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Post-Traumatic Stress Disorder (PTSD)

 
  Source: Dr Cheryl Loh, Associate Consultant, Psychological Medicine, Changi General Hospital
 
 
     
 

It is a condition occurring in people who have been caught in situations where they felt threatened and helpless. It is characterised by recurrent, intrusive memories or dreams, avoidance of things associated with the event and hyper-vigilance. These symptoms become a disorder when they persist beyond a month and cause disruption in daily functioning.

In what kind of cases do women develop PTSD?
Some events which might lead to development of PTSD include road traffic accidents or being a victim of physical or sexual assault or threats.

What are some symptoms of PTSD? How long do they last?
Untreated PTSD may not spontaneously resolve.

Anecdote: Give an example or two of PTSD cases: What happened to the patient, the problems caused by PTSD, the state she was in when she came to seek help, what treatment you prescribed, and how she got better / healed?
A 35 year old lady was riding on a bicycle in a carpark when she was hit from behind by a car. 6 months after the accident, she still had frequent vivid and intrusive memories of the incident. She described seeing the car’s wheels stopping just in front of her face and hearing the screeching sound of the brakes. It felt as if it were happening again each time she recalled it. She jumped whenever she heard loud traffic noises and especially when she heard car brakes screeching. She stayed in her room much more than usual, avoided using the bicycles at all and avoided travelling in any vehicle as much as she could. She felt helpless and useless to overcome her symptoms even though her family were warm and encouraging to her.

She was given some psychological information about post traumatic stress disorder. She started treatment with a psychologist who helped her to calm herself down when symptoms arose and slowly plan small steps to regain confidence about going out. Over the next few months, she was able to feel less troubled when talking about the event and slowly start going out more. Her family were included in her treatment plan and they provided lots of support as she progressed.

PTSD seem to be more commonly diagnosed among war veterans, in whom the disorder seems especially serious. Sufferers may sometimes turn suicidal, among other things.

Do PTSD sufferers all experience the same loss of hope / hopelessness?
Hopelessness is a frequent symptoms found in PTSD, but it is not a defining feature. Also, many patients with PTSD also have concurrent Major Depression, of which hopelessness and thoughts of death are major characteristics.

What causes PTSD?
PTSD is a kind of anxiety disorder.

How can PTSD be treated? Can it be cured?
PTSD is treated with a combination of medication and psychotherapy. Many other practical helps with re-entering daily life and routines are also often employed. The most common medications used are anti-depressants and anti-anxiety medications. Psychotherapy may involve support and education about the disorder, development of coping mechanisms and management of stress from the symptoms. With treatment, approximately 70% of patients experience good resolution of symptoms.

     
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