2. Definition
PTSD is a pathological anxiety
that usually occurs after an
individual experiences or
witnesses severe trauma that
constitutes a threat to the
physical integrity or life of the
individual or of another person
It is a debilitating psychological
condition trigged by a traumatic
event, such as rape, war, a
terrorist act, sudden or violent
death of a loved one, natural
disaster, or catastrophic accident
3. Traumas leading to PTSD
include,
War
Natural disasters
Car or plane crash
Terrorist attack
Childhood neglect
Kidnapping
Assault
Rape
Physical abuse
Sudden death of a loved one
Sexual abuse
4. Signs and symptoms
Symptoms of PTSD: Re-experiencing the traumatic event
Intrusive, upsetting memories of event
Flashbacks
Nightmares
Feelings of intense distress, when reminded of trauma
Intense physical reactions, as reminders of event (pounding heart, rapid
breathing, nausea, muscle tension, sweating)
5. Signs and symptoms
Symptoms of PTSD: Avoidance and numbing
Avoiding activities, places, thoughts, or feelings that remind the trauma
Inability to remember important aspects of the trauma
Loss of interest in activities and life in general
Feeling detached from others and emotionally numb
Sense of a limited future (you don’t expect to live a normal life span, get
married, have a career)
6. Signs and Symptoms
Symptoms of PTSD: Increased anxiety and emotional arousal
Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance (on constant “red alert”)
Feeling jumpy and easily startled
7.
8. Other common
symptoms
Anger and irritability
Guilt, shame or self blame
Substance abuse
Feelings of mistrust
Depression and hopelessness
Suicidal thoughts and feelings
Feeling alienated and alone
Physical aches and pains
10. DSM-5 Criteria for PTSD
Criterion A: Stressor
You directly experienced the
event.
You witnessed the event
happen to someone else, in
person.
You learned of a close
relative or close friend who
experienced an actual or
threatened accidental or
violent death.
You had repeated indirect
exposure to distressing
details of the event
Criterion B: Intrusion
Recurrent, involuntary, and
intrusive memories
Traumatic nightmares or
upsetting dreams with
content related to the event
Dissociative reactions, such
as flashbacks, in which it
feels like the experience is
happening again.
Intense or prolonged
distress
increased heart rate
Criterion C:
Avoidance
Persistent effortful avoidance
of distressing trauma-related
reminders after the event as
evidenced by the following:
Avoidance of trauma-
related thoughts or feelings.
Avoidance of trauma-
related external reminders,
such as people, places,
conversations, activities,
objects, or situations.
11. DSM-5 Criteria for PTSD
Criterion D: Neg mood
alterations
Inability to recall key
features of the traumatic
event
distorted negative
beliefs and expectations
about oneself or the world
distorted blame of self or
others for causing the
traumatic event
Feeling alienated, detached
or estranged from others.
inability to experience
positive emotions, such as
happiness, love, and joy.
Criterion E: Alterations
in arousal and
reactivity
Irritable or aggressive
behavior
Self-destructive or reckless
behavior
Feeling constantly "on
guard" or like danger is
lurking around every corner
(hypervigilance)
Exaggerated startle
response
Problems in concentration
Sleep disturbance
Criterion F: Functional
significance
Significant symptom-related
distress or impairment of
different areas of life, such
as social or occupational.
12. DSM-5 Criteria for PTSD
The disturbance is not due to
medication, substance use, or other
illness.
Criterion H: Exclusion
Criterion G: Duration
Persistence of symptoms in Criteria B,
C, D, and E for more than one month.
13.
14. Trauma focused
cognitive
behavioral
therapy
2. PSYCHOSOCIAL TREATMENT
It involves carefully and gradually “exposing”
yourself to thoughts, feelings, and situations
that remind you of the trauma
Exposure therapy
It involves gradually facing the
thoughts and memories of traumatic
event or situations (places where
the event occurred) that make one
anxious.
Done by using imaging techniques
or by actually returning to the place
where one had an accident.
Cognitive
restructuring
therapy
It involves identifying irrational
patterns of thought, feeling and
behavior that emerges after a
traumatic event.
It replaces dysfunctional
thoughts with realistic and
helpful ones.
Eye movement
desensitization
and reprocessing
The patient is asked to concentrate
on an image connected to the
traumatic event and the related
negative emotions, sensations and
thoughts
Patient is encouraged to let go of the
memories and discuss the images
and emotions he experienced during
the eye movements
Group
psychotherapy
Telling one’s story (the “trauma
narrative”) and directly facing the
grief, anxiety and guilt related to
trauma enables many survivors to
go on with their lives rather than
getting stuck in unspoken despair
and helplessness.
TREATMENT
1. PHARMACOLOGICAL TREATMENT
Anti-depressants
SSRIs- Sertraline, Fluoxetine; TCAs- Imipremine
Anti-anxiety drugs
Lorazepam
15.
16. Self help in
PTSD
PTSD self-help tip 1: Reach out to
others for support
PTSD self-help tip 2: Avoid alcohol and
drugs
PTSD self-help tip 3: Challenge your
sense of helplessness