Feeds:
Posts
Comments

Posts Tagged ‘PTSD’

Since it’s a federal US holiday, I’m reprising a previous Mental Health Monday post. I think it’s apropos because today is Memorial Day–a day of remembering those men and women who died while serving in the military. New research is being conducted identifying how pervasive PTSD (Post-Traumatic Stress Disorder) is in soldiers. Below, I’ve highlighted details of the illness and some examples of what it looks like.

Please note, this post is solely for the purposes of writing, and is NOT intended for medical advice or treatment.

PTSD (Post-Traumatic Stress Disorder) is classified as an anxiety disorder (see NOTE below, commenting on DSM 5). Technically, the person must have a constellation of symptoms for at least 30 days to qualify for the diagnosis. Some people recover, some go on to have a chronic course, lasting months to years. Symptoms can recur several years later as well, with a period of remission between.

An event must be perceived as life threatening or potentially life threateningto qualify as traumatic. Immediately, that lends a LOT of subjectivity. What’s life threatening to me may be different for  you. That being said, I’m sure we can all pretty much agree on the biggies–combat, rape, assault, natural disasters, terrorism, abuse (sexual, neglect, physical, emotional, verbal, whether as an adult or child).

The traumatic event can either be one “biggie,” or it can be the accumulation of “smaller” events over a prolonged period of time (such as child abuse or domestic violence).

Classic symptoms include:

Hypervigilence: The person doesn’t trust others. They may feel uncomfortable in exposed places (malls, crowded places, being around strangers). They will frequently make sure their back is to a wall (so it’s not exposed). They’ll keep an eye on the exits and make sure they can get to one fast if needed. They’ll also show a “startle” response, where they jump at a loud, sudden sound. Some people jump when the phone rings, for example.

Avoidance: This is pretty much self explanatory. The person will avoid triggers and things associated with the trauma. This can include movies, locations, people, even certain subjects of discussion for fear it will lead to symptoms. This, by the way, makes PTSD difficult to treat in some instances, because the very thing bringing a person to treatment, is the thing they want to avoid discussing.

What’s important to know is the brain remembers details about a traumatic event that the sufferer may not consciously recall. Furthermore, an otherwise innocuous stimuli may be paired with the event and become “dangerous.” If, for example, a person’s attacker wore a blue jacket, then the person may experience an anxiety response when confronted with a blue article of clothing. The jacket itself is benign, but the brain “remembers” it as a threat via association.

Another example would be a soldier in Iraq who has returned home and every time he goes under an overpass, he searches for IEDs (Improvised Explosive Devices) tucked under the framework.

Which leads me to my next point. For a soldier in Iraq, being hypervigilent is conducive to survival. It makes her good at her job. BUT, when she returned to civilian life, her sensitive attunement to stimuli in the environment does not return to baseline. That is NOT conducive to living in a non-war zone.

That’s what PTSD is. A state of “hyper arousal” that is above baseline. It’s like drinking 16 cups of coffee and maintaining that level of tension and awareness ALL THE TIME.

Other cardinal symptoms of PTSD include: Flashbacks and nightmares: If someone is presented with a “trigger” (like a blue jacket), they may experience a flashback. Flashbacks can be mild (where the person is able to recognize it as a flashback and they can control it) or they can be severe, where the person actually feels like they’re reliving the event in real time.

Final tidbit: The person who suffers from PTSD is at higher risk of misusing drugs and overusing alcohol. Substance abuse and dependence as a co-morbid diagnosis is therefore common and an important aspect to address.

NOTE: ***Once the DSM 5 comes out, PTSD will be in its own category. I look forward to seeing how this new classification system works and how it encapsulates a very serious and life-altering illness.***

Read Full Post »

Last week, I discussed the symptoms of PTSD. Arlee Bird (writer and blogger–Tossing It Out) had a great follow up question.

When did the term PTSD come into regular use?

Lee is completely correct in recalling that the term “Post-Traumatic Stress Disorder” wasn’t coined until 1980 when the American Psychiatric Association added it to the Diagnostic and Statistical Manual III.

But “PTSD” has been around for far longer than 30 some odd years.

Heck, it probably goes back to the dawn of time!

Anyway…

In the Civil War, PTSD was known as “Soldier’s Heart.”

In World War I, PTSD was known as “Combat Fatigue” or “Shell Shock”

In World War II, PTSD was known as “Battle Fatigue” or “Gross Stress Reaction”

Unfortunately, prior to PTSD being called PTSD, it was thought the symptoms indicated cowardice or personal weakness.

It wasn’t until after the Vietnam War when people started taking notice. Called “Post-Vietnam Syndrome,” the new designation allowed Vietnam Veterans to push the medical and military to recognize it as a real disorder.

A big thanks to Psychiatric Disorders (d0t) com for this fascinating information!

Check out Lydia’s Medical Monday post and Sarah’s The Strangest Situation. Remember, these posts are for writing purposes ONLY and are NOT to be construed as medical advice or treatment.

Happy Writing!

Read Full Post »

Amanda (writer and blogger–A Fortnight of Mustard) asks:

My character is a loner. He’s afraid to get close to people. He wasn’t neglected as a kid, but he’s lost most people close to him in [an epic tragedy]. Is this attachment disorder?

GREAT question, Amanda!

Attachment Disorder means there is a failure to form normal attachments to others. It is often associated with early experiences of neglect and abuse by primary care givers (ex. parents), or abrupt separation from caregivers between the ages of 6 months and 3 years, or frequent change in caregivers, or lack of a caregivers response to the child’s efforts to communicate.

An example of an attachment disorder is Reactive Attachment Disorder. This is evidenced by a toddler who fails to stay near familiar adults in a new environment or failure to be comforted by a familiar person OR by a six year old who displays excessive friendliness and inappropriate approaches to strangers.

Attachment theory posits that infants will attach to a caregiver as a means to protect itself from danger or as a means of survival. (This is an evolutionary theory.) This is not the same as love and affection, although those behaviors are needed to create a strong bond. ;)

Each person has his or her own Attachment style (or pattern of relating to others) based on early childhood caregiving experiences. The styles include: secure, anxious-ambivalent, anxious-avoidant, and disorganized. These styles are not in and of themselves disorders, but can lead to problems with relating to others, based on how prevalent the style is and which type.

I’m sure my dear friend Sarah Fine, who is a child psychologist, writer, and blogger (The Strangest Situation), can give a much better explanation of all the jargon I just threw at you.

I included the above discussion to state that it doesn’t appear your character has an Attachment Disorder because he wasn’t abused and he was normal before this traumatic incident.

However, there are several other things that could be going on, which I’ll touch on now.

Someone who goes through a severe trauma is susceptible to developing Post-Traumatic Stress Disorder. To be diagnosed with PTSD, the person has to be exposed to something that is PERCEIVED as life-threatening. They can develop flashbacks, nightmares, hypervigilance (ex. looking for any potential foe wherever they are, sitting in a corner to watch the exits, planning an exit strategy wherever they are, checking over their shoulder every few seconds), hyperarousal (ex. startle response–jumping when the phone rings), numbing of emotions, and avoidance (of talking about the situation, avoidance of others, avoidance of any stimulating situations).

Amanda, your character displays avoidance and perhaps numbing of emotions. He lost several people close to him and so it would seem that he’s at risk of having PTSD. I don’t know if he has intrusive, recurrent memories (flashbacks) or nightmares of the incident or if he has hyperarousal, so it’s difficult to do a formal diagnosis.

Additionally, you mentioned he is (or can be) reckless and go headlong into dangerous situations. So, it could be that though he is traumatized by what happened, he is also desensitized to horrific experiences. Interestingly, soldiers who are exposed to combat become more effective in that environment than in a civilian environment. They have in a way become adapted to staying in the hyperaroused state (for survival) and then can’t handle things when the danger is gone.

Finally, loss is one of the most difficult things a person can experience. I wouldn’t be surprised if your character also experiences significant bereavement, grief, or even depression secondary to loss. This can last years. AND it would be advantageous, in a way, to avoid getting close to others because then he wouldn’t have to face the agony or terror of losing someone else.

I hope this was helpful!

Keep your questions coming, folks! And check out Lydia Kang’s Medical Monday while you’re at it. Remember these posts are for writing purposes ONLY and are NOT intended to be medical diagnosis, treatment, or advice.

 

Read Full Post »

Follow

Get every new post delivered to your Inbox.

Join 4,506 other followers