: Poor social support, history of childhood trauma, low socioeconomic status, and cultural beliefs influence the

Description of the PTSD Diagnosis / Assessment

In DSM-5, a PTSD diagnosis is defined by the presence of specific symptoms for a specified duration following exposure to traumatic events. Structured interviews and assessment tools allow for an accurate diagnosis of PTSD with input from qualified healthcare professionals.

Assessment Tools

Structured interviews (eg, Clinician-Administered PTSD Scale), self-report questionnaires (eg, PTSD Checklist) and diagnostic criteria that are use to diagnose PTSD

Challenges in Diagnosis

Patients may have overlapping features with other psychiatric disorders, including depression and anxiety, as well as cultural considerations, all of which make it challenging to diagnose with certainty.

Treatment Approaches

Thankfully, there are a number of evidence-based approaches available for those struggling with PTSD. One highly effective form of therapy proven to help people address their trauma is Cognitive-Behavioral Therapy (CBT) - including Prolonged Exposure Therapy and Cognitive Processing Therapy. Medications (selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines) can also be used to help manage PTSD symptoms. Also, research with alternative treatments, like Eye Movement Desensitization and Reprocessing (EMDR) and meditation-based therapies, has provided some foundation for effectively treating PTSD.





Some effective treatments for PTSD are as follows.

Psychotherapeutic Approaches

  • Cognitive Behavioral Therapy (CBT): Therapy focusing on altering maladaptive thoughts and behaviors 
  • Eye Movement Desensitization & Reprocessing (EMDR)-A type of therapy that uses bilateral stimulation to process memories.
  • Prolonged Exposure Therapy (PE): Patients are systematically exposed to memories of their trauma and assignments they complete at home.

Pharmacological Interventions

Antidepressants SSRIs and SNRIs help alleviate PTSD symptoms. Antidepressant medications Neuron Wellbutrin Combo Majorly: SSRIs, SNRIs Some prescription drugs that might help alleviate PTSD symptoms are antidepressants.

How Does It Work?

One thought is that the PTSD relates to changes in the brain that we use to help manage stress. The brain chemicals known as neurotransmitters are thought to be at different levels in people with PTSD than in people without it. This theoretically restores balance to the chemicals in your brain, and is believed to help reduce symptoms of PTSD for about 3 out of every 10 people treated.

The potential side effects of using SRIs and SNRIs: it causes permanent or temporary damage because its side effects are not life threatening; it only upsets the stomach, causes sweating, headache and dizziness.

Other Medications: Antipsychotics, mood stabilizers, alpha-adrenergic blockers (in selected patients).

Complementary and alternative treatments

Yoga, mindfulness meditation, acupuncture and animal-assisted therapy as adjunctive treatments for posttraumatic stress disorder management.





Prevention and Coping Strategies :To help manage PTSD, non-medicinal strategies are:-

  • First line: For most adults with PTSD, trauma-focused psychotherapy is suggested as a first-line treatment.
  • It is very important to take time to heal properly and mourn the loss of what might have been.
  • Do not force the healing process.
  • Be patient with the recovery process
  • Prepare for complicated and erratic emotions
  • Allowing your experience to be what it is without judgement or guilt.
  • We must learn to re-associate with the uncomfortable feelings without becoming over whelmed.

Impact of PTSD

The effects of PTSD can ripple through every area of a person's life. It gets in the way of being able to have healthy relationships, do well at school or work, and be able to do normal things. These people also have greater chances of developing additional mental conditions like depression, anxiety, and abuse substances. PTSD can also be physically debilitating as a consequence of musculoskeletal stress and reduced immune functioning due to allostatic overload.

PTSD affects numerous areas of a person's life such as

    • Emotional Health: Greater probability of developing depression, anxiety disorders and substance abuse.
    • Physical health: Chronic pain, heart problems and autoimmune diseases are sometimes triggered as a result of untreated PTSD.
  • Social and occupational functioning: Relationship, work/school, and social avoidance/withdrawal is common.
  • Management and psychological strategies

    Managing PTSD involves:

    • Public education: Help people and their families to have a clear understanding about what is PTSD, how can they manage symptoms.



  • Supportive relationships – strong social support networks can help with recovery and provide emotional grounding.
    • Self-care practices: such as daily exercise, good diet and relaxation can help alleviate some of the stress and anxiety that comes with PTSD.

    Long Term Outcomes and Prognosis

    Impact on Quality of Life

    Chronicity Of Symptoms, level of social and occupational functional impairment; presence of comorbidities (eg alcohol/drug use disorders or cardiovascular diseases).

    Factors Influencing Prognosis

    Future results in patients with PTSD over the long run could be influenced by timely interventions, adherence to treatment and social support networks, as well as resilience and coping strategies [32].

    Conclusion:

    Post-Traumatic Stress Disorder (PTSD) is a serious mental health problem which can change and damage the way in which an individual leads his or her life. This article details what causes it, how to spot the symptoms and what treatments you can get by both medical professionals and support groups in society - so we can all work together to provide a more understanding and better trove of provisions in terms of mental health. Further research and education needs to be done to improves the lives of those who continue to suffer in the wake of traumatic events.

    Posttraumatic stress syndrome is a multifaceted psychiatric disease for which understanding and love are needed. This all emphasizes that the sooner people with PTSD are treated, the faster they will begin to feel better and enjoy life with a range of treatments including medications, psychotherapies, and supportive care interventions. Further ongoing study and comprehension is crucial in figuring out what causes PTSD, what the symptoms are, how it can be treated and how to support those who experience it.

    This paper provides a comprehensive overview of PTSD, emphasizing the importance of understanding its symptoms, diagnosis, treatment options, and broader impact. By enhancing awareness and knowledge of PTSD, healthcare professionals, caregivers, and communities can better support individuals affected by this debilitating condition




    Hypothesis Statements:

    The research paper may consider 2 Hypothesis statement for the study:

    Statement 1: Effective regular and early treatment and medical intervention do not significantly improve outcomes or reduce the long-term impact of PTSD on individuals.

    Statement 2: Effective regular and early treatment and medical intervention significantly improve outcomes or reduce the long-term impact of PTSD on individuals.

    Outcome: On hypothesis testing of the said statements on the basis of sampling and interviewing the interpretations can be drawn which may lead to corrective measures at reducing the impact of PTSD on individuals.

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    • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
    • Creamer, M., Burgess, P., & McFarlane, A. C. (2001). Post-traumatic stress disorder: Findings from the Australian National Survey of Mental Health and Well-being. Psychological Medicine, 31(7), 1237-1247. https://doi.org/10.1017/S0033291701004253
    • Foa, E. B., Keane, T. M., & Friedman, M. J. (Eds.). (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. Guilford Press.
    • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748-766. https://doi.org/10.1037/0022-006X.68.5.748
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    • Institute of Medicine. (2014). Treatment for posttraumatic stress disorder in military and veteran populations: Initial assessment. The National Academies Press.
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      • Magruder, K. M., Frueh, B. C., Knapp, R. G., Johnson, M. R., Vaughan, J. A., Carson, T. C., Powell, D. A., Hebert, R., & Martin, R. H. (2005). PTSD symptoms, demographic characteristics, and functional status among veterans treated in VA primary care clinics. Journal of Traumatic Stress, 18(6), 751-762. https://doi.org/10.1002/jts.20074
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  • Bibliography & References 

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    Future Directions for Research

    Future research should focus on:

    • Identifying biomarkers and neurobiological mechanisms underlying PTSD.
    • Developing personalized treatment approaches based on individual symptom profiles and genetic factors.
    • Implementing community-based interventions and preventive strategies to reduce the incidence of PTSD and promote resilience in vulnerable populations.