Post-traumatic stress disorder

Posttraumatic stress disorder: description

Posttraumatic Stress Disorder (PTSD) is a mental illness that occurs after traumatic events. The term trauma comes from the Greek and means “wound” or “defeat”. A trauma thus describes a very stressful situation in which the affected person feels helpless and helpless. This does not mean normal, if painful, life situations such as the loss of a job or the death of relatives. Post-traumatic stress disorder is caused by exceptional and extreme emergencies.

Such a trauma can arise, for example, from directly experienced violence (physical – also sexual – or psychological) or experienced violence such as during a war. The exceptional emergencies of natural disasters can also trigger a PTSD. The person is exposed to a life-threatening situation.

Posttraumatic stress disorder is also called post-traumatic stress syndrome because it can involve many different symptoms. Are possible, for example, complaints such as anxiety, irritability, sleep disorders or even panic attacks (tachycardia, tremors, shortness of breath). Flashbacks are also typical – the repeated experience of the traumatic situation, in which the person affected is flooded by memories and emotions.

Posttraumatic stress disorder: frequency

The post-traumatic stress disorder usually occurs six months after the experience and can in principle hit anyone. A US study estimates that eight percent of the population experience post-traumatic stress disorder once in their lifetime. According to another study, doctors, soldiers and police are at up to 50 percent more at risk of PTSD. German scientists published results according to which a rape in 30 percent of cases leads to a post-traumatic stress disorder.

Complex Post-Traumatic Stress Disorder

The complex post-traumatic stress disorder requires particularly severe or particularly long-lasting trauma. In those affected usually shows a serious disease with personality changes. Symptoms mainly affect personality and behavior.

Post-Traumatic Stress Disorder: Symptoms

You can read more about the posttraumatic stress disorder – symptoms in the article Posttraumatic Stress Disorder.

Post-Traumatic Stress Disorder: Causes and Risk Factors

The causes of posttraumatic stress disorder can be very diverse. In any case, it is a traumatic experience. The victim suffers a serious threat and feels that it is about his own survival.

Physical violence in the form of rape, torture or war usually favors a post-traumatic stress disorder more than natural catastrophes or accidents, for which nobody can be blamed directly. The experienced human violence can not usually be reconciled with the existing world view. There is then a direct “enemy” that represents the threat.

Individuals without social support are considered more susceptible to post-traumatic stress disorder. The unstable social background, low levels of parent education and low family support increase the risk of post-traumatic stress disorder. Crime in the immediate environment is also considered a risk factor.

People with a mental illness are also more susceptible to the post-traumatic stress disorder. Even those who suffered under a very authoritarian style of education with punitive consequences of the parents, carries a higher risk for the post-traumatic stress disorder.

The risk of a complex post-traumatic stress disorder is greater if the trauma occurred over a longer period of time, experts suggest.

Posttraumatic stress disorder: examinations and diagnosis

The post-traumatic stress disorder must be distinguished from an acute stress response. The symptoms are similar in both cases (anxiety, confusion, isolation, etc.). However, the acute stress response refers to a state of mental overwork immediately after experiencing a severe physical or mental condition. Posttraumatic stress disorder, on the other hand, only sets in after a delay after the trauma.

A PTSD is diagnosed by its symptoms. This is not always easy, as the symptoms often overlap with other illnesses (anxiety disorder, borderline disorder, depression). If a person feels physical suffering such as shortness of breath, rapid heartbeat, trembling or sweating, he usually turns to his family doctor first. This will first clarify organic causes. If there is a suspicion of a post-traumatic stress disorder, he refers the person concerned to a psychiatrist or psychotherapist.

In the initial consultation with a specially trained trauma therapist, the diagnosis “post-traumatic stress disorder” is usually not asked. The therapist first asks questions about the CV and any existing illnesses. Only cautiously he inquires about any triggering factors for the current condition. Direct questions about the trauma can worsen the condition and eventually overwhelm the patient and make him inaccessible to subsequent psychotherapy.

Posttraumatic stress disorder: diagnostic criteria

In order to diagnose a post-traumatic stress disorder, according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the following criteria must be met:

• The patient was exposed to a stressful event (of extraordinary threat or catastrophic magnitude) that would provoke almost every helplessness and despair.
• There are growing and lasting memories of the experience (flashbacks).
• The person concerned avoids situations and circumstances that are similar to the triggering situation.
• Irritability and temper tantrums
• difficulty concentrating
• Sleep-in and sleep-through disorders
• hypersensitivity
• Increased dreadfulness
• A partial to complete inability to remember the stressful event
• Symptoms must occur within six months of the trauma.

Posttraumatic stress disorder: test

To diagnose the post-traumatic stress disorder, there are several standardized questionnaires:

The so-called “Clinician-Administered PTSD Scale“has been developed specifically for the diagnosis of” Posttraumatic Stress Disorder. “It initially includes questions about the trauma itself, it raises questions about whether, how often and in what intensity the various symptoms of PTSD appear, and finally depression or suicidal thoughts are clarified.

Of the SCID-I Test is also a widely used structured clinical interview to diagnose post-traumatic stress disorder. It is a guide interview: The interviewer asks questions and then encodes the answers. For inpatients, performing a SKID-I test takes on average 100 minutes. The diagnosis “posttraumatic stress disorder” can be secured with this test.

Complex post-traumatic stress disorder: test

Whether a complex post-traumatic stress disorder is present, is usually also clarified with the help of an interview. The Structured Interview on Disorders of Extreme Stress (SIDES) has proven itself.

A German-language test version is the “Interview on the complex post-traumatic stress disorder” (I-KPTBS). Questions are also asked and answers are coded.

Posttraumatic stress disorder: treatment

The post-traumatic stress disorder should be treated by a trauma therapist trained psychiatrist or psychologist. If a wrong therapy is used, the post-traumatic stress disorder may otherwise solidify.

Post-Traumatic Stress Disorder: Psychotherapy

Posttraumatic stress disorder can be successfully treated with a psychotherapeutic procedure. The treatment usually takes place in several steps:

1.Safety: First and foremost is to create a secure environment and a sense of security for the person concerned. The patient must feel reasonably safe and secure in order to be able to address his post-traumatic stress disorder. Often a semi-stationary or inpatient stay is therefore recommended for the beginning of treatment. Before the psychotherapy is started, the patient is usually informed (psychoeducation) so that he or she understands the posttraumatic stress disorder better as a clinical picture.

2.Stabilization: The planned psychotherapeutic procedure is usually discussed jointly by the patient and the therapist. Strategies are developed to handle everyday life. Relaxation exercises and breathing exercises can help to keep your own thoughts in check. In addition, drug support can be helpful in resolving anxiety. However, patients suffering from posttraumatic stress disorder have a higher risk of being drug dependent. The drugs should therefore be targeted and used under observation.

3. Trauma Overcoming / Integration and Reorientation: At this stage, the patient has already gained security and learned techniques to guide his emotions. Often, those affected quickly feel overwhelmed with emotions. Therefore, it may be helpful if the therapy is initially not addressed directly to the trauma, but an indirect processing of the memory takes place. Step by step the sufferer is slowly confronted with pictures and feelings. This advanced form of behavioral therapy (Confrontational Therapy) is widely used to treat post-traumatic stress disorder.

Another therapy developed specifically for post-traumatic stress disorder is the Eye Movement Desensitization and Reprocessing (EMDR). Here, the patient is slowly introduced to the trauma in the protected context of PTSD therapy. At the moment of remembrance and when the fear rises again, a quick change in the direction of vision should bring about a habituation to the trauma experience. The post-traumatic stress disorder is treated by embedding the traumatizing experience in the mental processes and no longer leads to fear and helplessness.

Complex Post-Traumatic Stress Disorder: Therapy

The complex post-traumatic stress disorder in Germany is usually treated by the psychodynamic imaginative Traumatherapienach Luise Reddemann. Imaginative therapy generally combines different treatment techniques. The patient learns to mentally create a safe space to which to retire when the emotions become too strong. The aim here is to overcome the post-traumatic stress disorder by embedding the experience in the normal emotional world.

Post-Traumatic Stress Disorder: Disease course and prognosis

How a post-traumatic stress disorder works depends on the severity and your own resources. In about one third of those affected, the post-traumatic stress disorder disappears on its own within twelve months. After extensive psychotherapy, half of those affected are already symptom free after four years. However, ten years after trauma, a third of patients still have not gotten rid of post-traumatic stress disorder.

A manifested post-traumatic stress disorder often influences the everyday life of those affected. It leads to avoidance strategies, which in turn increase anxiety and helplessness. A possible job loss or early retirement can lead to social isolation. The affected then usually feel even more helpless and lonely.

The support from the social environment is very important for the healing process. The affected person must feel safe and secure in everyday life in order to overcome the post-traumatic stress disorder.

Some patients succeed in seeing the trauma as a process of maturation and gain something positive from what they have experienced (“traumatic growth”). You can help others who are affected by it Post-traumatic stress disorder tackle or campaign for victim organizations.