Post-traumatic stress disorder: overview and clinical implications

¶ … combat can be the most stressful of times for men and women who serve in the army. There are multiple factors that add to there frustration, which put them at a high chance of acquiring Post-Traumatic Stress Disorder, PTSD. A study was conducted amongst military men who served in Iraq and Afghanistan. It was found the soldiers who faced more stressors had a greater chance of developing PTSD. Moreover, it was also concluded that those who served in Iraq had a higher chance of suffering from the disease than those who served in Afghanistan. (T. Litz, 2009)

The symptoms of PTSD are more likely to surface after a few months following return from service. It is necessary to screen them immediately after their return, so that therapy can be started without delay. The physician must take a detailed history of the patient and should inquire about his mental health before deployment along with mental status on returning. Diagnosis is based on the Diagnostic and Statistical Manual of Mental Diseases (DSM) criteria. (Wilson, Friedman, & Lindy, 2001, p. iii)

Post-Traumatic Stress Disorder (PTSD) Treatment:

There are certain PTSD treatment guidelines that focus on different options for effective management. In the United States, several facilities are available for the veteran that helps combat this disorder, such as, VA medical centers, community based out patient clinics and VET centers. All facilities provide treatment based on a certain guidelines discussed below. (Wilson, Friedman, & Lindy, 2001, p. iii)

Along with medication, one on one discussions or group therapy is also needed for effective management. The cognitive behavioral theory has proven to be useful in the treatment of veterans, and is used in order of priority by the physicians. Treatment and assessment of family members is also crucial.

Medications: The aim of psycho pharmacotherapy is to facilitate normal homeostasis. It works to cure the symptoms of PTSD. Drugs, such as selective serotonin reuptake inhibitors, Monoamine Oxidase (MAO) inhibitors, beta blockers, benzodiazepines, and anticonvulsants, are useful options. (Wilson, Friedman, & Lindy, 2001, p. iii)

The goal of cognitive behavioral therapy is to gain full control of the memories of the trauma, to help the patient be able to talk about the problems that he is trying to avoid and to talk about the impact of the various stressors that has led to the condition. Anxiety disorders, often associated with PTSD, respond best to this mode of therapy. Types of cognitive therapy include, exposure therapy, stress inoculation therapy and cognitive processing therapy. (Tull, 2008)

In exposure therapy, the patient is made to confront his problems. With repetition of this process there comes a time when the thought of the event does not trigger anxiety. Anti-anxiety medicines may also be given with this to desensitize the patient to the anxiety that he faces while imagining the event. Furthermore, deep breathing exercises are encouraged, due to the change of breathing patterns during an anxiety attack. One may have trouble carrying out normal daily life chores that remind him of the trauma faced in the war-front, for instance, the noise of the fan may remind him of the war helicopters. The patient must therefore confront these problems repeatedly so as to regain the confidence and control over life. Writing about their problems have also proved to be a useful technique and should be encouraged. Talking about the traumas faced in group therapy is also very beneficial. (National Center For PTSD, 2009)

Stress inoculation therapy is a better option of patients who are not comfortable with direct confrontation. The therapist helps the individual identify what factors incite memories and cause symptoms of fear and anxiety. The Anxiety is managed through deep breathing exercises and muscle relaxants. (Tull, 2008)

Cognitive Processing theory is one of the most effective method used for the treatment of veterans with PTSD. This theory focuses on several aspects. First, it emphasizes on the need to help patients acknowledge their condition and the problems they face. It begins with educating the sufferer about PTSD and the modes of treatment. Patients are welcomed to ask questions during any part of the therapy session. Next, it focuses on helping the individual to be consciously aware of the thoughts that come to their minds. A sense of understanding is developed of the events and negative thoughts are suppressed. After the learning process, the individual is taught to choose what they want to think about, and how they want to feel about the trauma that they have suffered. This is done with the help of spreadsheets. This part of the session also helps one deal with day-to-day life events. The final part of the therapy helps the patient create a balance between their beliefs, and to understand its change before and after the trauma. (National Center For PTSD, 2009)