Post-Traumatic Stress Disorder (PTSD)
In Brief
PTSD is a complex mix of psychological, social and biological factors where the reactions themselves create more stress. PTSD can be seen as a common way of coping after a life-changing event and is not a psychiatric illness. It's the brain's way of adapting to a sudden influx of new information about the world. It does this by:-
- Re-experiencing - allows us to review and learn.
- Hyperarousal - gives energy, increases awareness, contributes to action if needed.
- Avoidance - protects us from pain and danger - 'once bitten , twice shy'.
Persistent reactions can be reduced by specific trauma reduction techniques, drugs, by managing external stresses and by boosting coping skills and support networks.
PTSD Diagnosis: DSM-IV 1994
The diagnosis below is the official clinical diagnosis for deciding whether you have PTSD. It was created by a committee in America for the Diagnostic Statistical Manual (DSM). IV refers to the edition written in 1994. Remember, PTSD is not a specific illness like a physical disease - it is a label given to a collection of common reactions and such labels are often driven by the needs of the legal profession and compensation cases.
- Exposure to a traumatic event
- Persistent re-experiencing
- Persistent avoidance
- Persistent increased arousal
- Duration more than one month
- Significant disturbance to health/life
Exposure to a traumatic event (Children's reactions in brackets). Both:
- Person experiences, witnesses or is confronted with real or threatened death/serious injury, or threat to physical integrity of self or others.
- Person responds with intense fear, helplessness or horror. (disorganised/agitated behaviour)
Persistent re-experiencing. One or more:
- Recurrent, intrusive, distressing recollections (repetitive play)
- Recurrent, distressing dreams of event (any frightening dreams)
- Acting or feeling as if event recurring, including hallucinations, dissociative flashbacks even if drunk (trauma specific re-enactment)
- Intense psychological distress to actual or symbolic cues
- Physiological reactivity to these cues
Persistent avoidance and numbing. Three or more:
- Avoids trauma-related thoughts, feelings, conversations
- Avoids activities, places, people associated with event
- Unable to recall important aspects of the trauma
- Marked diminished interest in activities
- Feels detached or estranged from others
- Restricted range of effect (eg loss of loving feelings to others)
- Sense of foreshortened future (no expectation of career, family)
Persistent arousal. Two or more:
- Difficulty falling and staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hyper-vigilance
- Exaggerated startle response
Duration of symptoms. More than one month
The impact of the disturbance:
- Causes clinically significant distress or
- Impairs social, work or other important areas of life.
Specify:
- Acute - Symptoms last less than three months.
- Chronic - Symptoms last more than three months.
- Delayed - Onset at least six months after the event.