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Topic of the week:
PTSD can affect all of us
Imagine you just experienced a serious car accident without injuries and you are fully conscious, how would you respond to what just happened?
You may experience the after math of the accident, responding with high anxiety, even terror, cognitively (e.g. poor concentration), emotionally (e.g. feeling numb), physically (e.g. feeling lightheaded), and behaviorally (e.g. irritability).
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V), “Acute Stress Disorder” is defined as “Exposure to actual or threatened death, serious injury, or sexual violation…learning that an event happened to a close relative or friend…experiencing repeated or extreme exposure to aversive details of a traumatic event(s) (e.g. first responders, such as police officers repeated exposure to details of child abuse)”.
Symptoms of acute stress disorder (a car accident for example) may be intense anxiety, confusion, rapid heart beat, intrusive memories of the event (nightmares or flashbacks of images of crashing into the other car), startling when hearing an ambulance drive by, anger or depression, altered sense of reality, and avoiding situations (such as driving a car). Often these symptoms will resolve within the first few weeks of the “trauma”, however if they persist past 30 days, the individual may meet criteria to be diagnosed with Posttraumatic Stress Disorder (PTSD) and should be evaluated by a psychologist, who specializes on trauma.
PTSD is a complex health condition that can develop in response to a traumatic experience – a life-threatening or extremely distressing situation that causes a person to feel intense fear, horror or a sense of helplessness. PTSD can cause severe problems at home or at work. Anyone can develop PTSD – men, women, children, young and old alike. Prevalence of PTSD ranges from 6.8% in the general population (NIMH, 2014) to 25% (PTSD.gov) among military veterans., and 35% among first responders (fire fighters) to the September 11th tragedy.
Trauma is about perceived threat and not all individuals experiencing a life-threatening event end up with Acute Stress- or PTSD.
However, along with military veterans, first responders, such as fire fighters, EMTs and police officers have a higher risk in developing not only acute stress disorder, but also complex and delayed (symptoms surface 6 months after the trauma) PTSD, due to the frequency of involvement in detailed stressful events (deaths, injuries, domestic violence, child abuse etc.).
Untreated PTSD can have devastating consequences on the individual’s quality of life; not only does sleep become severely compromised, due to frequent nightmares about traumatic events, but often severe depression and anxiety set in; the individual with untreated PTSD may avoid social interactions and appear irritable and sometimes even explosive in their daily interactions with friends and family; his or her professional life may also be affected, because the individual may call in sick often, suffering from headaches, frequent colds and other illness, and exhaustion due to severe insomnia; he or she may avoid responding to specific job duties because they trigger more anxiety, even panic attacks.
Daily life becomes hopeless because added stressors, such as fighting with a spouse often related to substance abuse, can turn thoughts into a very dark place.
Fortunately, PTSD is not a life-long condition and very treatable via psychotherapy and sometimes medication can be helpful.
First responders are not very good about asking for help themselves; often they are noticed because of drastic performance changes at work (not responding to an emergency call, and/or displaying exaggerated aggressive behavior toward coworkers or while on duty).
On the home front, first responders with PTSD may become more and more socially withdrawn and appear “mentally checked out” or aggressive toward spouse and children; a spouse is frequently the first one to notice drastic changes in behavior, sleep patterns, and overall negative demeanor in their wife or husband.
I am urging not only spouses, friends or family members to encourage first responders to seek help for psychological assessment and treatment of PTSD, but also administrators, human resources and public policy to provide regular “checkups from the neck up” to all professionals who are first responders to emergency situations (Firefighters, EMTs, Police Officers etc.); it is time to stop stigmatizing utilization of mental health services to those who may need it the most but may never ask for it, resulting in a poor quality of life and also potential liability issues on the job.
If you think someone needs immediate mental health assistance call 911 or the nearest hospital emergency room.
Resources: ptsd.va.gov ptsdalliance.org nimh.nih.gov samsha.gov
Redcross.org apa.org azpa.org