PTSD awareness is key to treatment Published Jan. 27, 2009 By Staff Sgt. Brian Stives 366th Fighter Wing Public Affairs Office MOUNTAIN HOME AIR FORCE BASE, Idaho (ACCNS) -- After a trauma or life threatening event it's common to have upsetting memories of what happened, to have trouble sleeping, to feel jumpy, or to lose interest in things you used to enjoy. For some people, these reactions don't go away on their own, or may even worsen over time. These people may have post-traumatic stress disorder, or PTSD. "PTSD is an anxiety disorder that can occur after a traumatic event," said Capt. Samuel Tobler, 366th Medical Operations Squadron psychologist. "A traumatic event can develop after exposure to an experience in which there was the potential for serious physical harm or death. During this type of event, individuals may think that their life or others' lives are in danger. They may feel afraid or feel that they have no control over what is happening. PTSD is distinguished from 'normal' remembering of stressful events because it is persistent, causes emotional distress, and disrupts functioning in daily life." Anyone who has gone through a life-threatening event can develop PTSD. These events can include: Combat or military exposure Physical abuse Terrorist attacks Sexual or physical assault Serious accidents, such as a car wreck. Natural disasters, such as a fire, tornado, hurricane, flood or earthquake "After the event, it is a common reaction to feel scared, confused, or angry. When these feelings don't go away or they get worse, it may be due to PTSD," said Captain Tobler. "Symptoms of PTSD frequently disrupt life, making it hard to continue with daily activities." Here is some addtional information from the National Center for Post Traumatic Stress Disorder. How does PTSD develop? All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD. "Most people who go through a traumatic event have some symptoms at the beginning," said the captain. "Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. The likelihood of developing PTSD depends on many things. Some factors affecting the development of PTSD include: the intensity and duration of the trauma; degree of loss associated with the trauma; how close you were to the event; how strong your reaction was; how much you felt in control of events; or amount of help and support you got after the event." Many people who develop PTSD get better at some point. But about one out of three people with PTSD may continue to have some symptoms. Even if they continue having symptoms, treatment can help them cope. The symptoms don't have to interfere with everyday activities, work and relationships. What are the symptoms of PTSD? "Symptoms of PTSD can be terrifying," said the captain. "They may disrupt your life and make it hard to continue with daily activities. In some cases, it may be hard just to get through the day." PTSD symptoms usually start soon after the traumatic event, but they may not surface for months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause great distress, or interfere with work or home life, the person may have PTSD. There are four types of symptoms: reliving the event, avoidance, numbing and feeling keyed up. Reliving the event Reliving the event involves experiencing the same mental, emotional or physical experiences that occurred during or just after the trauma, such as: unexpected and distressing memories of the event or flashbacks (feeling as if the event were happening again while awake); nightmares consisting of the event or other frightening images; exaggerated emotional and physical reactions to triggers that remind the person of the event. Avoiding reminders of the trauma Survivors may or may not realize their behaviors can be motivated by the need to avoid reminders of the trauma. Avoidance is indicated by: extensive avoidance of activities, places, thoughts, feelings or conversations related to the traumatic event; feeling detached from others; loss of interest in activities that used to be enjoyable; restricted emotions; shutting down emotionally or feeling emotionally numb; trouble having loving feelings or feeling any strong emotions; losing interest in things you used to enjoy doing. Increased arousal Physical reactions to trauma reminders such as: trouble sleeping; difficulty concentrating or remembering information; irritability, feeling agitated, or outbursts of anger; feeling hypervigilant or on-guard, constantly on the lookout for danger; getting startled by loud noises or someone touching you when you are not expecting it; feeling shaky and sweaty; having your heart pound and/or having trouble breathing. What treatments are available? Practicing relaxation methods "These can include muscular relaxation exercises, breathing exercises, meditation, swimming, stretching, yoga, prayer, listening to quiet music, spending time in nature and so on," said Captain Tobler. "While relaxation techniques can be helpful, they can sometimes increase distress by focusing attention on disturbing physical sensations or by reducing contact with the external environment. Be aware that while uncomfortable physical sensations may become more apparent when you are relaxed, in the long run, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking, or other activities) helps reduce negative reactions to thoughts, feelings, and perceptions." Increasing positive distracting activities "Positive recreational or work activities often help to distract a person from his or her memories and reactions," said the captain. "Artistic endeavors have also been a way for many trauma survivors to express their feelings in a positive, creative way. This can improve your mood, limit the harm caused by PTSD, and help you rebuild your life. It's important to emphasize that distraction alone is unlikely to facilitate recovery; active, direct coping with traumatic events and their impact is also important." Talking to another person for support "When survivors are able to talk about their problems with others, something helpful often results," said Captain Tobler. "Of course, survivors must choose their support people carefully and clearly ask for what they need. With support from others, survivors may feel less alone, feel supported or understood, or receive concrete help with a problematic situation. Often, it is best to talk to professional counselors about issues related to the traumatic experience itself; they may be more likely than friends or family to understand trauma and its effects. It's also helpful to seek support from a support group. Being in a group with others who have PTSD may help reduce one's sense of isolation, rebuild trust in others, and provide an important opportunity to contribute to the recovery of other survivors of trauma." Sometimes PTSD symptoms worsen and ordinary efforts at coping don't seem to work. It is important to reach out and contact a therapist or counselor for more intensive services. You can obtain additional information about PTSD at www.ncptsd.va.gov