Posttraumatic Stress Disorder (PTSD)

What is Posttraumatic Stress Disorder?

Posttraumatic Stress Disorder (PTSD) is a disorder in response to a frightening, dangerous or life-threatening event such as an accident, assault, military combat or natural disaster. People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended.

For some, the “fight-or-flight” biological instincts continue long after the traumatic event, leaving them with an over-active central nervous response system that no longer serves them well. Because the body is busy increasing its heart rate, pumping blood to muscles, preparing the body to fight or flee, all physical resources and energy are focused on getting out of harm’s way. Patients with PTSD have trouble effectively returning to “normal” even after there is no harm present, leaving the person with an uncomfortable feeling of dread, even if the event is essentially a false alarm.

PTSD affects roughly 3.6 percent of the U.S. adult population—about 9 million individuals. About 37 percent of those diagnosed are classified as having severe symptoms. PTSD can occur at any age and usually begins within three months after the traumatic event. Occasionally, symptoms may emerge years afterward.

Symptoms/Diagnosis/Treatment

PTSD Symptoms

PTSD symptoms need a medical diagnosis but they generally fall into these broad categories:

• Intrusion: recurring involuntary memories, flashbacks, nightmares and intrusive thoughts
• Avoidance: staying away from a person or place that might trigger symptoms; avoid talking about it
• Cognitive and mood symptoms: negative self-image and trouble recalling the traumatic event; feeling numb; distorted thoughts about the cause or consequences of the event leading to wrongly blaming self or others; ongoing fear, horror, anger, guilt or shame
• Changes in arousal and reactivity: having difficulty sleeping; outbursts of anger; intense reaction to circumstances that resemble the trauma; exhibiting reckless and self-destructive behavior

PTSD Diagnoses

• A person must have at least on re-experiencing symptom
• Experience three avoidance symptoms
• Have two negative cognitive/mood symptoms
• At least two changes in arousal or reactivity systems

These PTSD symptoms must last more than one month. These symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety.

PTSD Treatment

PTSD can be effectively treated and managed using psychotherapy, medications, service animals, self-management strategies or a combination of these options.

• Treatment options include:

• • Cognitive Behavioral Therapy - focuses on the relationship among thoughts, feeling and behaviors. Therapists will encourage patients to re-evaluate their thinking patterns and assumptions that are unhelpful patterns to a more balanced and effective thinking pattern.
  • Eye Movement Desensitization and Reprocessing (EMDR) - helps patients process and make sense of the trauma and allows one to start to heal. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).
  • Cognitive Processing Therapy - is a specific cognitive behavioral therapy which teaches one to re-frame negative thoughts about the trauma.
  • Prolonged Exposure - teaches the patient how to gain control by facing the negative feelings related to the traumatic memories.
  • Seeking Safety - specifically targets someone that struggles with drug or alcohol use as well as PTSD.

Help is Available

MyMichigan Health offers integrated behavioral health at many providers offices as well as a comprehensive psychiatry team to provide treatment options.

• Integrated Behavioral Health (if available in the office) can provide immediate interventions to assist with patients attending provider appointments who are experiencing a crisis.
• Psychiatry Team includes psychiatric evaluations, psychotherapy and sports psychiatry. For additional information, please call (989) 839-3385.