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What is Post Traumatic Stress Disorder?

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Andy, a previous fire officer, was attending to a house that had caught fire and it was his duty to remove the remains of the three people who had passed away there. A couple of days later he had become ‘distressed, started crying and feeling upset’. This response ‘came as a shock’ to him, but he didn’t want to disclose his emotions to anyone so didn’t say anything about the matter. These feelings continued to disturb him for a couple more weeks but due to his work he felt like he needed to push his emotions aside.

17 years later the emotions came back – intensified. On his worst days he would have ‘three or four flashbacks a day’, others noticed odd-behaviour but Andy felt ‘detached from his surroundings’. He soon decided to get help and received ‘trauma-focused cognitive behavioural therapy’. It was there that he realised that what he experienced was a traumatic event and that his emotional responses towards the situation were normal. Talking about the event proved difficult at time but Andy soon felt able to ‘get on with his life’. (NHS, 2015)

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The anxiety disorder, Post Traumatic Stress Disorder (PTSD) can be a life changing condition affecting children and adults both young and old who have been exposed to some form of a traumatic event; complex-Post Traumatic Stress Disorder (C-PTSD) comes from this traumatic event being repeated or prolonged. Whether it is rape, a car crash, sustained neglect or abuse, terminal illness, military combat, or a natural disaster such as an earthquake, events like these can leave lifelong scars: both mental and physical.

These experiences can sometimes take victim several years to come to terms with and in the worst case scenario lead to suicide. Symptoms usually appear after a month and can present themselves through someone ‘re-living’ the trauma: this may be through a person having flashbacks, nightmares or having psychosomatic experiences. (NHS, 2015) In children specifically, they may relive the trauma over and over through their play or artwork. (Reed, et al., 2012)

Someone may also want to not be reminded of the traumatic event so they might try and avoid certain places, sounds or smells that remind them of the event to stop them from re experiencing the trauma. In addition, they might try to avoid remembering the experience by diverting their attention to school, work or activities. However, at times a person might become ‘emotionally [numb]’ to try and avoid having any feelings, this can mean a person may end up being reserved or they may stop participating in things they used to enjoy. People with PTSD may also have anxious thoughts about the trauma happening again which means they may constantly feel ‘on edge’. Feeling like this can mean that sleeping becomes difficult, concentrating for a certain amount of time can be challenging, and a person can become easily irritable. (NHS, 2015)

Older children may have ‘aggressive’ outbursts or may seem ‘withdrawn’ (Reed, et al., 2012)making their already difficult adolescent years more problematic; the issues that come with PTSD can inevitably lead to more co morbid disorders such as depression, anxiety and substance abuse. It is thus clear to see how disabling this condition can be. In my report I will discuss how PTSD can affect the brain and more importantly how it can change certain structures in the brain, such as the amygdala and hippocampus, I will then discuss whether brain scans should be used to diagnose PTSD in addition to (or instead of) clinicians using the diagnostic criteria in the DSM V to diagnose the condition. In addition, I will review how PTSD is manage and treated whilst exploring how these different treatments work.

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