What Is Post Traumatic Stress Disorder

What Is Post Traumatic Stress Disorder, PTSD? Psychiatric Disorder Caused by a Trauma Event, an Outside Influence

Psychiatry had emphasized the deficiencies of individuals as the source of mental problems. Before the 1970s, combat veterans, crime victims and other trauma survivors were usually blamed for their symptoms and regarded as weak. The high rate of psychiatric disorders suffered by Vietnam vets led to research by the Veterans Administration, which helped to establish the validity of PTSD. According to the DSM IV TR, a person has to experience a traumatic event that there was threatened death, serious injury to oneself or others which involved terror, extreme fear and/or helplessness.

PTSD and Reliving the Event

The event is constantly replayed in one or more ways. There can be continual memories of the trauma which includes thoughts, images or perceptions. There can be nightmares of the incident.

Some PTSD sufferers feel the event is recurring and are re-experiencing it and may also have flashbacks, hallucinations and illusions. There can be intense psychological distress and physiological reactions to cues that symbolize or resemble an aspect of the event.

PTSD and Avoidance

A person avoids cues associated with the trauma and emotions are numbed in several ways. There can be attempts to avoid thoughts, emotions, talking, people, places or activities that evoke memories of the event.

Some patients with PTSD may repress important memories of the event, have less interest or taking part in formerly important activities or feel detached from others. There can be a limited gamut of feelings or a sense of doom.

PTSD and Other Symptoms

There can be indications of PTSD that were not present before the traumatic event. Some examples of these other symptoms of post-traumatic stress disorder include insomnia, short temper, increased startle response, decreased concentration and hyper-vigilance, over-alertness.

PTSD and Intervention

Critical Incident Stress Debriefing (CISD) is a therapy offered to people within two days following a civilian or combat trauma. It is intended to avert the development of PTSD.

The PTSD treatment usually has four stages: describing the traumatic event, sharing emotional reactions to it, discussing symptoms and reassurance that these are normal responses, then, a discussion of coping methods.

PTSD and Psychotherapy

There are several psychotherapy methods used to treat PTSD. These methods include:

  • Cognitive-Behavioral Therapy – There are two methods are desensitization which attempts to decrease the symptoms of PTSD by addressing the fear and anxiety management training, which teaches strategies for reducing anxiety. Strategies include relaxation training, biofeedback, distraction techniques or cognitive restructuring.
  • Psychodynamic Therapy – This helps the patient improve a sense of self, learn new ways of coping and how to deal with emotions related to the trauma.
  • Discussion Groups – These groups are usually designed for survivors of specific traumas. They help people recognize that others who had the same experience have identical emotions and reacted in similar ways.
  • Family Therapy – This is recommended for people whose family has been affected by their PTSD symptoms.

The Prognosis for PTSD

Those who receive CISD as soon as possible after the event have the best prognosis for total recovery. A combination of peer-group meetings and individual psychotherapy are often successful. Treatment may require several years and the individual is likely to relapse.

For some people, PTSD becomes a chronic disorder that can last for decades or the rest of their lives. They have the poorest prognosis for recovery. Unfortunately, some don’t respond to any of the current treatments for PTSD.

Preventing PTSD

Some traumas, such as disasters and accidents, can never be eliminated. Traumas caused by people’s intention, such as mass murders, would require major societal changes to reduce their occurrences and brutality. At present, the use of CISD and psychotherapy appear to be the best form of prevention for these survivors while for those who are under the influence of drugs, heroin centers miami can help.

what makes an addict

What Makes An Addict?

When one hears the word “addiction” the immediate thought is most likely to include “drugs”. This is only natural, as newspaper and television reports constantly refer to drug addiction in some form or another. The World Health Organisation (WHO) refers to substances like heroin where heroin centers Miami come in, as well as opium, cannabis, alcohol, amphetamines and tranquilizers when they talk about addiction, and a search on PubMed is more likely to yield results including these drugs than anything else, if only because they are the most studied means of addiction.

Certainly the WHO defines addiction as “using a substance repeatedly, despite knowing and experiencing its harmful effects”, and this is by and large true. Yet there are non-pharmaceutical addictions which can have equally harmful effects, be they social or health-related; gambling, sex and food spring to mind. It may be correct to use the term “substance-dependency” for drug use, but physical and psychological dependence are both intrinsically linked to each other and share the same biochemical patterns.

Dopamine and Addiction – What Makes Us Addicted?

There is evidence emerging that all types of addiction lead to the same changes in the brain. Certainly chemical dependence causes rewiring of the brain’s dopamine and serotonin pathways (Siegel A and Sapru HN, Essential Neuroscience, pub. Lippincott Williams and Wilkins, 517-520), simply because the substances taken artificially alter dopamine levels. Yet gambling has been shown to do the same, as has food. Essentially, anything that causes a “feel-good” response will cause dopamine and serotonin to be released.

So addiction ought to be defined as any substance or behaviour which leads to a dependence on dopaminergic alterations in the central nervous system; this would cover all bases with regard to drugs, food, gambling and so on. Even the mere thought of the substance or behaviour is usually enough to elicit cravings and a response; one study by Heinz et al showed that certain cues could elicit a neuronal response in alcoholics.

Heinz’s study used magnetic resonance imaging (MRI) and positron emission tomography (PET) to show changes in the dopamine pathways: recovering alcoholics have fewer dopamine type 2 receptors (D2) than healthy subjects and this is closely linked to a high relapse rate. Similar changes have been shown by other groups using PET and MRI in other forms of dependence, such as food and gambling (see previous links).

Psychological Dependence and Dopamine – the Same as Physical Dependence?

What causes this change is the release of a protein known as cocaine-amphetamine-related-transcript (CART), so called because cocaine and amphetamine were the first stimulants to be implicated in its production. Busto et al have linked CART release in the hypothalamus (the region of the brain commonly linked to reward behaviour) to several drug-seeking changes in the brain, especially that of dopamine stimulation. The authors note that some genetic alterations to CART may predispose individuals to addiction.

The best treatment by far is detoxification and abstinance (sometimes with the aid of less-addictive substances), but as yet no study has shown any kind of reversal of the brain signalling pathways. In other words, an addict remains an addict for life. A sufferer has to abstain from the substances or behaviours that led to their addiction or risk relapse.

This makes food addiction all the more tragic: while it might be possible for someone to never drink another drop of alcohol or smoke another cigarette in their entire life, try telling someone who was morbidly obese to never eat again. Even with diet and exercise (and a great deal of hard work) a person who loses weight can find it all too easy to relapse and begin overeating – after all, food is readily available in the western world and we need it to survive. But the temptation will be there, and in all likelihood stronger than that for alcohol, say, or tobacco.

It is all too easy for people to pour scorn upon any addict – whether they are substance abusers, alcoholics, obese – but were it not for circumstance the roles could be so easily reversed. That addict could be anyone. It could even be you.