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Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is an anxiety problem that can develop after extreme events, such as combat, crime, an accident, or natural disaster. Those with PTSD may relive the event through intrusive memories or nightmares and may avoid anything that reminds them of the event including people, places, objects, or even thoughts and feelings. They may experience distress, and depressive and anxious feelings that weren’t present before the event. If these problems cause significant distress, or interfere at work, in relationships, or with leisure time, a PTSD diagnosis may be appropriate.

PTSD SYMPTOMS

Dr. Martin speaking with patientAnyone may develop PTS symptoms, regardless of age, race, gender, intelligence, or other characteristics, such as bravery or mental toughness (for example, PTS is seen in first responders and members of the military). The chance of developing PTSD is increased by prior traumatic experiences, especially during childhood.

PTSD symptoms develop when there is a disconnect between two things – 1) the way our mind sees the world; and 2) something that happens to us. For example, our mind may see the world as a place where we can prevent all negative things from happening to us. But then something happens that is out of our control – like an automobile collision we couldn’t avoid, or a physical assault or illness we couldn’t prevent. Suddenly, there is a conflict in our thoughts – a conflict between the way our mind sees the world, and the traumatic event that happened.

Whether our mind changes its view of the world too much, or it changes its memory of the event, life becomes more difficult. We might begin shaking or crying even though the day has not been stressful, or we may not want to get out of bed in the morning or drive in traffic, or we might start doubting our ability to make decisions. We may avoid anything that might remind us of the traumatic event. And when we are reminded of the event, we feel intense distress, or panic. Without realizing it, we start avoiding things that might remind us of the event, so that we can avoid the distress and panic. But if we avoid thinking about the event, or we struggle with distress and panic, we don’t have a chance to feel our natural feelings, like anger, sadness, or grief, and we wind up carrying around a lot of emotional pain.

TREATMENT & PROGNOSIS

The prognosis with treatment is good. About 70% of people who participate in a treatment specifically designed for PTS experience long-term relief. Typical treatment involves a thorough psychological assessment, building a trusting and non-judgmental therapeutic relationship, then addressing the trauma. Some of the treatment involves talking about the traumatic event, and some involves learning about and changing the effects the trauma has had on our thoughts, feelings, and behavior. The trauma only needs to be discussed long enough to allow associated feelings to arise and finally run their course. That way we needn’t relive a traumatic event each time we’re reminded of it. Then we focus on how the trauma affected how we think about ourselves, others, and the world, in terms of safety, trust, power and control, esteem, and intimacy. Along the way, we learn to see some of our thoughts we weren’t previously aware of, learn how to challenge them if they are unhelpful or painful, and learn to replace them with balanced and realistic thoughts. Most treatments involve 8-16 weekly, hour-long sessions using a treatment technique called Cognitive Processing Therapy for Trauma. The companion software application for this treatment is called “CPT Coach,” and is available for iOS and Android.

To schedule an appointment for Post-Traumatic Stress Disorder, please call 757-596-1900. You do not have to be an Orthopaedic or Interventional Pain Management patient at OSC to schedule a consultation with Dr. Martin.

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