Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that that may develop after experiencing or witnessing events such as sexual or physical assault, natural or man-made disasters, war, and torture, and where the person experienced intense feelings of helplessness, fear, or horror. People with PTSD are haunted by events that happened in their past.
Estimates are that about 70% of people will experience a traumatic event in their life, but not all will develop PTSD. According to a report published in 2004, PTSD has affected 18% of Operation Iraqi Freedom veterans.
Persons with PTSD experience considerable distress when confronted with reminders of the events. They may also have intrusive thoughts about the event, vivid flashbacks where they feel as though they are reliving the event, upsetting dreams and nightmares, and they may be easily frightened or startled. They may try to cope with their symptoms by avoiding people, places, and situations that remind them of the event; they may withdraw and/or feel estranged from loved ones; they may have difficulty experiencing emotions and may come to believe that their future will be cut short. Additionally, PTSD sufferers are at high risk for developing other psychological disorders, such as depression, they are more likely to engage in self-destructive behaviors, such as alcohol and substance abuse, and they are six times more likely than persons without PTSD to commit suicide. PTSD has been associated with unemployment and a work productivity loss of approximately US $3 billion annually.
Untreated, PTSD exacts an enormous toll on individuals, families, and society. The importance of developing effective treatments that rapidly treat sufferers of PTSD thus cannot be overemphasized. But people with PTSD often do not recognize that they are having problems and generally do not seek treatment on their own. Thus, if you have a loved one who has been exposed to a trauma such as combat service in OIF/OEF, it is important to encourage them to seek help. In some cases, you may need to seek out a health care specialist for them, make the initial appointment, and take them to it. Visit the Resources page for parents, loved ones, or the general public to find out more about what you can do.
Treating PTSD
PTSD treatment generally involves psychotherapy as well as medication. In the recent Institute of Medicine (IOM) review of treatments for PTSD commissioned by the VA, the IOM concluded that the only treatment (medication or psychotherapy) with evidence enough to support efficacy is exposure therapy.
Cognitive-behavioral therapy (CBT) has been shown to be effective in the treatment of PTSD. Trained CBT therapists educate the patient about trauma reactions, patient relaxation techniques for use in anxiety management, and they teach the patient to develop a more realistic view of themselves, others, and the world. An essential CBT component for the treatment of PTSD is imaginal exposure (IE), a technique that facilitates the processing of the traumatic experience through structured retelling of the experience. As patients tell their story, they learn to tolerate their memories and feelings and their PTSD symptoms decrease.
A class of medications called selective serotonin reuptake inhibitors (SSRIs) has also been found to be effective in the treatment of PTSD related symptoms. However, researchers have found that PTSD symptoms do not significantly improve in approximately 17-42% of patients treated with prolonged exposure and they do not significantly improve in over 50% of patients treated with SSRIs.
Moreover, across interventions, civilians respond better to treatment than military personnel. Given the substantial number of U.S. military personnel deployed to the combat theater in Operation Iraqi Freedom (OIF) who have developed PTSD, it is important for clinical researchers to find ways to increase the effectiveness of PTSD treatments.