Post-Traumatic Stress Disorder may occur from exposure to real or threatened serious physical and mental injury such as childhood trauma, natural disasters, motor vehicle accidents, intimate partner violence, domestic violence, exposure to violence from the environment, sexual assault, combat trauma from wars, and many other situations.
These experiences may be direct or witnessing in person as it occurs to others, Learning about the traumatic events to family and close friends. Repeated exposure to trauma.
Risk Factors for PTSD:
- Gender – females have increased risk for gender violence
- Pre-existing mental illness
- Family history of violence
- Less education
- Childhood adversity
- Prior – traumatic events
- Military members
- Unsafe environment
Symptoms to PTSD:
- Avoidance of triggers of trauma. Avoidance of thinking about the experience
- Re-experiencing of the traumatic event. Intrusive thoughts of the event.
- Intense negative emotional AND physical reaction to the reminders of the traumatic event
- Hyperarousal for potential danger
- Increased startle reaction
- Reckless behavior
- Self-harming acts
- Sleep disturbance
- Poor concentration
- Mood and cognition – alternations
- poor concentration
- Negative beliefs of oneself
- Guilt and blaming of self for the trauma
- Negative beliefs about the trauma
- Persistent negative emotions with excessive sadness, guilt, horror
- Unable to feel happy thoughts
- Isolation – loss of interest in activities in life
- Withdrawal from family and friends
It is important that Psychological First Aid is administered immediately after a traumatic event. Psychoeducation is critical so that the trauma can be processed. Initial symptoms are a normal reaction to an abnormal event.
Evidence-based management for PTSD is a combination of therapy and medication management or “Pills and Skills” that are effective in the treatment of PTSD. SSRI and SNRI antidepressants are first-line medication management to alleviate PTSD symptoms. SSRI has a black box warning for teenagers. Other medications are used off-label to decrease hyperarousal symptoms.