trauma resources

https://www.phoenixaustralia.org/recovery/fact-sheets-and-booklets/

What Is Post-Traumatic Stress Disorder?

https://www.verywellmind.com/ptsd-in-the-dsm-5-2797324

Post-traumatic stress disorder (PTSD) is a psychiatric disorder involving extreme distress and disruption of daily living that happens in relation to exposure of a traumatic event.1 About 6% of the U.S. population will experience PTSD during their lives.2

To be diagnosed with PTSD, a mental health professional would reference the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and evaluate whether or not the patient meets the criteria. The criteria in the fifth edition are somewhat different than the criteria in the fourth edition.

PTSD Symptoms

The DSM-5 outlines PTSD symptoms into four categories:

Intrusion symptoms
Avoidance of thoughts and behaviors
Negative changes in thoughts and mood
Changes in arousal and reactivity

These symptoms are associated with a traumatic event. Each of the four categories includes a group of related symptoms.

Intrusion

These symptoms are related to intrusive thoughts and memories of the traumatic event.

Reoccurring, involuntary, and intrusive upsetting memories of the event
Repeated upsetting dreams related to the event
Dissociation (for example, flashbacks, feeling as though the event is happening again)3
Strong and persistent distress to cues connected to the event that are either inside or outside of the body
Strong bodily reactions (for example, increased heart rate) when reminded of the event

Avoidance

People with PTSD may avoid people, places, conversations, activities, objects, or situations that bring up memories of the event. They may also avoid thoughts, feelings, or physical sensations that recall the event.

Negative Changes in Thoughts and Mood

People with PTSD may experience a pervasive negative emotional state (for example, shame, anger, or fear). Other symptoms in this category include:

Inability to remember an important aspect of the event
Persistent and elevated negative evaluations about oneself, others, or the world (for example, "I am unlovable," or, "The world is an evil place")
Elevated self-blame or blame of others about the cause or consequence of the event4
Loss of interest in previously enjoyable activities
Feeling detached from others
Inability to experience positive emotions (for example, happiness, love, joy)

Changes in Arousal and Reactivity

People with PTSD often feel constantly "on guard" or like danger is lurking around every corner (or hypervigilance). Similar symptoms include:

Difficulty concentrating
Heightened startle response
Impulsive or self-destructive behavior5
Irritability or aggressive behavior
Problems sleeping

Diagnosis

The first criteria for a diagnosis of PTSD listed in the DSM-5 is exposure to one or more traumatic event(s), which is defined as one that involved death or threatened death, actual or threatened serious injury, or actual or threatened sexual violence.

Experiencing the event could be direct, but it doesn't have to be. Exposure could also occur in the following ways, according to the DSM-5:

Witnessing it as it occurred to someone else
Learning about an event where a close friend or relative experienced an actual or threatened violent or accidental death
Having repeated exposure to distressing details of an event, such as a police officer repeatedly hearing details about child sexual abuse

Once the exposure has occurred, PTSD symptoms are evaluated for a diagnosis.

DSM-5 PTSD Diagnosis

In order to be diagnosed with PTSD according to the DSM-5, the following criteria should be met:

Exposure to the traumatic event
One (or more) intrusion symptom(s)
One (or more) symptom(s) of avoidance
Two (or more) symptoms of negative changes in feelings and mood
Two (or more) symptoms of changes in arousal or reactivity

These symptoms also:

Must last for longer than one month
Must bring about considerable distress and/or interfere greatly with a number of different areas of your life
Can't be due to a medical condition or some form of substance use

Changes in the DSM-5

The biggest change in the DSM-5 is removing PTSD from the category of anxiety disorders and putting it in a classification called "Trauma- and Stressor-Related Disorders."4

Other key changes include:

More clearly defining what kind of events are considered traumatic
Adding different types of exposure to the event
Increasing the number of symptom groups from three to four by separating avoidance symptoms into their own group
Changing the wording of some of the symptoms
Adding a new set of criteria for children aged 6 or younger
Eliminating the acute and chronic phases
Introducing a new specifier called dissociative features3

Causes

PTSD is caused by exposure to trauma. However, it's not clear why some people develop PTSD after traumatic events while others do not. There are some risk factors that can make someone more likely to develop it than others. For example, genetics may play a role. It's also more common in women than men.6

Other risk factors include:

A lack of social support following the event
An experience of past trauma
History of mental illness
History of substance use7

Types

There are different types of PTSD, including:

Complex PTSD: Characterized by a series of traumatic events occurring over time and typically earlier in life.8 Notably, complex PTSD is not listed in the DSM-5.
Delayed expression: Before the DSM-5, this type of PTSD was referred to as "delayed onset." It occurs when someone is diagnosed at least six months after the traumatic event took place.
Dissociative: In addition to meeting criteria for a PTSD diagnosis, this subtype—classified specifically as "with dissociative symptoms"—requires symptoms of either depersonalization or derealization.

Acute stress disorder is related to PTSD. While it shares some symptoms, a PTSD diagnosis requires symptoms are present for more than a month, whereas someone with acute stress disorder could experience symptoms for just three days to one month.

Acute and chronic PTSD are no longer used in the DSM-5. Acute referred to PTSD symptoms lasting less than three months and chronic referred to symptoms lasting more than three months.9

Treatment

Treatment for PTSD can involve medication, psychotherapy, or both. Consult a mental health professional to find the best treatment for you.

Medication

Antidepressants, or more specifically selective serotonin reuptake inhibitors (SSRIs), are typically considered the first-line medication option to treat PTSD. These can help someone with PTSD with mood, anxiety, eating, and sleep.10

Zoloft (sertraline) and Paxil (paroxetine) are FDA-approved to treat PTSD.11 Others that have been shown to be effective for PTSD include Prozac (fluoxetine) as well as Effexor XR (venlafaxine), which is a selective norepinephrine reuptake inhibitor (SNRI).12 In addition, there are other medications that may be used to treat PTSD. Be sure to discuss your options with your healthcare provider.

Psychotherapy

Cognitive behavioral therapy (CBT) is a form of talk therapy that has been found to be effective for treating the symptoms of PTSD.13 CBT may help manage your symptoms by working to change your beliefs and behaviors. Other types of psychotherapy that may be used for PTSD include:

Coping

PTSD gets in the way of everyday life, and it's important to take good care of yourself to manage it. These ways to cope are known to be effective.

Mindfulness practice16
Support groups and supportive relationships with loved ones17
Abstinence from drugs and alcohol
Exercise

Posttraumatic Stress Disorder (PTSD) in Children

https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579

What is posttraumatic stress disorder (PTSD) in children?

Posttraumatic stress disorder (PTSD) is a mental health problem. It can affect people of all ages. A child with PTSD keeps having scary thoughts and memories of a past event. He or she finds the event terrifying, either physically or emotionally.

The symptoms of PTSD may start soon after a stressful event. Or they may not happen for 6 months or longer. Some children with PTSD have long-term effects. They may feel emotionally numb for a very long time. PTSD in children often becomes a long-term (chronic) problem.

PTSD may be accompanied by:

Depression
Substance abuse
Anxiety

What causes PTSD in a child?

A traumatic event that triggers PTSD may be:

Something that happened to the child
Something that happened to someone close to the child
Something the child saw

A child or teen may suffer from PTSD after one of these traumatic events:

Bad accidents, such as car or train wrecks
Invasive medical procedures, especially for children younger than age 6
Animal bites
Natural disasters, such as floods or earthquakes
Manmade tragedies, such as bombings
Violent personal attacks, such as a mugging, rape, torture, or kidnapping
Physical abuse
Sexual assault
Sexual abuse
Emotional abuse or bullying
Neglect

Which children are at risk for PTSD?

A child’s risk for PTSD is often affected by:

How close the child was to the traumatic event
How bad the event was
How long the event lasted
If the event happened more than once
How well the child is able to recover quickly from difficult things (resiliency)
How well the child copes
How supportive a child’s family and community are after the event

What are the symptoms of PTSD in a child?

Children and teens with PTSD feel a lot of emotional and physical distress when exposed to situations that remind them of the traumatic event. Some may relive the trauma over and over again. They may have nightmares and disturbing memories during the day. They may also:

Have problems sleeping
Feel depressed or grouchy
Feel nervous, jittery, or alert and watchful (on guard)
Lose interest in things they used to enjoy. They may seem detached or numb and are not responsive.
Have trouble feeling affectionate
Be more aggressive than before, even violent
Stay away from certain places or situations that bring back memories
Have flashbacks. These can be images, sounds, smells, or feelings. The child may believe the event is happening again.
Lose touch with reality
Reenact an event for seconds or hours or, in rare cases, days
Have problems in school
Have trouble focusing
Worry about dying at a young age
Act younger than their age, such as thumb-sucking or bedwetting
Have physical symptoms, such as headaches or stomachaches

How is PTSD diagnosed in a child?

Not every child or teen who goes through a trauma gets PTSD. PTSD is diagnosed only if symptoms keep happening for more than 1 month and are negatively affecting the child’s life and how he or she functions. For those with PTSD, symptoms most often start within 3 months after the traumatic event. But they can also start months or years later.

A child psychiatrist or mental health expert can diagnose PTSD. He or she will do a mental health evaluation.

How is PTSD treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

PTSD can be treated. Early diagnosis and treatment is very important. It can ease symptoms and enhance your child’s normal development. It can also improve your child’s quality of life.

Treatment may include:

Cognitive behavioral therapy. A child learns skills to handle his or her anxiety and to master the situation that led to the PTSD.
Medicines for depression or anxiety. These may help some children feel calmer.

Recovery from PTSD varies. Some children recover within 6 months. Others have symptoms that last much longer. Recovery depends on the child’s inner strengths, coping skills, and ability to bounce back. It is also affected by the level of family support. Parents play a vital role in treatment.

How can I help prevent PTSD in my child?

These measures may help prevent PTSD in children:

Teach children that it is OK to say no to someone who tries to touch his or her body or make him or her feel uncomfortable.
Encourage prevention programs in your community or local school system.

How can I help my child live with PTSD?

As a parent, you play a key role in your child’s treatment. Here are things you can do to help:

Admit that the event happened. Pretending everything is normal won't help your child.
Be supportive and get counseling for children and teens who have seen or gone through a traumatic event. A child or teen may at first not want counseling. But it may be needed months or even years after the traumatic event.
Keep all appointments with your child's healthcare provider.
Talk with your child’s healthcare provider about other providers who will be included in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on his or her needs and how serious the PTSD is.
Tell others about your child’s PTSD. Work with your child’s healthcare provider and school to create a treatment plan.
Reach out for support from local community services. Being in touch with other parents who have a child with PTSD may be helpful.
Take all symptoms of depression and suicide very seriously. Get treatment right away. Suicide is a health emergency.

When should I call my child’s healthcare provider?

Call your healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others
Feels out of control
Hears voices that others don’t hear
Sees things that others don’t see
Can’t sleep or eat for 3 days in a row
Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to get help

PTSD increases risk for other mental health disorders, including depression, anxiety, and suicidal thinking.

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.

Key points about posttraumatic stress disorder in children

PTSD is a mental health problem. A child with PTSD has constant, scary thoughts and memories of a past event.
A traumatic event, such as a car crash, natural disaster, or physical abuse, can cause PTSD.
Children with PTSD may relive the trauma over and over again. They may have nightmares or flashbacks.
PTSD is diagnosed only if symptoms keep occurring for more than 1 month and are negatively affecting the child’s life.
A child with PTSD may need therapy and medicine. They are at higher risk for other mental health problems such as depression, anxiety, and suicidal thoughts
Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.

Thursday, October 28, 2021