PTSD

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• PTSD
• "soldier's heart"

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definition
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• Anxiety disorder after exposure to terrifying
  event in which grave physical harm was threatened

definition
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• Fear triggers split-second changes in body to
  defend against danger or avoid it

definition
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• This fight-or-flight response is healthy meant
  to protect person from harm

definition
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• In PTSD, reaction is changed or damaged - one may
  feel stressed or frightened even when no longer
  in danger

definition
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• Complex Posttraumatic Stress Disorder (C-PTSD)
• prolonged exposure to traumatic event
  long-lasting problems of emotional social
  functioning

definition
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facts
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• Women sexually abused at earlier ages more likely
  to develop C-PTSD

facts
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• Up to 100 of children who endured sexual abuse
  tend to develop

facts
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• Women twice as likely as men to develop

facts
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• Approximately 7-8 of US likely develop in
  lifetime

facts
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symptoms
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• Persistent frightening thoughts and memories of
  ordeal

symptoms
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• Feel emotionally numb, especially with people
  once close to

symptoms
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• Children and teens can have extreme reactions to
  trauma, symptoms may not be the same as adults

symptoms
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• Re-experiencing
• problems in everyday routine
• can start from own thoughts, feelings, words,
  objects, or situations
• flashbacks - reliving trauma over and over,
  including physical symptoms like a racing heart
  or sweating bad dreams

symptoms
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• Avoidance
• avoiding places, events, or objects reminders of
  experience
• strong guilt, depression, or worry
• losing interest in activities enjoyable in past
• trouble remembering event

symptoms
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• Hyper Arousal
• easily startled
• feeling on edge
• difficulty sleeping
• angry outbursts
• usually constant

symptoms
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• C-PTSD
• Problems regulating feelings
• Suicidal thoughts
• Passive aggressive behaviors
• Feel detached from one's life (dissociation) or
  body (depersonalization)
• Persistent feelings of helplessness, shame, guilt
• Feeling completely different from others

symptoms
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• Often co-occurs with
• Depression
• Substance abuse disorder
• Bipolar disorder (manic depression)
• Eating disorder
• Obsessive compulsive disorder (OCD)
• Panic disorder
• Social anxiety disorder
• Generalized anxiety disorder

symptoms
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diagnosis
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• To be diagnosed person must have all of the
  following for at least 1 month

diagnosis
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• At least one re-experiencing symptom

diagnosis
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• At least three avoidance symptoms

diagnosis
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• At least two hyperarousal symptoms

diagnosis
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• Not everyone who lives through a dangerous event
  gets PTSD - in fact, most will not get the
  disorder

diagnosis
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factors
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Risk factors make a person more likely to get PTSD
factors
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Resilience factors reduce risk of the disorder
factors
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Factors present before trauma and others become
important during and after traumatic event
factors
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• Risk factors include
• Living through dangerous trauma
• History of mental illness
• Feeling helplessness or extreme fear
• Little or no social support after event
• Dealing with extra stress after event

factors
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• Resilience factors include
• Seeking out support from others
• Support group after traumatic event
• Feeling good about actions in face of danger
• Having coping strategy and learning from it
• Being able to act and respond effectively despite
  feeling fear

factors
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treatment
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• Main Treatments
• Psychotherapy (talk therapy)
• Medications
• Or both

treatment
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• Psychotherapy can occur one-on-one or in group

treatment
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• Talk therapy usually lasts 6 to 12 weeks or more

treatment
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• Research shows support from family and friends an
  important part of therapy

treatment
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• Exposure Therapy
• Helps face and control fear
• Exposes to trauma in safe way
• Mental imagery, writing, or visits to place where
  event happened

treatment
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• Cognitive Restructuring
• Helps make sense of bad memories
• Sometimes remember event differently than how
  happened
• May feel guilt or shame about what is not fault

treatment
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• Stress Inoculation Training
• Teaches how to reduce anxiety
• Helps look at memories in healthy way

treatment
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helping
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• To help a friend
• Offer emotional support, understanding, patience,
  and encouragement
• Talk and listen carefully
• Be understanding of situations that trigger
  symptoms

helping
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• To help a friend
• Invite friend to positive distractions (walks,
  outings, fishing)
• Remind friend, with time and treatment, she can
  get better
• Never ignore comments about harming herself and
  report comments to doctor

helping
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• To help yourself
• Talk to doctor
• Engage in activity
• Set realistic goals
• Break large tasks into small ones

helping
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• To help yourself
• Spend time with people, confide in trusted friend
  
• Tell others about symptom triggers
• Expect symptoms to improve gradually
• Identify seek comforting situations, places,
  people

helping
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• Mental Health Resources
• psychiatrist psychologist - social worker -
  counselor - community mental health center -
  outpatient clinic - universities - family service
  or social agency - peer support group - private
  clinic - employee assistance - local medical or
  psychiatric society - National Alliance for
  Mentally Ill - National Mental Health Assoc -
  PTSD Info Hotline - PTSD Sanctuary - Rape, Abuse
  and Incest National Network

Resources
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• For more information
• National Library of Medicine
• National Institute of Mental Health
• PTSD in Children Adolescents A National
  Center for PTSD Fact Sheet
• Meta-analysis of risk factors for posttraumatic
  stress disorder in trauma-exposed adults
• Psychobiological mechanisms of resilience
  vulnerability implications for successful
  adaptation to extreme stress
• Clinical response risk for reported suicidal
  ideation suicide attempts in pediatric
  antidepressant treatment, a meta-analysis of
  randomized controlled trials
• Journal of the American Medical Association
• Trends in mental illness suicidality after
  Hurricane Katrina
• Social, psychological, psychiatric
  interventions following terrorist attacks
  recommendations for practice research
• Neuropsychopharmacology
• Assessment and treatment of adult acute
  responses to traumatic stress following mass
  traumatic events
• Psychological debriefing for preventing post
  traumatic stress disorder (PTSD)
• Cochrane Database
• A Randomized, Controlled Proof-of-Concept Trial
  of an Internet-Based, Therapist-Assisted
  Self-Management Treatment for Posttraumatic
  Stress Disorder

Resources
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• PTSD
• "soldier's heart"