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Introduction to Post-Traumatic Stress Disorder
-- "I was raped when I was 25 years old. For a long time,
I spoke about the rape on an intellectual level, as though it
was something that happened to someone else. I was very aware
that it had happened to me, but there just was no feeling. I
kind of skidded along for a while."
"I started having flashbacks. They kind of came
over me like a splash of water. I would be terrified.
Suddenly I was reliving the rape. Every instant was
startling. I felt like my entire head was moving a bit,
shaking, but that wasn't so at all. I would get very
flushed or a very dry mouth and my breathing changed.
I was held in suspension. I wasn't aware of the cushion
on the chair that I was sitting in or that my arm was
touching a piece of furniture. I was in a bubble, just
kind of floating. And it was scary. Having a flashback
can wring you out. You're really shaken."
"The rape happened the week before
Christmas, and I feel like a werewolf around the anniversary
date. I can't believe the transformation into anxiety
and fear."
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Ordinary events can serve as reminders of the trauma and
trigger flashbacks or intrusive images. Anniversaries
of the event are often very difficult.
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Post-Traumatic Stress Disorder (PTSD) is a debilitating
condition that follows a terrifying event. Often, people
with PTSD have persistent frightening thoughts and memories
of their ordeal and feel emotionally numb, especially
with people they were once close to. PTSD, once referred
to as shell shock or battle fatigue, was first brought
to public attention by war veterans, but it can result
from any number of traumatic incidents. These include
kidnapping, serious accidents such as car or train wrecks,
natural disasters such as floods or earthquakes, violent
attacks such as a mugging, rape, or torture, or being
held captive. The event that triggers it may be something
that threatened the person's life or the life of someone
close to him or her. Or it could be something witnessed,
such as mass destruction after a plane crash.
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Whatever the source of the problem, some people with PTSD repeatedly
relive the trauma in the form of nightmares and disturbing recollections
during the day. They may also experience sleep problems, depression,
feeling detached or numb, or being easily startled. They may
lose interest in things they used to enjoy and have trouble
feeling affectionate. They may feel irritable, more aggressive
than before, or even violent. Seeing things that remind them
of the incident may be very distressing, which could lead them
to avoid certain places or situations that bring back those
memories. Anniversaries of the event are often very difficult.
PTSD can occur at any age, including childhood. The disorder
can be accompanied by depression, substance abuse, or anxiety.
Symptoms may be mild or severe--people may become easily irritated
or have violent outbursts. In severe cases they may have trouble
working or socializing. In general, the symptoms seem to be
worse if the event that triggered them was initiated by a person--such
as a rape, as opposed to a flood.
Ordinary events can serve as reminders of the trauma and trigger
flashbacks or intrusive images. A flashback may make the person
lose touch with reality and reenact the event for a period of
seconds or hours or, very rarely, days. A person having a flashback,
which can come in the form of images, sounds, smells, or feelings,
usually believes that the traumatic event is happening all over
again.
Not every traumatized person gets full-blown PTSD, or experiences
PTSD at all. PTSD is diagnosed only if the symptoms last more
than a month. In those who do have PTSD, symptoms usually begin
within 3 months of the trauma, and the course of the illness
varies.
Some people recover within 6 months, others have symptoms that
last much longer. In some cases, the condition may be chronic.
Occasionally, the illness doesn't show up until years after
the traumatic event.
Antidepressants and anxiety-reducing medications
can ease the symptoms of depression and sleep problems, and psychotherapy,
including cognitive-behavioral therapy, is an integral part of
treatment. Being exposed to a reminder of the trauma as part of
therapy--such as returning to the scene of a rape--sometimes helps.
And, support from family and friends can help speed recovery.
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-excerpted from the National Institutes of Health, Publication
97-3879
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