INTRODUCTION: At my primary website I discuss the practical steps that can be taken to alleviate anxiety. However, here at ejournalarticles.com the focus is on getting under the hood to better understand the psychology of various forms of stress and anxiety. In the ejournalArticles.com blog our intent is to explore a more specific type of stress known as post traumatic stress syndrome. So we start here by defining it.
People who suffer from post traumatic stress syndrome often don’t know what it is, but the are highly aware of panic attacks, anxiety, depression symptoms, and relationship difficulties that are it’s notorious effects. Post traumatic stress syndrome is often referred to as posttraumatic stress disorder or PTSD. In this brief article, I will describe the basic, clinical definition of post traumatic stress syndrome as most mental health professionals and academics think of it.
At what point do painful memories of traumas become a full-blown anxiety disorder or depression? The following checklists are from the standard diagnostic manual used by mental health professionals. It’s a summary of the criteria for Posttraumatic Stress Disorder of PTSD.
In a Nutshell
Post traumatic stress syndrome is the persistent or delayed reaction to a life-threatening event that involves:
- reexperiencing the event in distressing ways (nightmares, flashbacks, anxiety attacks, depression)
- various tricks of the mind to avoid any reminders of the event
- symptoms that show that the person is much more keyed up than they used to be (sleep problems, irritability, outbursts of anger, exaggerated startle response).
This type of stress becomes a disorder when it negatively impacts one’s life in significant ways. When this happens it is often referred to as post traumatic stress syndrome or Posttraumatic Stress Disorder (PTSD).
What is a trauma?
A trauma is an overwhelming event or situation that forces a person to develop a cluster of symptoms. Traumatic stress is the cluster of distressing symptoms. It is called posttraumatic stress because it often has a delayed onset. Many New Yorkers who seemed to be doing well after the September 11 attacks began to develop major problems months later.
Clinical Criteria for a Diagnosis
It is important to understand that people usually cannot make these symptoms disappear just by trying hard to “put the past behind them.” The American Psychiatric Association diagnostic manual (DSM-IV) defines Posttraumatic Stress Disorder (post traumatic stress syndrome) with specific clinical criteria in order to make a diagnosis:
Criterion A: Post traumatic stress syndrome involves EXPOSURE TO A LIFE-THREATENING EVENT or one in which there is a threat of serious injury. Whatever causes it, there must be intense fear at the time of the event. This can also include witnessing a violent act or being in a situation of extreme danger.
Criterion B: Post traumatic stress syndrome means that THE EVENT IS PERSISTENTLY REEXPERIENCED in one of the following specific ways:
- distressing memories of the event that intrude suddenly or will not go away;
- persistent nightmares;
- acting or feeling as if the frightening event is happening all over again, such as with flashbacks or distorted perceptions;
- intense mental anguish that is triggered by cues or symbols that mimic some aspect of the original traumatic event;
- intense physiological reactivity such as tension or pain also triggered by reminders of the event.
Criterion C: Post traumatic stress syndrome involves EMOTIONAL NUMBING AND A STRONG TENDENCY TO AVOID TRIGGERS OR REMINDERS in at least three of the following ways:
- the person makes efforts to avoid thoughts and feelings related to the trauma (he or she won’t talk about it)
- the person avoids activities, people or places that might remind them of the trauma
- the person can’t remember the event or can’t recall aspects of what happened;
the person shows a noticeable loss of interest or participation in significant activities - he or she has the feeling of being estranged, disconnected or detached from other people
- the person has awkward barriers to the full range of emotions such as an inability to feel affection from another or to have loving feelings
- he or she has a distorted and short view of the future such as not expecting to have a career or normal life span.
Criterion D: Post traumatic stress syndrome involves PERSISTENT SYMPTOMS OF INCREASED AROUSAL as shown by at least two of the following:
- difficulty falling or staying asleep
- outbursts of anger or irritability
- difficulty concentrating
- hypervigilance (scanning the surroundings for possible danger); and
exaggerated startle response.
Criterion E: SYMPTOMS PERSISTING FOR MORE THAN ONE MONTH.
Criterion F: THE SYMPTOMS NEGATIVELY IMPACT THE PERSON’S LIFE by causing intense distress or impairment in important areas of living such as the person’s social life, close relationships, school, or work.
This definition of post traumatic stress syndrome is very useful as a checklist of symptoms that can arise after an overwhelmingly dangerous event. However, I do not find it very useful in deciding who needs treatment. Apparently, I am not alone. Dr. John Briere, a trauma specialist at USC Medical School once said that the most traumatized individual he had ever treated did not meet the exact criteria for PTSD. The definition is so tightly crafted (by a committee) that many people who suffer intensely from post traumatic stress syndrome end up with another diagnosis that does not highlight the trauma-based roots of the problem.
The real value of the diagnostic criteria is in providing a partial list of trauma-related symptoms. It can be a starting point for understanding what’s going on inside your head. For example, one set of symptoms (Criterion B) involves replaying the tape of the trauma over and over. The next set of symptoms (Criterion C) involves avoiding anything related to the traumatic event. It is as if the brain is moving in opposite directions at the same time.
When you consider the collision of these two brain processes, it’s not hard to see how trauma can be confusing and frustrating.