Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder, better known as PTSD, is a condition arising out of experiencing, witnessing or otherwise being exposed to extreme trauma such as death, serious injury, or sexual violation, all whether actual or threatened. Some of the most common situations that can cause PTSD are combat (this was once called “shell shock” and “combat fatigue”), child abuse, serious accidents, and natural disasters.

Examples of Traumatic Events

The psychiatric definition of PTSD is expected to be broadened to include more ways a person can be exposed to trauma leading to PTSD. Some examples:

1. A man is held up at gunpoint or involved in a serious auto accident.
2. A child or adult is sexually abused once or multiple times.
3. A woman witnesses or learns about the death of her child by accident or violence.
4. A person assists in removing bodies after natural disasters, accidents involving multiple fatalities, etc. As with combat, this may be an example of a series of events that build up into trauma over time.
5. A person’s best friend experiences a life-threatening situation.

In practice, these guidelines are sometimes used flexibly — for example, a caregiver living with a parent who has severe dementia may be diagnosed with PTSD if long-term symptoms occur after the situation has ended.

Symptoms of PTSD:

Re-Experiencing:

A person diagnosed with PTSD has one of more of these symptoms:

1. Recurring and distressing recollections of the experience(s) that intrude in daily life.
2. Nightmares about the event(s).
3. Flashbacks and feelings as if the traumatic experience was occurring in the present.
4. Intense or prolonged psychological distress in response to reminders. For example, a parent whose child died in a car accident may become overwhelmed and cry uncontrollably on the child’s birthday.
5. Marked physiological reactions to reminders of the trauma. An example might be a soldier who becomes physically ill at the sound of fireworks.

Avoidance:

Examples of this could be:

1. Being unable to remember the event(s).
2. Feeling intense guilt or depression.
3. Being unable to drive or ride in a car after an auto accident.
4. Becoming emotionally numb.

Hyperarousal:

Two or more of these symptoms:

1. Difficulty falling or staying asleep.
2. Outbursts of anger or irritability.
3. Difficulty concentrating.
4. Exaggerated startle response.
5. Extreme tension or edginess (hypervigilance)

Duration and Severity:

The symptoms must have persisted for at least a month and be causing clinically significant distress in or impairment to the patient’s life.

Delayed Onset:

It’s possible for symptoms to show up long after a traumatic event occurred.

Children’s symptoms

can be different from those of adults. A child’s nightmares, for example, may be terrifying without referring directly to the trauma. The traumatic event(s) may be acted out in play. Children may refuse to speak or wet the bed. Some consideration is being given to making Post-Traumatic Stress Disorder in Preschool Children a separate diagnosis due to differences in symptoms from those of older children and adults.

PTSD and Migraine

Women are more likely to have migraines and also to have PTSD. However, men are significantly more likely to have both PTSD and migraines. One study concluded that “PTSD in migraine sufferers is associated with a significantly greater level of disability [from the migraines] as compared with those migraine sufferers without PTSD.”

Researchers have suggested that it is important to screen migraineurs for past trauma, and that treatment for any diagnosed PTSD may also help chronic headache and episodic migraine.