What is Post-traumatic Stress Disorder (PTSD) ?
A health article about Post-traumatic Stress Disorder (PTSD) from Mental Health Problems dealing with Health Problems & nutritional Self Care Strategies
If you have experienced a major trauma like war, torture, abuse in childhood, car accidents, fires or violence you may continue to feel terror long after the event is over. You may experience nightmares or flashbacks for many years after the event.
Post Traumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association’s official manual in 1980.
PTSD is a label for the range of symptoms that may be experienced days, weeks, months or even years after being exposed to a traumatic event or series of events.
These traumatic events range from experience of war, child abuse, domestic violence, rape, robbery, assault or car accidents.
Sometimes PTSD arises from witnessing the trauma of another person, particularly a friend or relative.
The events usually involve threat to the person’s life or physical integrity. The immediate feelings are helplessness, horror and/or intense fear.
PTSD is unique amongst mental disorders because the person has to have been exposed to a previous event that is considered traumatic in order to be diagnosed with PTSD.
The History of PTSD
Although PTSD has been around since the beginning of humanity, it wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 1980.
The term PTSD became much more familiar to the common American after the Vietnam War, and continued to become more common after recent conflicts.
In other times in American history, PTSD was referred to as other things. Physicians noted changes in people, usually soldiers, that couldn’t be wholly explained by wounds or injuries.
Here are the names used to describe PTSD before 1980:
●
Nostalgia was coined by Swiss
physician Dr. Johannes Hofer in the late 1600s to describe soldiers
experiencing deep despair and homesickness. He noted other common PTSD symptoms
like sleeplessness and anxiety.
●
Soldier's heart or
irritable heart
was a term used by Dr. Jacob Mendez Da Costa to describe physical issues
soldiers in the Civil War experienced that were not related to combat wounds.
These issues included constricted breathing, heart palpitations, and other
heart issues.
●
Railway spine or railway
brain
were PTSD terms that weren’t related to soldiers. During the 1800s railroad
travel became very common. It also saw a stark rise in railroad related
accidents. People who survived these accidents sometimes suffered from anxiety
and sleeplessness that they referred to as railway brain.
●
Shell shock was a term used after
World War I. World War I was a particularly brutal war, with many soldiers
coming home experiencing things like anxiety, nightmares, impaired sight and
vision, tremors, and fatigue. Many of the soldiers who came home with these
symptoms were directly exposed to exploding shells on the battlefield, giving
the name “shell shock” it’s origin.
●
Battle fatigue, combat
fatigue, and combat stress reaction were the terms used to describe PTSD symptoms in
relation to World War II. It was believed that the symptoms exhibited were due
to long deployments.
●
Gross stress reaction was the term used in the
DSM-I in 1952 to diagnose psychological issues connected to traumatic events.
At this time, it was believed that symptoms would only last a short period of
time. If symptoms persisted longer than 6 months, it was no longer thought to
be related to a specific traumatic event.
●
Adjustment reaction to
adult life. In
1968, PTSD-related terms were removed and replaced with the words “adjustment
reaction to adult life.” Many experts believe this change failed to truly
encompass the disorder and related complications and was a step in the wrong
direction.
● Post-traumatic stress disorder was officially added to the DSM-III in 1980. Writers of the DSM-III used symptoms from people who had survived traumatic events such as war veterans, Holocaust survivors, and sexual victims to help develop the diagnosis description.
PTSD Defined in the 1980s
The 1980s term PTSD was a major shift in the way that people began looking at the reaction to trauma. During World War I, many perceived soldiers with PTSD symptoms as being weak or feeble. It was thought that the things they were feeling were due to a poor constitution.
The change during the 1980s put PTSD in an entirely new light. According to the U.S. Department of Veterans Affairs:
From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of "trauma."
In other words, anyone can be susceptible to a physical and mental reaction to a highly traumatic life event. An outside factor like war or sexual abuse can have a serious effect on a person.
PTSD in the DSM-5 (in 2013)
In 2013, the Diagnostic and Statistical Manual was updated. At this time, PTSD was changed from being categorized as an anxiety disorder to being classified as a “trauma or stressor-related disorder.”
One of the reasons for this change is that PTSD is not only exhibited as anxiety.
Psychiatrist Dr. Tracey Marks explains:
With the Diagnostic and statistical manual that came out in 2013, it was moved to the category of trauma and stress-related disorders. The significance of this is that PTSD is more than anxiety. People have very complex emotions afterward that include guilt, shame, and anger and those are just examples...but lots of things more than just anxiety.
Symptoms
The symptoms that commonly occur in people suffering from PTSD have been divided into three categories: Intrusions, Hyper-alertness and Avoidance.
Intrusions: Re-experiencing the events as flashbacks or nightmares that occur suddenly, without conscious control. These are very distressing, disrupting sleep and normal activities of life.
Hyper-alertness: A state of hyper-vigilance or increased sensitivity to things such as a phone ringing or the sudden appearance of a person which leads to a physical reaction (e.g. jumping with fear; feeling nauseous) which is out of proportion to the stimulus.
The person is edgy, agitated and appears to be on the lookout for a perceived danger.
Avoidance: The person tends to avoid anything (e.g. certain places, going out at night, being alone) that may result in a memory of, or a feeling from, the original traumatic experience.
This symptom particularly impacts upon interpersonal relationships.
The person may report feeling emotionally numb; unable to experience their usual feelings for people and things, and will often act very impersonally to people with whom they are closest.
Often the person finds it difficult to trust others or to feel safe and secure anywhere. As this continues the person becomes detached from friends, colleagues and family, thus adding to his/her isolation.
The person may experience physical signs such as rapid breathing, sweating and becoming agitated. Poor sleep patterns (due to insomnia and nightmares) affect concentration and memory, and thus can lead to a deterioration of work and study performance.
The person may report feeling emotionally numb; unable to experience their usual feelings for people and things, and will often act very impersonally to people with whom they are closest.
OTHER CHARACTERISTIC SYMPTOMS OF PTSD
Often the person finds it difficult to trust others or to feel safe and secure anywhere. As this continues the person becomes detached from friends, colleagues and family, thus adding to his/her isolation.
Furthermore, the person may experience physical signs such as rapid breathing, sweating and becoming agitated.
Poor sleep patterns (due to insomnia and nightmares) affect concentration and memory, and thus can lead to deterioration of work and study performance.
Post-Traumatic Stress Disorder is rarely diagnosed on its own. It is often accompanied by depression, anxiety, panic attacks, social phobia, agoraphobia or other psychiatric illnesses.
Many people recovering from the after-effects of trauma abuse alcohol, nicotine and other drugs, thus complicating the situation further. Substance abuse is addressed within PTSD treatment.
What Causes PTSD?
PTSD is not limited to one demographic or a single type of trauma. It’s not limited to an age group, gender, or socioeconomic background.
While PTSD is most often associated with veterans, it is also common with:
● Accidents such as a car crash
● Violent attacks
● Sexual assault or threatened sexual abuse
● Being bullied or harassed
● Kidnapping
● Witnessing someone else being harmed or killed
● Traumatic birth (either from the mother or the partner witnessing a traumatic birth)
● Terrorist attack
● Natural disaster
● Living in a war zone
● A history of trauma or abuse
While other people may develop mental disorders from trauma in their life, PTSD is reserved for a distinct type of trauma. For example, people who are going through a difficult life experience such as sickness, divorce, or loss of a job may experience anxiety, depression, or other mental health issues.
However, PTSD is defined for a certain group of people experiencing a specific set of symptoms. The type of trauma used to diagnose PTSD as defined by the DSM-5 is:
A person exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows:
●
Directly experiencing the traumatic event
●
Witnessing a traumatic event in person
●
Indirect exposure to a traumatic event such as an event that
happened to a close friend or loved one. The event must be violent in nature.
●
Experiencing repeated or indirect exposure to aversive details of a
traumatic event. This usually happens in the course of normal job duty, such as
a police officer repeatedly working on child abuse cases, or first responders
cleaning up the aftermath of a car crash.
Note: This does not include
non-professional exposure such as people watching the news or watching movies
depicting traumatic events).
Some people may feel invalidated when they do not receive a PTSD diagnosis, thinking that they’re being told that their trauma isn’t serious enough to warrant the diagnosis.
While these feelings are understandable, it doesn’t mean that they are not feeling or experiencing symptoms brought on by mental health issues or by trauma. People with anxiety often have heart palpitations and avoidance is a common symptom of depression.
The difference between PTSD and other trauma-based or mental health diagnoses is not meant to downplay or delegitimize their experience, but rather to illuminate a specific mental health disorder with a very specific set of symptoms.
Risk Factors for PTSD
While PTSD can be experienced by any demographic, there are some factors that do increase the probability of it developing.
These risk factors include:
● History of anxiety or depression
● Lack of support
● Early childhood trauma
● History of abuse
● History of drug or alcohol abuse
● Women are more likely to suffer from PTSD than men
● Family history of mental illness
● Past traumatic experiences
● Poor coping skills
● Ongoing stress
●
Working in jobs that include potentially traumatic events such as
first responders, hospital workers, or those who are in the military
Different Types of PTSD
Although major symptoms are similar across the board, there are different types of PTSD.
Depending on what type of PTSD someone has, their symptoms may be more severe or long-lasting or they may require different types of therapeutic treatments.
Complex PTSD
PTSD may have become more familiar to the common person, but there is a lesser-known variation of PTSD called complex PTSD (c-PTSD).
The traditional form of PTSD may emerge after a single traumatic event. An example may be a life-threatening car crash.
A person who lived through a car crash may find themselves afraid of driving, may avoid getting in the car or driving in traffic, and may have other symptoms associated with PTSD.
C-PTSD, on the other hand, is the result of repeated or ongoing traumatic events. Those who develop c-PTSD may have suffered ongoing childhood abuse, neglect, or repeatedly witnessed violence acted out on someone else.
C-PTSD is more often associated with people who experience trauma in their childhood. It affects the way that a person develops, since they’re exposed to trauma during a highly developmental time in their life.
This term is not in the DSM-5, but it is a term that mental health workers use to help describe the difference between someone who has experienced a single traumatic event, and one that has experienced chronic trauma, especially in childhood.
Symptoms of c-PTSD are similar to PTSD, but they also include additional behavioral differences.
Dr. Tracey Marks explains c-PTSD in this way:
...the [early childhood] trauma shapes your development and your personality. It's like you have a fractured self and people suffering from this can spend years trying to mend a fracture.
So unlike a person with PTSD who may be checking locks, and having flashbacks, and refusing to drive or jumping every time I hear a loud noise, [those] with c-PTSD [have] more behavioral things like relationship difficulties, poor self-esteem, anger problems, [and] mood instability.
She went on to say:
The person with c-PTSD can develop depression or anxiety secondary to these problems but at the core is the issue of this fractured self that came from a serious emotional disruption during the formative years.
Additional symptoms associated with c-PTSD are:
●
Negative self-view. Those with c-PTSD may
think very poorly of themselves or may carry ongoing feelings of guilt, shame,
and helplessness.
●
Trouble controlling or
regulating emotions. They may have what’s considered an explosive temper, given easily
to sadness, or even have feelings of depression or suicidal thoughts.
●
Difficulty developing or
maintaining relationships. Those with complex PTSD often have trouble trusting
others and will avoid starting relationships with others.
●
Feelings of distrust. In general,
people with c-PTSD may have significant trust issues towards the world and
other people.
●
Dissociative symptoms are disconnected thoughts,
memories, actions, and identity. It’s a brain’s defense mechanism that tries to
escape reality. Some people with dissociative disorders develop alternative
identities, but they may also suffer from amnesia.
People with dissociative symptoms may struggle with concentration or may
disconnect from the world around them.
Therapy can help people diagnosed with c-PTSD, but it’s usually a longer process and takes more effort from a therapist and patient to undo the damage done in childhood.
Post-Traumatic Stress
PTS or Post Traumatic Stress is actually not a type of PTSD, but it could be a precursor for it.
When people experience a traumatic event, it’s normal to be affected by it.
Those with PTS experience many of the same symptoms as PTSD such as avoidance or nightmares.
The difference is that those who suffer from PTS experience those symptoms with less severity and for a shorter period of time.
People with PTSD will continue showing those symptoms for longer periods of time and with greater intensity.
According to Dr. James Bender of the Deployment Health Clinical Center:
PTS is a common, normal, and often adaptive response to experiencing a traumatic or stressful event. Common occurrences, like car accidents, can trigger PTS as well as more unusual events like military combat or kidnapping. Almost everyone who experiences a scary situation will show at least a few signs of post-traumatic stress.
Dr. Bender went on to say that the symptoms from PTS will subside after a few days and they won’t interfere with a person’s life in any meaningful way. The traumatic event may make them more careful in the future, but it won’t stop them from living their life normally.
Comorbid PTSD
Those with comorbid PTSD are people who have both PTSD and another mental disorder.
In this case, someone may have PTSD and depression, or PTSD and generalized anxiety disorder.
Anxiety, depression, and substance abuse are the most common types of comorbidity with PTSD.
It’s estimated that as much as 80% of people with PTSD have another co-occurring psychiatric disability.
PTSD And Risky Behavior
People with PTSD are more likely to engage in risky or destructive behavior.
If PTSD is triggered by trauma, doing something that might lead to additional trauma is difficult to understand.
It’s a common belief that people with PTSD turn to these behaviors as a way to escape the symptoms of PTSD, especially intrusion.
Those who use drugs or alcohol may be using them as a coping mechanism to help them avoid thinking about their original trauma.
It may also be a way to assuage guilt or shame associated with the trauma.
Types of risky behavior may include:
● Gambling
● Drinking
● Drunk driving
● Aggression
● Drugs
● Unsafe sex with strangers
● Extreme sports without regard for self-protection
This self-destructive behavior may diminish symptoms of PTSD momentarily, but ultimately the stress of these choices prolongs PTSD symptoms and make the disorder worse.
Dr. Naomi Sadeh, an Assistant Professor the National Center Boston VA/Boston University, is quoted saying:
For individuals with PTSD, exposure to new stressful events will often prolong their symptoms and can even make them worse.
So these findings suggest that treatment providers should ask trauma-exposed veterans about reckless behavior to make sure they are not engaging in harmful behaviors that could make their PTSD symptoms worse.
When it comes to treating PTSD, a therapist will try to address any risky behaviors the patient may be engaging in to help reduce the risk of continued trauma.
PTSD and Relationships
It’s no secret that PTSD can strain relationships, particularly with a spouse or partner.
There have been many cases of strong marriages unable to withstand the effects of severe PTSD.
Though both members may want to maintain the relationship, there are times when people are unable to resolve the inherent issues with PTSD.
In 2019, Meagan Drillinger wrote a piece for Healthline called “6 Things I Learned From Dating Someone With PTSD.”
In the article she explained, “For three years, I was in a relationship with a man who experienced PTSD symptoms daily. My ex, D., was a decorated combat veteran who served in Afghanistan three times. The toll it took on his soul was heartbreaking.”
She went on to say:
Being the partner of someone who has PTSD can be challenging — and frustrating — for many reasons.
You want to take away their pain, but you’re also dealing with your own guilt at needing to care for yourself, too.
You want to have all the answers, but you often have to come to grips with the reality that this is a condition that can’t be loved out of someone.
In this section, we will look at some of the things you can do to support loved ones with PTSD.
That being said, it’s extremely important to know that supporting someone with PTSD does not mean you’re responsible for making them better.
If you have a relationship with someone who has PTSD, you can’t heal them with support.
You can make their road easier, but your loved one should seek professional help to give them the tools needed to help with their disorder.
With that said, there are some things that you can do that might help ease their burden and lessen the strain in your relationship:
- Understand that PTSD is real.
Perhaps
one of the first steps in helping someone with PTSD is acknowledging that
it’s a real disorder that produces real symptoms. Though mental disorders
are difficult to understand or relate to for those who are not
experiencing them, to people with the disorder, it is very real and very
debilitating.
- Give them room not to talk. Talking about a
traumatic event might help someone who has PTSD, but that doesn’t mean
they’re always willing or able to discuss the details of their trauma.
●
Their resistance to talking about the traumatic event is not a sign
of being unloving or untrusting, it’s more likely because they want to avoid
thinking about the event. Bringing it up often is more likely to cause them to
pull away and become uncommunicative.
●
Gently encourage them to talk about it when it seems appropriate
but allow them to be the one to discuss it when they’re ready.
- Work with a routine. A routine is a good
way to help establish order in your home for a person suffering from PTSD.
Doing this can give a person with PTSD a sense of security and stability
and provide comfort in a world that feels chaotic and out of control.
●
The schedule you use will be different than someone else’s, but it
may include exercise, meditation or prayer, planned mealtimes, and daily
chores.
- Learn more about PTSD. Educating yourself
on PTSD will be one of your biggest strengths for helping a loved one and
yourself cope with the reality. You can do this by reading, watching
videos, talking with other people who have PTSD, or discussing it with a
therapist.
- Understand that caregiver
burden is real. People taking care of someone struggling mentally or
physically can be extremely stressful and draining.
●
In a study published in part by the National Institute of Health,
the authors explain,
Unlike professional caregivers such as physicians and nurses, informal caregivers, typically family members or friends, provide care to individuals with a variety of conditions including advanced age, dementia, and cancer.
This experience is commonly perceived as a chronic stressor, and caregivers often experience negative psychological, behavioral, and physiological effects on their daily lives and health.
●
Though the study was specifically talking about people taking care
of loved ones with cancer or advanced age, the sentiment is the same for
general, non-professional caregivers. Long-term care of a person can lead to
secondary issues and can be a burden for them as well.
●
To help lighten this load,
if you’re a caregiver, it’s a good idea to take time for yourself. Every moment of every day
can’t be consumed with PTSD. Take time to do things that you love and enjoy.
●
Another good solution is to find a support group for those who are
also caring for loved ones with PTSD. Finding a community of people dealing
with the same thing can help you manage your own feelings and concern.
● In addition, seek loved ones in your life and allow them to be part of your greater support network.
Treatment for PTSD
Seeking outside help is essential for helping you and your loved one cope with PTSD.
Although some may feel there’s a stigma with working with professional help, this viewpoint is becoming less common as people open up about mental health issues across the board. There is no shame in seeking professional help.
If you’re living with or helping care for someone with PTSD, it is often beneficial to seek therapy as well.
There isn’t a one-size-fits-all solution to PTSD, and it isn’t something that will be resolved in a short amount of time.
Not only that, but if there are comorbidities involved, it will take longer for the therapist to determine what diagnosis and treatment are appropriate.
Note: If substance abuse is present, look for a therapist trained to help with both PTSD and substance abuse.
What type of treatment you or your loved one will get is up to your therapist, but below are some common forms of treatment for people with PTSD.
Cognitive Processing Therapy
Cognitive Processing Therapy (CPT) is a specific type of therapy used to help people change the way they view trauma.
It has been effective in helping reduce symptoms of PTSD, and many mental health specialists recommend this course of action for people diagnosed with the disorder.
It’s thought to be one of the most effective treatments available.
CPT is usually performed over 12 sessions (often 12 weeks) in 60-90-minute sessions. Sessions can be either individual or in a group setting.
Trauma changes the way a person feels about themselves and the world, often causing them to develop an overly negative and hopeless view of things. This type of therapy can help them begin to reprocess the way they think about things.
Prolonged Exposure Therapy
Since avoidance is a symptom of PTSD, therapists will sometimes use a treatment called Prolonged Exposure therapy (PE). This treatment helps people confront the things they’re avoiding in increments.
PE is usually broken down into 15 individual sessions lasting around 60-120 minutes. Sessions usually begin with the therapist asking questions about the original trauma to help develop an understanding of the issue.
This type of therapy will induce more anxiety and stress than CPT typically does, so therapists will try to equip their patients with anxiety-reducing coping skills. For example, a patient might be taught breathing exercises to help manage the stress.
There are several ways that therapists expose a patient with the thing they’re avoiding. These techniques are:
●
Imaginal exposure. In this type of exposure,
the patient describes the traumatic event in present tense.
●
In vivo exposure. This type of exposure is
performed outside of the therapy session. The therapist and patient work
together to come up with a list of things the patient has been avoiding. Then
they agree on which ones to confront between therapy sessions in a gradual fashion.
Eye
Movement Desensitization and Reprocessing
EDMR is a different kind of treatment than talking through traumatic events. Instead, the patient is asked to think about the traumatic event while the therapist directs their eye movement.
It’s thought that the eye movement while remembering a traumatic event can help drain the emotion and negative feelings attached to it.
This type of therapy is still relatively new and is considered a non-traditional form of therapy. Though non-traditional, It is still considered to be an effective form of therapy.
Medication For PTSD
For some, medication may be helpful in addition to therapy. According to the National Center for PTSD, antidepressants are sometimes effective for treating symptoms of PTSD.
These types of medications include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors).
Your doctor or therapist can help you determine if medication might be right for you.
WHAT TO DO
Immediate intervention after trauma in the form of counselling, where a person can recount the details of the event, express their feelings and become aware that their reactions are a normal part of coping with traumatic stress, can sometimes prevent an acute reaction from becoming chronic (a long-term problem).
TREATMENT
There is a range of effective psychological and pharmacological treatments available. Therapists treating PTSD aim to provide a safe and trusting environment in which the person can deal safely with the impact of the event/s.
Treatment often involves basic counselling - listening and allowing the person to tell his/her story.
Further treatment may involve cognitive behavioural therapy and group work. The aim of therapy is to help people accept the original trauma without being so overwhelmed by memories or planning their lives around avoiding situations that remind them of the trauma.
Anti-depressants, anxiety medication and/or sleeping medications may assist a person to cope with the symptoms whilst learning to gain some control over their behaviour, thoughts and feelings again.
Often these symptoms need to be treated to provide symptom relief so a person can participate effectively in other treatment –i.e group therapy.
Individual therapy followed at some later point by group therapy is sometimes considered a useful treatment pattern for PTSD.
Group therapy can be of great value as it helps people regain a sense of community and practice their interpersonal skills and healthy ways of relating to people.
PTSD and the Road to Healing
Treatment for PTSD may not be a cure, as with most mental health disorders total recovery can be difficult or unobtainable.
However, many people who receive therapy see a significant and life changing improvement of symptoms. For some, therapy may even lead to a near absolution of symptoms.
If you’re suffering from PTSD or you know someone who is, know that there are people who can help:
● The Substance Abuse and Mental Health Services Administration is available 24/7 by calling 1-800-662-HELP (4357).
● For veterans, the National Center for PTSD is also available by calling 1-800-273-8255 or you can reach online here: https://www.veteranscrisisline.net
Hotlines are a good short-term solution that should be followed up with therapy work from a trained professional. Build up a support network of people ready and willing to help when symptoms of PTSD become overwhelming.
Be patient with yourself (or your loved one) because PTSD is a real disorder that requires time and care to improve.
Remember that setbacks don’t erase all progress. For best results, learn all you can about PTSD, seek professional help, and keep your focus on healing.
RELUCTANCE TO SEEK TREATMENT
Almost all people with PTSD can be assisted to some extent by treatment. However, often people are reluctant to ask for help. Reasons that a person may not want to seek help my include:
• Fear that instead of helping them, therapy will only make them feel worse about themselves
• Feelings that if they forget about things that the feelings will just go away
• Beliefs that nothing will help, that nothing could possibly work
• Beliefs that they ought to be able to handle it themselves, without any help.
HOW TO BE A GOOD HELPER TO SOMEONE WITH PTSD
• Listen when the person talks of his/her feelings: don’t judge
• Offer support, not pity.
• Acknowledge that the experience of a traumatic event has made a major impact on his/her life
• Recognise that the traumatic event/s was the cause: don’t blame the survivor
• Believe the victim; validate his/her experience
• Accept your own limits, and communicate this. Encourage him/her to find professional help
• Take care of yourself; maintain a life of your own;
• Seek emotional support for yourself from other sources - a person with PTSD may not be able to be as emotionally available as before
• Avoid survivor guilt. It isn’t your fault that it happened to others and not to you
• You cannot “fix” a person. You can listen - that is good enough.
GETTING HELP
• Your local Community Health Centre - see listing under ‘Community Health Centres’ in White Pages
• Your General Practitioner - for referral to a psychologist/psychiatrist/counsellor
• Sexual Health Hotline (Family Planning Australia): 1800 188 171
• Sydney Rape Crisis Centre: (02) 9819 6565 - 24 hr crisis intervention counselling for women experiencing trauma related to sexual assault (including from childhood)
• STARTTS (Service for Treatment & Rehabilitation for Trauma & Torture Survivors): (02) 9726 1033 (Fairfield) or (02) 9794 1900 (Carramar) - counselling & various rehabilitation programmes available.
• Post Traumatic Stress Disorder Unit – (02) 9845 6904 – free psychological service for victims of crime, accident or other traumatic event. Westmead Hospital.
• Clinic for Anxiety & Traumatic Stress: (02) 9722 8992 (Bankstown)
• Lifeline: 13 1114 - for 24 hour counselling/support
• Victims of Crime: 1800 633 063 - telephone counselling for emotional trauma resulting from any crime
• Vietnam Veterans Counselling Service: (02) 9635 9733 or 1800 043 503 (Sydney & country NSW)
Sources:
Foy, DW (1992) Treating PTSD, The Guildford Press. / Porterfield, KM (1996) Straight Talk About Post Traumatic Stress Disorder, Facts on File. / The Harvard Mental Health Letter (posted July 1996), Post-Traumatic Stress Disorder, Internet Mental Health, Public Information - http://www.mentalhealth.com / Public Information (posted September 1996) Post-Traumatic Stress Disorder, APA Online,
http://www.psych.org/public_info/ptsd.html
Diet change strategies:
When You Crave A Good Feeling
Some moods trigger food cravings -- and vice versa. The challenge is to keep both in check.
Think of your body as an insanely complex, gooey car. Put in gas and oil (a balanced diet), and you're good to go. Put in nicotine, alcohol, caffeine, weird, manufactured fats, gummy, washed-out flour, and sugar, and it's like pouring sugar into the gas tank. You'll sputter, run on, stop and start, or stall.
Put Food In, See a Difference
Senior New York University clinical nutritionist Samantha Heller, MS, RD, would probably prefer an analogy to a chemistry set. "If you are chemically balanced," Heller contends, "your moods will be balanced."
A lot of factors can throw the body out of balance. "A lot of women are anemic," she says. "This leads to depression and fatigue.
Older people are often deficient in the B vitamins. People who don't eat regularly often have big shifts in blood sugar." People also have chemical sensitivities to certain foods that can govern mood.
In a study of 200 people done in England for the mental health group known as Mind, subjects were told to cut down on mood "stressors" they consumed, while increasing the amount of mood "supporters."
Stressors included sugar, caffeine, alcohol, and chocolate (more of that coming up). Supporters were water, vegetables, fruit, and oil-rich fish.
Eighty-eight percent of the people who tried this reported improved mental health. Specifically, 26% said they had fewer mood swings, 26% had fewer panic attacks and anxiety, and 24% said they experienced less depression.
How Moods Are Fed or Starved
One big set of chemicals that control mood are the neurotransmitters in the brain led by the pleasure "drug" serotonin. These substances determine whether you feel good and energetic or tired, irritable, and spacey.
They run on sugar, preferably the form that comes from low glycemic carbohydrates (not doughnut sprinkles), according to Molly Kimball, RD, sports and lifestyle nutritionist at the Ochsner Clinic Foundation and Hospital in New Orleans.
The idea, she says, is to maintain a stable blood sugar level through the day, slowly feeding these substances into the brain. Low glycemic carbs include whole grain bread, beans, whole grain crackers, soy, apples, pears, peaches, and other fruits.
What Kimball calls "crappy carbs" -- commercial granola bars, animal crackers, graham crackers, potato chips, and of course, cakes and pies -- flood into the system too fast and cause your body to order up a big shot of insulin, which then tips the balance you've tried to maintain.
"You can see it when you've had a white flour pancake and syrup for breakfast," Kimball says. "By mid-afternoon, you're ready for a nap." This sugar alert/insulin cycle can gradually become less efficient and lead to diabetes and other problems.
Comfort Foods Really Work
If you have let your neurotransmitters get off balance or if external forces have conspired to put you in a bad mood, don't fret, it happens. That's when your body will start to think "comfort food."
According to Joy Short, MS, RD, assistant professor and head of undergraduate nutrition and dietetics at St. Louis University, you should fulfill that craving -- but in moderation. "You might take time to think, 'Am I really hungry or just feel like eating because I am stressed,'" she says.
However, if you can't think of a healthier response, eat your comfort item and enjoy it! If you must eat a deep-fried Twinkie, eat one and lighten up on (but don't skip) the rest of the meals in the day, she says.
You could make comfort foods more nutritional, she says. Interestingly, both men and women choose ice cream as their preferred comfort food, but coming in second is chocolate for women and pizza for men. "If you want a cookie, make it oatmeal raisin or vanilla wafers. Buy low-fat ice cream. Make your hot chocolate with skim milk. And forget the chips, in favor of popcorn or pretzels," Short says. Or after Domino's arrives, throw some artichoke pieces, anchovies, or frozen veggies on top and heat.
What about that universal comfort food, chocolate? Much has been written about chocolate's rich complement of mood-altering chemicals, some of which trip the serotonin receptors and cause a "falling in love" feeling, according to millions of chocoholics.
Chocolate is also supposedly loaded with antioxidants that keep the brain and other organs from being bashed by rogue cells called free radicals. Kimball says chocolate can act almost as a cannabinoid -- the mood-altering chemical found in marijuana. But Heller and Short say the touchy-feely chemicals are not in sufficient strength to make a difference in the body.
Recommendations for Managing Moods
• Maintain a stable blood sugar, no big swings. This means frequent small meals and snacks, every four hours or so.
• Be sure to drink a lot of water and juice.
• Exercise 20 minutes a day for mood -- and an hour for fat-burning.
• Do not follow an extremely low-fat diet (quick weight loss is also bad for mood, Heller says). Fat is needed for anti-depression. Stick with polyunsaturated and monounsaturated fats and fatty fish or flaxseeds, which are full of healthy omega-3 fats.
• Take in tryptophan, an amino acid that makes blood sugar accessible to the neurotransmitters. This means milk or turkey. Eat a carb alongside your tryptophan source for better absorption.
• Have breakfast.
• Spend time in the produce department when you shop (try to eat a lot of bright colors, which means fruits and veggies).
• Pass on food items that come wrapped in crackly cellophane.
• Limit coffee (even nutritionist Kimball drinks some).
• Don't eliminate any one food group, such as carbs.
HERBS
Herbs and related supplements are one natural treatment alternative for mental health disorder patients. Some patients prefer to use natural treatment choices as stand alone treatment, whereas others use them in combination with medication and psychotherapy. Work with your health care practitioner to find out what is best for you.
The best place to get quality supplements is from a natural healthcare provider. There are dozens of supplements marketed on supermarket shelves today, but many of these do not receive standardization. It is important if you decide to use supplements that you get the best quality supplement possible.
Here is a listing of a few supplements that healthcare providers have used for many years to treat symptoms of bipolar and related disorders. Most herbs come from plants and can help relax or provide support with sleep disorders and depression in patients.
Black Cohosh – This may affect one’s hormones, which may be one cause for symptoms of some mental health disorders.
Damiana – Often used to help lessen depression, but may cause mania in people with bipolar disorder.
Ginseng – May help provide more energy to people who feel fatigue during depressive states.
Gotu Kola – May help address symptoms of anxiety.
St. John’s Wort – One of the most popular of herbal supplements supported with scientific research that may help lessen mild depression. Again, one should use with caution and can interact with other medications including antidepressants.
Vitamin & Nutrient Associations
If you suffer from mental health disorders, it is important you eat well to nourish your body. Deficiencies of vitamins and minerals can contribute to your symptoms. Deficiencies of vitamins and minerals in anyone can contribute to symptoms including anxiety, depression and poor health.
A good quality multivitamin is a good start, especially if you do not have a history of eating well. Even if you do eat well, not all people absorb the vitamins and nutrients from their foods completely, so a multivitamin may help correct any shortages.
Many therapists recommend patients with bipolar disorder take extra B vitamins because these vitamins may affect our moods. A deficiency in vitamin B of any type may result in symptoms of depression or anxiety.
B vitamins are also often recommended to people to help lessen fatigue. For most, B vitamins help energize the body. There are many forms of B vitamins, so your best bet is a complex tablet containing all the B vitamins. For your information, here is a breakdown of the B vitamins by category.
• B-1 – Also known as “Thiamin.” This may impact anxiety, irritability and improve blood circulation in the brain and body.
• B-6 – Also known as “Pyridoxine.” This B vitamin may help reduce irritability. Doctors sometimes recommend it to patients with premenstrual irritability and agitation. You can take too much however, so be sure you consult with your doctor.
• B-12 – This vitamin helps convert what you eat into fuel for your body. It is most helpful for reducing drowsiness.
• Folic Acid – Important for preserving the body’s systems and biochemical balance. Careful however, as this supplement may interact with some of the more commonly prescribed mood stabilizers including Depakene.
Other vitamins that may prove helpful may include vitamin E, which may combat the risk of seizures often associated with the use of traditional medication therapies.
Here are some other supplements and nutrients that may prove useful for combating the symptoms of mental health disorders.
• SAMe (pronounced Sammy) – This supplement may affect levels of dopamine and serotonin in the brain, but carries with it a risk of mania.
• Tyrosine – Often used in combination with B vitamins, this amino acid is a precursor to dopamine and norepinephrine, important neurotransmitters in the body. What this means is your body needs tyrosine to make norepinephrine and dopamine.
• GABA – May help relieve some symptoms including anxiety, insomnia, racing thoughts and tension in patients with bipolar or related disorders.
• Essential Fatty Acids – Essential fatty acids are important for our entire body to work properly. They nourish the brain and may help reduce symptoms of depression. You can get essential fatty acids by eating more fatty fishes and flax seed or by taking an Omega 3 supplement. Some healthcare providers recommend as much as 5,000 I.U. or more for patients with severe depression. Be sure you check in with your doctor. Most over-the-counter supplements contain only 1,000 I.U. per serving.
• Lecithin – This substance may help stabilize mood swings. If you plan to use this supplement, you should do so while working with a natural health care provider.
• Calcium – Calcium is a mineral our bodies need for proper neurotransmitter production. Look for a supplement with calcium and magnesium to heighten the effects. A lack in magnesium can often lead to insomnia and anxiety.
• Zinc – This important and often ignored mineral is often lacking in many people’s diet. It can help combat colds and may help reduce some symptoms of depression or other mental disorders.
Remember, as with herbal supplementation you should embark on vitamin and nutritional therapy under a skilled practitioner’s guidance.
Even when we try to eat well, we're disadvantaged. The nutritional content of most food has been compromised over the years, not only by deficient soils and modern production, transportation, storage and processing methods, but also by the enormous amounts of chemical and artificial substances added to promote growth, storage life, taste and appearance.
It's for this reason that more and more medical authorities are advocating the use of vitamin and mineral supplements. However, finding them in the right combination can be both confusing and costly.
The nutrition products I am going to recommend you make use of knowledge gained from the botanical world's 6,000 year history. They incorporated health building nutritional herbs with the best modern technology to help our bodies cleanse and detoxify so that the cells - the tiniest living units - can be as fully nourished as possible.
This allows the cells to grow, repair and to perform their functions with the best possible efficiency so that we feel and look better and are more able to prevent and fight disease. Once the body begins to clear itself of toxins it can more efficiently absorb nutrition.
Aloe Vera Juice is a refreshing and anti-bacterial drink, you might find that taking this daily, diluted in some filtered water will not only refresh you like ‘a shower inside you’ but also assists in dealing with any digestive issues you may also be experiencing.
You may find benefit from our information on detoxification as well as a bit about detoxing because of change of diet
It may be due to difficulties with your digestive system that is causing your body to be starved of key nutrients, vitamins or minerals. In this case you may find useful answers by reviewing our article on Nutrition For Your Cells. There is also more information here about why is nutrition such an issue nowadays?
It may be that your metabolism has slowed due to pressures that have been placed on your system through life in general or through specific “challenges” you have faced in the last few months or last few years. Review this by looking at our article about balancing your Metabolic Rate.
Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your problem through giving your body the nutrition products that will assist you body to heal from the inside out.
Most mental health disorders are complex and often misunderstood, that affects millions of people every year. It is important that patients understand their disorder is one that they can live with, and even learn to enjoy life with.
There are many misconceptions surrounding mental health disorders. There are times when a patient’s symptoms may become very serious. In cases like this it is critical a person seek professional care and guidance. A mental health disorder can manifest in many different ways. It can for example, manifest as a mild disorder with mild mood swings, or a major mood disorder with swings that are very extreme.
There are many approaches to treating a mental disorder. A patient should always work with a competent doctor or other healthcare provider they can rely and trust on in times of need. Also important to one’s health is his or her ability to build a supportive wellness team.
Your wellness team can help you during the tough times, offering support and helping you make critical decisions when you may not be up to it. The most important step a patient can take, the one that will ultimately lead to their success and fulfillment, is to take a proactive role in their recovery and in their care. To do this, you must first embrace and accept the fact that you have a mental health disorder.
Once you do this, life gets a lot easier. You can then help manage your disorder by working actively with each member of your wellness team as well as with members of your family and your healthcare team to create an action plan that allows you to live a happy, healthy life. Many people live with mental health disorders. Your job is to learn to not only live with, but also learn to enjoy life with bipolar disorder or any serious ailment.
Congratulations on taking a step in the right direction, one that will lead to your long-term recovery and happiness.
We wish you well in your search for solutions to this problem and your movement towards better health in all areas.
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SITE DISCLAIMER: Do these products “cure” anything? Of course not… but it stands to reason that if you cleanse your body and feed it the finest nutrition available, giving it everything it needs in balance, on a daily basis, that your body will do what nature intended, and give you the best possible chance to fend off sickness and disease. This Post-traumatic Stress Disorder (PTSD) information is not presented by a medical practitioner and is for educational and informational purposes only. The Post-traumatic Stress Disorder (PTSD) content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any Post-traumatic Stress Disorder (PTSD) questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read.
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