Trauma and Stress-Related Disorders

In all cases of trauma and stress-related disorders, exposure to a stressful or horrifying event is involved. The two most common types of trauma and stress-related disorders are post-traumatic stress disorder (PTSD) and acute stress disorder (ASD).

The primary difference between them is the latter occurs for a short-term and the former for a long-term period of time. A significant commonality between the two conditions is that in order to get a diagnosis of ASD or PTSD, those symptoms must produce serious distress in you and have deleterious enough effects on your ability to function socially and/or at work. These problems must also not be able to be attributed to a different medical problem or substance use.

In the past, trauma and stress-related disorders were simply classified as types of anxiety disorders. Even today, they are still grouped with anxiety disorders under the larger category of anxiety and stressor-related disorders. Trauma and stress-related disorders are considered distinct from anxiety disorders in that many of the patients experiencing trauma and stress-related disorders do not have anxiety. Rather, they may have dysphoria or anhedonia, dissociation, aggression or anger symptoms. If you believe you may suffer from a trauma-related disorder, then use the following information to make an informed opinion before taking action.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder involves persistent unwanted memories of a terribly traumatic occurrence. These memories typically start within six months of the occurrence and recur for longer than a month. The emotions most associated with the event are horror, helplessness and fear. Individuals who experience a traumatic event should seek mental health help.

Events triggering PTSD can be events you experience directly, such as an injury or near-death experience, or an event you experienced indirectly, such as witnessing abuse, injury, killing or a threatened life. An indirect experience prompting PTSD may also be learning about a traumatic event occurring to someone close to you. Common causes of PTSD include disasters, both man-made and natural, sexual assault and combat. Doctors do not yet completely understand the disorder and the physical processes that lead to it. Their diagnoses of PTSD are based on presenting symptoms such as the following:

  • Unwanted, intrusive recollections of the event
  • Avoiding things that provoke memories of the event
  • Flashbacks
  • Nightmares
  • Disinterest in daily activities
  • Emotional numbness
  • Guilt regarding your actions (or inaction) during the triggering event or due to your survival of an event that others did not
  • Other concomitant disorders, like substance abuse, anxiety or depression

In general, doctors break down these and all the many other possible symptoms of PTSD into four basic categories: avoidance symptoms, intrusion symptoms, negative impacts on mood and cognition and altered reactivity and arousal. Often, when memories, flashbacks or nightmares of the event occur, you re-experience the traumatic reactions you had when first experiencing that event.

Occasionally, symptoms may indicate a prior condition of ASD has continued beyond its one-month window, progressing into PTSD. In other cases, PTSD and ASD may occur separately and independently of one another despite being associated with the same event. In some instances, symptoms of PTSD may not present until months or years following the event.

Treatment may include a combination of medication and therapy. Among the types of therapy found effective in treating PTSD are psychotherapy and exposure therapy. Among the medications found effective in PTSD treatment are the following:

  • Selective serotonin reuptake inhibitors (SSRI), a type of anti-anxiety and anti-depression medication that inhibits the reabsorption of serotonin in the brain.
  • If you are experiencing nightmares related to your PTSD, then your doctor may prescribe Prazosin as well. You may also be prescribed atypical antipsychotic or mood stabilizing medications.

In some cases, untreated PTSD may simply diminish over time, although never quite disappearing. In other cases, the impairment continues to remain severe unless and until treated. For optimum treatment, psychotherapy with a sympathetic and empathic therapist is recommended. In these therapeutic environments, you are counseled and coached to confront the distressing memories in a way that desensitizes you to their emotional impact while you learn new techniques for controlling the anxiety produced in those scenarios.

Acute Stress Disorder (ASD)

In acute stress disorder, you experience a period of brief intrusive memories of a traumatic event you experienced or witnessed within the past four weeks. When ASD incidents occur repeatedly, you tend to avoid anything that may remind you of the traumatic event. While experiencing a period of ASD, your degree of emotional responsiveness and reactivity is elevated. ASD is diagnosed by the existence of several symptoms, including:

  • Arousal, avoidance and dissociative symptoms.
  • Intrusion symptoms (unwanted thoughts and memories).
  • Involuntary, recurring and disturbing memories of the occurrence.
  • Recurring dreams of the occurrence.
  • Flashbacks where you feel like the event is happening again.
  • Extreme distress, psychologically or physiologically when reminded of the occurrence.
  • Continued incapacity to feel positive feelings.
  • Sense of reality altered.
  • Incapacity to recall important pieces of the occurrence.
  • Struggles to avoiding remembering or being reminded of the event, including thoughts, feelings, situations, people and objects.

Other symptoms used in the diagnosis of ASD include trouble sleeping, negative mood, outburst of anger or irritability, hypervigilance, trouble concentrating and startled or exaggerated responsiveness to things. Symptoms generally last for at least three days. While there are many similarities between ASD and PTSD, the key difference is ASD tends to start right after the traumatic event occurs and can last between three days and one month. Post-traumatic stress disorder, by contrast, may not appear for up to six months following the event or as a progression of ASD but, either way, lasts for more than just one month.

Treatment for ASD is often as simple as removing you from the traumatic situation and providing you with empathy and understanding while allowing you the chance to talk about what happened and how it affected you. Experts sometimes recommend finding out from others aware of the event about what happened from their perspective so as to help you, the patient, separate your experiences of reality from the actual sequence of events. Drugs are not typically prescribed to help treat ASD unless to be used as a sleep aid.

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