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Wednesday, January 6, 2010

Health checkup: Post-traumatic stress | | Democrat and Chronicle


Post-traumatic stress disorder is the fourth most common psychiatric disorder, affecting as many as 10 percent of men and 18 percent of women at some time in their lives.

Attention to this syndrome was initially focused on Vietnam veterans returning with psychological injuries. Recent estimates suggest that because of the disturbing increase in the rate of violence in our society, the majority of the population will experience at least one extremely traumatic event during the course of their lives and about 25 percent of trauma survivors will develop PTSD.

Potential traumatic events may include a physical assault such as sexual assault or mugging, robbery, automobile accident or being diagnosed with a life-threatening illness.

PTSD describes a syndrome in which a trauma survivor is unable to get the event out of his or her mind. Scenes of the traumatic event return involuntarily as images, unwanted memories, nightmares or flashbacks. Intense distress usually is associated with this re-experiencing of the traumatic event, and survivors commonly experience palpitations, shortness of breath and other panic symptoms.

If left untreated, survivors are at considerable risk for developing other psychiatric conditions such as major depression, panic attacks, generalized anxiety and substance abuse disorders.

A diagnosis of PTSD cannot be made unless a doctor or other health care professional asks about whether the person ever experienced a traumatic event.

Studies have shown that only 2 percent to 8 percent ever pose the question. A number of rating scales can help identify the most upsetting trauma and the frequency and intensity of the PTSD symptoms.

Treatment of PTSD may involve a combination of approaches including education, supportive group or individual talk therapy and medication to help manage mood instability, poor sleep, sweating, trembling, racing heart, shortness of breath, angry outbursts and poor impulse control.

Various medications have shown to benefit PTSD symptoms. Antidepressants often are the first choice of therapy. Beta blockers, alpha-antagonist drugs and anticonvulsants also are helpful.

PTSD can last for decades, particularly if left untreated. Improving recognition of this disorder will lead to discussion about treatment options and increase the quality of life for trauma survivors.

Jane Sundberg, doctor of pharmacy, is a psychiatric clinical pharmacist at Strong Health's department of pharmacy.

Health checkup: Post-traumatic stress | | Democrat and Chronicle

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