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During the last two decades, the world has witnessed various unpleasant activities that have posed a challenge to the psychological well being of individuals and societies. Such happenings include massive terrorist activities, devastating natural disasters like Tsunamis, earthquakes, floods and severe climate changes. There have also been immense political and economic crises, weakening social and family relations and much more. These activities are posing serious challenges to the well being of the individual members of the society. The particular effect of any or a combination of several of the above occurrences is the rapid increase of cases of Post Traumatic Stress Disorder. This has become a challenging occurrence that needs urgent medical and therapeutic attention in order to ensure productivity of individuals within the society and longevity of life for affected persons. Post Traumatic Stress Disorder (PTSD) is an anxiety disorder of severe magnitude that results from exposure to any event or events that can result in psychological trauma. Such events may include life-threatening, frightening or other highly unsafe conditions (Delahanty, 2011). People who suffer from PTSD are mostly highly sensitive to their environment and may experience trauma when faced with conditions that are similar to those that caused the disorder. Any trauma, which can be described as a life threatening or highly frightening event that affects an individual’s emotional well, being, can result to PTSD. Complex Post Traumatic Stress Disorder (C-PTSD) occurs after exposure to traumas associated with long lasting emotional and social problems. The severe nature of these occurrences overwhelms an individual’s emotional ability leaving the person vulnerable and unable to cope.Some causes of PTSD are extreme domestic violence, rape, assault, intensive bullying, exposure to extreme physical pain, torture, kidnapping, and other forms of abuse. A person may sustain emotional trauma if they are the victims, or are witnesses of either of the examples above and especially if the victims are related to the witnesses. Other non-personal but equally traumatizing experiences that may result in Post Traumatic Stress Disorder include experiences of unpleasant terrorist activities, genocide or war of extremely horrendous nature, natural disasters like life challenging floods, earthquakes, volcanic eruptions and other similarly disturbing events. Some PTSD causes are in the family life and may include divorce, verbal or physical abuse, extreme poverty, lasting severe medical conditions on the individual or close relatives among others. Causes of PTSD associated with the social life may include unemployment and insecurity of threatening magnitudes. There are various aspects of PTSD and various means of coping with it. There is the social aspect, biological and the psychological aspects. This paper will discuss the three aspects of PTSD, and the means to cope with the disorder.
Biological aspects of PTSD
These aspects concern the body functions, which include increased heart rate, enhanced thyroid function, and hyper-arousal. There are several brain areas that are in control of emotions, reactions to stimuli, rest, sleep, rest, activity, reproductive cycle and feeding. Of particular interest with regard to PTSD, is the brain area that comprises of the brainstem or hypothalamus, the neocortex and the limbic system (Tabachnick & Fidell, 2007). The limbic systems monitor and controls response to emotions and behavior necessary for self-preservation and survival. Signals sent to the hypothalamus from the sensory organs are distributed to the cortex, limbic system and the basal ganglia. People with PTSD are unable to store memory properly due to the release of stress hormones during extreme stress. These hormones affect the memory process, resulting in incomplete or incorrect memory processes. For instance, excessive hormone neropinephrine, released during the trauma, can cause Amnesia, a common symptom in PTSD (Davis, 2006). During one study, lectrodermal responses of patients with PTSD to olfactory stimuli were measured. The study concluded that there might be a correlation between such PTSD symptoms as image intrusions, psychological numbing and hyper vigilance to damage of the cerebral lateralization during trauma (Delahanty, 2011). Extreme stress as is evident during the traumatic experiences may also damage the hippocampus area, which controls learning and memory. Information processed by the motor and sensory cortex is sent to the hippocampus, which records the spatial and temporal aspects of experience into memory. Any malfunction in the hippocampus will lead into either a low sensory capacity or hyper vigilance as observed in PTSD. This can be dangerous in cases where, the individual, after receiving a stimulus, reacts without first processing the nature of the stimulus, thus processing an appropriate reaction path. Such reactions appear as fight- or- flight responses and may lead to over reactive moods in patients (Davis, 2006). During an empirical study conducted in women who had gone through traumatic childhood experiences of sexual abuse, it was found that women with PTSD experience increased heart beat rate and slower skin conduction responses. This is when they were exposed to startling tones as compared to women who had undergone similar childhood experiences but had no PTSD (Delahanty, 2011). An increase in heart rate is a defense mechanism found in people exhibiting hyper vigilance characteristics.
PTSD patients also show higher levels of tyrosine and thyroxin, hormones commonly associated with extreme stress. Thyroxin accelerates the rate of metabolism in order to degrade proteins to form energy. This normally happens when the body lacks sufficient food resources, which is typical in PTSD due to poor eating habits. This explains the usually weight loss in patients with PTSD. Other biological traits, such as the hyperactivity, poor coping ability, disturbed sleep physiology, enhanced thyroid function and high cardiovascular reactivity are associated with PTSD (United Nations, 2006). The common biological symptoms include:
Increased heart rate
Patients of PTSD often experience increased heart rate, especially during times when there are slightly threatened or faced with situations with the slightest resemblance to those of the past.
Hyper arousal or hyper-vigilance
This is the tendency to be overly sensitive even to minor stimuli. A patient with this symptom may scan his/her environment continually for threats even when statistical probabilities of such occurrences are minimal.
Increased thyroid function
A victim of PTSD has increased hormonal functions, especially hormones that regulate a body’s reaction to the threat (Davis, 2006). This is due to the body’s hyperactive state among other factors.
These are aspects of PTSD that affects the mind functions of the patient. These typically include depression, poor coping, over reacting and sometimes hostility. There are several neurotransmitters that are affected during exposure to trauma. These are the Epinephrine, norepinephrine, cortisol, endorphins and serotonin. Epiphrine that is produced by the adrenal gland functions to help the body cope with stress (Ozer & Weiss, 2003). Such functions as the heart rate, blood sugar, breathing and muscle coordination are controlled to help the body cope with the situation. Cortisol releases blood sugar into the bloodstream if needed. Norepinephrine moves through the blood into the brain and enhances the brain’s capacity for alertness and problem solving. The relative levels of this hormone ultimately affect the patient’s ability to stay alert and problem solving skills. Serotonin affects arousal and responsiveness, the patient exhibiting over arousal is related to the lack of serotonin. Other factors controlled by serotonin include self-directed aggression, hostility and impulsivity- all of which are often found in cases of PTSD (Davis, 2006).
Re-occurrence of the traumatic event
Patients of PTSD often re-experience events similar to those in which the trauma first occurred. Such occurrences like war scenes, death scenes, extreme pain or violence, and other similarly disturbing events usually torment the patient (Delahanty, 2011).
Fear and avoidance
The patient constantly withdraws from people, places, locations or even memory spurring events that are likely to remind them of what happened.
The PTSD is associated with immense psychological distress if exposed to external or internal cues that remind the victim of any of the aspects of their past experiences. Such distress may be evident in such reactions as reactions to colors of things resembling colors present during the traumatic experience, buildings, trains or airplanes (including toys or models of these), persons resembling people who may have caused the experience like in the case of assault or rape and other similar reminders (Delahanty, 2011).
This involves hostility to other persons, especially if the nature of the interaction between the victim and others is such that it reminds them of the traumatic experience such as hostility. Other similar occasions may be hostility towards family members in the mention of financial requests before exhaustive consideration by a victim of domestic fraud or money extortion.
Social Aspects of PTSD
These are the symptoms normally visible to others in the society settings and which usually affect the way an individual relates with others in the society (Tabachnick, & Fidell, 2007).
Patients fail to enjoy the same activities that they used to enjoy before the experience and which they may still be expected to enjoy. Such activities include one’s hobbies like sports, travelling and indoor games.
The person appears to be restless and shifty, often being unable to maintain attention or focus on a particular activity or person. In a classroom setting, the victim may appear to drift from discussions and become abstract in reasoning. In some cases, the person may show physical signs of restlessness like shaky hands even when no threatening occurrences or obvious reminders of the trauma exist.
Depressive tendencies such as suicide
Patients may express deep regrets over what happened even when there is clearly no reason for them to blame themselves (United Nations, 2006). For example, a patient undergoing depressive reaction may mention intention of committing suicide as one way of dealing with depression.
Coping With Post Traumatic Stress Disorder
There are varied methods of coping with PTSD and these can be broadly categorized into therapeutic and medical. The medical methods are especially effective against the physical or biological effects such as headaches, sleep disorders and stomachaches. Therapeutic interventions usually target the psychological and social effects of PTSD. They may also be classified according to level at which it is done, and can be either pre-screening, preventive or for treatment (Ozer & Weiss, 2003).
This concept has not been fully developed, but the basic method involves checking the response time and hippocampal volume. It has been found that a higher response time and the small hippocampal volume has been identified as having links to PTSD (Delahnty, 2011).
Cognitive Behavior Therapy (CBT)
This is a type of therapy that changes a patient’s behavior patterns, especially the patient’s control for thoughts that cause negative emotions. Individuals are thought to identify thoughts that can lead to depressive moods and how to avoid or handle them. Exposure therapy helps victims re-visit the traumatic thoughts in a manageable manner (Ozer & Weiss, 2003).
The main procedure here is to involve the victim in social grouping as a way to open up and share different experiences. This may introduce other procedures like exposure therapy (Tabachnick, & Fidell, 2007).
• Serotonin reuptake inhibitors (SRI) are commonly used to treat obsessive thinking also remove effects of traumatic memories in persons with PTSD. They also help in handling aggressive impulses, compulsive repeat of trauma triggered behavior patterns and the ability to cope (Delahanty, 2011). These include Citalopram, Fluoextine, Sertraline among others.
• Alpha-adrenergic antagonists such as Clonidine are effective in relieving nightmares.
• Antipsychotics- these reduce effects of mood disorders
• Antidepressants help with sleep disturbance symptoms (Ozer & Weiss, 2003).
Post Traumatic Stress Disorder is a condition that affects a significant portion of the society and whose statistical count is increasing as causative factors such as war, terrorism, social unrests, financial and family insecurities increase. It is noteworthy that, there be identified new more efficient methods of preventing it, as well as coping with it in an effective and sustainable manner. There are already founded some highly effective methods of preventing of coping with PTSD, such as psychotherapy and various medications like antidepressants, antipsychotics and serotonin reuptake inhibitors. Another extremely helpful measure that has not been advanced is pre-screening (Delahanty, 2011). It is recommended that, victims or relatives of victims take necessary pre screening measures immediately if one month after a traumatic experience the victim is still unable to handle the experience. Such feelings as depressive moods, recurrent trauma experiences, headaches, sleep disturbances, withdrawal from normal activity even after a month should be sufficient indicators, and one should seek pre screening. It is also crucial to involve close relatives or friends when one is coping with PTSD, as is done in exposure therapy. Solitary moments should be avoided as they slow down healing by allowing one to remain in the depressive moods (Tabachnick, & Fidell, 2007).