Post-Traumatic Stress Disorder (PTSD)

WHAT IS IT? 

This is an anxiety disorder that is characterized by persistent experiencing of a previous traumatic event (such as war, rape, a robbery, serious accident, etc.)

WHY IS IT A PROBLEM?

Patients will be unable to experience stimuli that reminds them of their traumatic experience without reacting negatively. The risk of suicide is also very high in these patients.

WHAT MAKES US SUSPECT IT?

Risk factors: woman, exposure to life threatening trauma, surviving a disaster, exposure to war, history of mental health problems.  

Presentation: nightmares/flashbacks, helplessness, intense fear, horror. Patients will typically avoid the stimuli associated with the trauma and are constantly aroused.

HOW DO WE CONFIRM A DIAGNOSIS?

*Patients will experience the following symptoms for at least one month:

  • Hyperarousal: such as jumpiness, trouble sleeping, angry outbursts
  • Intrusive thoughts: such as daytime dreams or flashbacks
  • Numbness: patients can have limited emotions and affect. They can feel detached from the world or others around them.
  • Avoidance: patients will avoid the stimuli that reminds them of the traumatic event which is behind their anxiety.
HOW DO WE TREAT IT? 

First line therapy:

Cognitive Based Therapy (CBT): this is a form of behavioral therapy that is designed to give the patient tools/strategies to address their current problems (i.e. coping strategies, reconditioning though processes, etc).

Selective seretonin re-uptake inhibitors (SSRIs): these medications inhibit the re-uptake of serotonin in the neural cleft, resulting in increased serotonin signaling.

  • Escitalopram is one example of a first-line medication that is used.

Venlafaxine: a seretonin/norepinephrine re-uptaken inhibitor (SNRI)

Other antidepressants can be used: such as TCAs and MAOIs

HOW WELL DO THE PATIENTS DO?

About one third of patients with PTSD develop chronic PTSD (source)

WAS THERE A WAY TO PREVENT IT? 

Avoiding the initial exposure/traumatic event would in theory prevent PTSD. Given that such events will occur to a fraction of patients regardless, screening for high risk patients is important.

WHAT ELSE ARE WE WORRIED ABOUT? 

Suicide: about 1 in 5 patients with PTSD will attempt suicide (source)

OTHER HY FACTS?
Page updated: 12.15.2015