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Brain Games - Conformity (Standing Ovations)

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Fact: Mental health issues can affect anyone. In 2020, about:

One in 5 American adults experienced a mental health condition in a given year

One in 6 young people have experienced a major depressive episode

One in 20 Americans have lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

Additionally, suicide is a leading cause of death in the United States. In fact, it was the second leading cause of death for people ages 10-24. Suicide has accounted for the loss of more than 45,979 American lives in 2020, nearly double the number of lives lost to homicide.

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Can you tell the difference between a mental health myth and fact? Learn the truth about the most common mental health myths and information to help destigmatize them.

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10 Psychological Experiments You Would Never Believe Happened

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Post traumatic stress disorder (PTSD) | Talking about mental health - Episode 17

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People who have lived through a traumatic event can find themselves experiencing emotional challenges long after the event has taken place.

Although it is common for people to experience emotional challenges after trauma, their symptoms can lessen in intensity over time as they continue to heal. However, people who struggle with post-traumatic stress disorder (PTSD) find themselves experiencing symptoms that continue to cause them significant distress.

Definition

The current Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, is a manual that clinical professionals use to diagnose mental health conditions. In previous years, PTSD fell under the category of anxiety related conditions. The current version of the manual has placed post-traumatic stress disorder under the category of trauma- and stressor-related disorders.

Post-traumatic stress disorder can develop after the experience of a traumatic event, either a single isolated event or more chronic and recurring traumatic experiences. A variety of emotional disturbances and symptoms are associated with PTSD that cause clinically significant distress or impairment in the person's social interactions, their ability to work, or other important areas of functioning.

Who Is Affected

It is estimated that there are currently around 8 million people in the United States who are living with PTSD. These numbers vary depending on things like gender, emotional response to trauma, and other factors.

Altogether, it is estimated that 7 to 8 percent of people will experience PTSD at some point during their lifetime.

About 70 percent of adults in the US have reported experiencing a traumatic event at least once in their life. With this in mind, it is important to note that most people who experience a traumatic event will not develop PTSD.

Some factors that can contribute to the likelihood of developing PTSD include things like:

Mental or physical health condition

Emotional response during the trauma

Type of trauma

Gender (studies have shown women to be twice as likely to have PTSD)

Age

Marital status

Emotional support system

Experience of additional stressors after trauma

Types of PTSD

Within the diagnosis of PTSD there can be certain specifiers identified, which means there are distinct features present that make it different from the more broad diagnosis of PTSD. Some of these specifiers are identified in the DSM-5 including:

Dissociative

Delayed onset/expression

One of the changes made in the most recent update of the diagnostic manual for clinicians is the inclusion of specific PTSD symptoms for children six years or younger. As children witness and live through traumatic events they, too, can experience emotionally distressing symptoms after the event. Just as with adults (and anyone over six years old) there are certain criteria that need to be met in order for a young child to be diagnosed with PTSD.

Dissociative

The dissociative specifier within the PTSD diagnosis refers to the presence of persistent or recurrent depersonalization or derealization symptoms. Depersonalization means that someone is experiencing something as if they are an observer to themselves, observing from outside of their body. Derealization refers to sensing as if things around you are not real, almost as if you are unfamiliar and disconnected from the world around you.

Delayed Onset

The term delayed onset was recently changed to delayed expression in the DSM-5. Although people with this particular specifier do meet the necessary criteria for PTSD, the criteria are not fully met until at least six months after the traumatic event. A person could experience the onset and expression of some of the symptoms more immediately, however, the full symptom criteria for diagnosis would not have been met until after that six month mark.

Sometimes people can experience isolated, acute instances of trauma such as a horrific car accident or being robbed at gunpoint, for example. These would be considered acute because they are not likely to become recurring experiences. There are other types of traumatic events that can be more recurring, such as domestic violence, sexual abuse, or childhood neglect. The person would experience the event again and again over the course of time. When people have experienced this type of more chronic trauma, it is sometimes referred to as complex PTSD.

Although there are many people who will experience a traumatic event in their lifetime, many will not develop PTSD. There are certain symptoms that someone needs to be experiencing, referred to as diagnostic criteria, in order for them to be accurately diagnosed with post-traumatic stress disorder. PTSD symptoms are divided into four separate clusters including:

1) Re-experiencing:

Frequent upsetting thoughts or memories about a traumatic event.

Having recurrent nightmares

Feeling as though the event were happening again, sometimes called a flashback

Strong feelings of distress when reminded of the event

Being physically responsive, such as increased heart rate or sweating, when reminded of the event.

2) Avoidance:

Making an effort to avoid thoughts, feelings, or conversations about the traumatic event

Actively trying to avoid places or people that remind you of the traumatic event

Keeping yourself too busy to have time to think about the traumatic event

3) Hyperarousal:

Having a difficult time falling or staying asleep

Feeling more irritable or having outbursts of anger

Having difficulty concentrating

Feeling constantly on guard or like danger is lurking around every corner

Being jumpy or easily startled

4) Negative Thoughts and Beliefs

Having a difficult time remembering important parts of the traumatic event

A loss of interest in important, once positive, activities

Feeling distant from others

Experiencing difficulties having positive feelings, such as happiness or love

Feeling as though your life may be cut short

Many of these symptoms are an extreme version of our body's natural response to stress. Understanding our body's natural response to threat and danger, known as the fight or flight response, can help us better understand the symptoms of PTSD.

To be diagnosed with PTSD, you don't need to have all these symptoms. In fact, rarely does a person with PTSD experience all the symptoms listed above. To receive a diagnosis of PTSD, you only need a certain number of symptoms from each cluster.

Additional requirements for the diagnosis also need to be assessed, such as how you initially responded to the traumatic event, how long you've been experiencing your symptoms and the extent to which those symptoms interfere with your life. For an accurate PTSD diagnosis you would need to review these things with a qualified mental health professional.

The symptoms of PTSD can be difficult to cope with, and as a result, many people with PTSD can be susceptible to developing unhealthy coping strategies, such as alcohol or drug abuse or deliberate self-harm. Because of these risks, it is important to develop a number of healthy coping skills to manage your PTSD symptoms. Coping strategies you can work on incorporating in your life include:

Treatment Options

A number of psychological treatments have been found to be effective in helping people cope with the symptoms of PTSD. Some of these include:

Cognitive-behavioral therapy (CBT) for PTSD focuses on changing the way in which you evaluate and respond to situations, thoughts, and feelings, as well as unhealthy behaviors that stem from your thoughts and feelings.

Exposure therapy is a behavioral treatment for PTSD that aims to reduce your fear, anxiety, and avoidance behavior by having you fully confront, or be exposed to, thoughts, feelings, or situations that you fear.

Acceptance and commitment therapy is a behavioral treatment that is based on the idea that our suffering comes not from the experience of emotional pain, but from our attempted avoidance of that pain. Its overarching goal is to help you be open to and willing to have your inner experiences while focusing attention not on trying to escape or avoid pain, since that is impossible to do, but instead on living a meaningful life.

Eye movement desensitization and reprocessing (EMDR) is another highly effective therapy for treating PTSD that involves thinking about your trauma while paying attention to an outside stimulus, such as a light or a finger moving back and forth. It helps you make new connections between your trauma and more positive thinking.

In Children

Children are not immune to the challenges of post-traumatic stress disorder. The National Child Traumatic Stress Institute (NCTSI) states that more than two-thirds of children have reported at least one traumatic experience by the age of 16. Additionally, it is estimated that 19 percent of injured and 12 percent of physically ill youth have PTSD. Examples of potential traumatic experiences could include events such as:

Psychological, physical or sexual abuse

Community or school violence

Witnessing or experiencing domestic violence

Natural disasters

Terrorism

Commercial sexual exploitation

Sudden or violent loss of a loved one

Life threatening illness or accident

Because children can have a more difficult time processing their experiences and coping with the lasting emotional impact of trauma, it is important for support people (caregivers, relatives, etc) to allow children the opportunity to talk about their experience. A critical part of a child's recovery and healing is their support system. Having a strong support system and access to trauma-informed care is essential to their healthy coping and overall healing.

For Loved Ones

Finding ways to support a loved one with PTSD can be a struggle. One of the most helpful things you can do is learn about the symptoms and the challenges of living with post-traumatic stress disorder. Becoming familiar with what your loved one might be experiencing can help increase compassion and understanding, making it easier to have conversations about their challenges.

Inviting and encouraging your loved one to seek help from a trained professional is paramount. Since unaddressed symptoms of PTSD can become more severe over time, it is important to try and help your loved one find helpful resources to begin the healing process.

Do not be afraid to ask your loved one about their experiences and be open to actively listening. You are not expected to "fix" anything, just allow your loved one space to talk openly without fear of judgment or criticism.

Ask your doctor or mental health professional for a recommendation or referral to someone who specializes in treating PTSD.

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Could You Have Post-Traumatic Stress Disorder (PTSD) Symptoms?

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People who have lived through a traumatic event can find themselves experiencing emotional challenges long after the event has taken place. Although it is common for people to experience emotional challenges after trauma, their symptoms can lessen in intensity over time as they continue to heal.

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Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event - either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

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Symptoms

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
Intrusive memories
Symptoms of intrusive memories may include:

Recurrent, unwanted distressing memories of the traumatic event

Reliving the traumatic event as if it were happening again (flashbacks)

Upsetting dreams or nightmares about the traumatic event

Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Avoidance
Symptoms of avoidance may include:

Trying to avoid thinking or talking about the traumatic event

Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world

Hopelessness about the future

Memory problems, including not remembering important aspects of the traumatic event

Difficulty maintaining close relationships

Feeling detached from family and friends

Lack of interest in activities you once enjoyed

Difficulty experiencing positive emotions

Feeling emotionally numb

Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

Being easily startled or frightened

Always being on guard for danger

Self-destructive behavior, such as drinking too much or driving too fast

Trouble sleeping

Trouble concentrating

Irritability, angry outbursts or aggressive behavior

Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:

Re-enacting the traumatic event or aspects of the traumatic event through play

Frightening dreams that may or may not include aspects of the traumatic event

Intensity of symptoms
PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.
When to see a doctor
If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
If you have suicidal thoughts
If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:

Reach out to a close friend or loved one.

Contact a minister, a spiritual leader or someone in your faith community.

Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

Make an appointment with your doctor or a mental health professional.

When to get emergency help
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

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Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

Stressful experiences, including the amount and severity of trauma you've gone through in your life

Inherited mental health risks, such as a family history of anxiety and depression

Inherited features of your personality - often called your temperament

The way your brain regulates the chemicals and hormones your body releases in response to stress

Risk factors

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

Experiencing intense or long-lasting trauma

Having experienced other trauma earlier in life, such as childhood abuse

Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders

Having other mental health problems, such as anxiety or depression

Having problems with substance misuse, such as excess drinking or drug use

Lacking a good support system of family and friends

Having blood relatives with mental health problems, including anxiety or depression

Kinds of traumatic events
The most common events leading to the development of PTSD include:

Combat exposure

Childhood physical abuse

Sexual violence

Physical assault

Being threatened with a weapon

An accident

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Complications

Post-traumatic stress disorder can disrupt your whole life - your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD may also increase your risk of other mental health problems, such as:

Depression and anxiety

Issues with drugs or alcohol use

Eating disorders

Suicidal thoughts and actions

Prevention

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt - all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

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Post-traumatic stress disorder (PTSD) - Symptoms and causes

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Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.

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Temeljna osobina posttraumatskog poremećaja karakteristični su simptomi koji slijede psihološki stresni događaj i nadmašuju uobičajeno ljudsko iskustvo

Laici su prije stručnjaka prihvatili činjenicu da jaka (psiho)trauma može izazvati određene psihičke tegobe koje imaju kvalitetu psihičkog poremećaja. Takav je psihički poremećaj i posttraumatski stresni poremećaj (PTSP) ili sindrom (PTSD), što se javlja u osoba koje su proživjele izuzetan emocionalni ili fizički traumatski doživljaj koji je po karakteru traumatsko zbivanje praktički za svaku normalnu osobu.

Taj je pojam našoj stručnoj javnosti postao blizak tek početkom Domovinskog rata, u jesen 1991. Destruktivnost, okrutnost, neljudskost i mahnitost agresora, kao i napad na sve suštinske vrijednosti ljudske vrste, gotovo ne poznaju presedana u povijesti ratovanja. O tome svjedoče brojna nedjela protiv pojedinaca, njihova života, tjelesnog integriteta, morala, dostojanstva, ali i uništavanje svega onoga što dokazuje ljudsko postojanje, rad i trud. PTSP u takvim se situacijama ne javlja samo u osoba koje su bile izravno pogođene navedenim zbivanjima nego i u onih koji su im svjedočili.

Stresni čimbenik u podlozi zbivanja

Poremećaj se može javiti u bilo kojoj dobi, uključujući i dječju. Prethodna psihopatološka stanja predisponiraju osobu za pojavu PTSP-a, ali se poremećaj može javiti i u psihički zdravih ljudi kada je intenzitet stresa velik. Temeljna je osobina poremećaja nastajanje karakterističnih simptoma koji slijede psihološki stresni događaj i nadmašuju uobičajeno ljudsko iskustvo (npr. ono što se obično javlja u procesu žalovanja, organske bolesti, obiteljskih konflikata, gubitka posla i sl.). Stresni čimbenik treba biti takve prirode da bi ga svaka osoba doživjela kao osobito teškog i obično je praćen strahom, užasom i osjećajem bespomoćnosti. Najčešće je posrijedi izravna prijetnja nečijem životu ili fizičkom integritetu, neposredna prijetnja članovima uže obitelji, iznenadno razaranje nečijeg doma ili zajednice, prisustvovanje teškom ozljeđivanju, smrti ili zlostavljanju druge osobe.

Traumu osoba može doživjeti pojedinačno (prepad, silovanja) ili u skupini (ratno događanje). Stresovi mogu biti prirodnog podrijetla (potresi, poplave), mogu se javiti kao slučajna nesreća (prometna nesreća, veliki požari, rušenje zgrada), a mogu biti i uzrokovani ljudskom rukom (bombardiranje, granatiranje, mučenje, ubijanje). Neki stresovi gotovo uvijek izazivaju PTSP, npr. mučenje, a neki rijetko, primjerice prirodne katastrofe. Poremećaj je gotovo u pravilu znatno teži i dugotrajniji kada je kreiran ljudskom namjerom.

Individualizirano proživljavanje

Traumatsko se iskustvo proživljava na razne načine. Obično osoba doživljava unutarnja prisjećanja događaja i ponavljane, uznemirujuće snove u kojima se obnavlja sadržaj traumatskog događaja. Katkad se mogu pojaviti i tzv. disocijativna stanja koja mogu trajati od nekoliko sekundi do nekoliko dana, tijekom kojih osoba proživljava elemente stresnog događaja i ponaša se kao da se taj događaj upravo zbiva. Simptomi karakteristični za PTSP često se javljaju ili pojačavaju kad je osoba izložena situaciji ili aktivnostima koje nalikuju ili na neki način simboliziraju proživljenu traumu te u njoj izazivaju jaku uznemirenost i nelagodu. To podsjećanje može biti, doduše, samo prigodne, simbolične prirode, npr. godišnjica traumatskog događaja. Uz proživljavanje događaja postoji trajno nastojanje izbjegavanja svih podražaja koji asociraju na događaj, a uz to se javlja smanjena reaktivnost na okolna zbivanja što prije traume nije postojalo. Osoba se često pokušava intenzivno naprezati kako bi izbjegla misli i osjećaje vezane uz traumu te situacije i djelatnosti koje bi je mogle podsjećati na nju. U takvo izbjegavanje elemenata koji podsjećaju na traumu može se uključiti i psihogena amnezija koja se javlja za važne elemente traumatskog doživljaja.

Ubrzo nakon traumatskog događaja razvija se smanjenje odgovora prema stvarnom svijetu, što se opisuje kao psihička otupjelost ili emocionalna anestezija. Osoba se tuži na osjećaj odvojenosti i udaljenosti od drugih, njoj prije bliskih, te da više ne može ni približno uživati u aktivnostima koje su je prethodno radovale. Osobito su pogođene aktivnosti koje uključuju nježnost, senzibilnost, intimnost i seksualnost. Javljaju se smetnje kvalitetna usnivanja i prosnivanja, prekomjerna napregnutost, preosjetljivost, razdražljivost, teškoće u pažnji, koncentraciji i obavljanju posla. Mogu se javiti i agresivne reakcije koje variraju u rasponu od povećane iritabilnosti i straha od mogućega gubitka kontrole nad svojim ponašanjem, pa sve do otvorena i manifestna agresivnog ponašanja.

Djeca takve traumatske doživljaje mogu iskazivati na svoj način, pa katkad postati autistična ili odbijati razgovor o traumi, što ne znači da se takvo stanje ne može promijeniti u općenito neugodne snove u kojima se javljaju razna čudovišta ili opasni događaji koji prijete njima ili drugim ljudima. Takva djeca nemaju osjećaj da ponovno proživljavaju prošlost, a ponovno proživljavanje traume odigrava se u akciji i scenogafiji kroz ponavljanu igru koja u sadržaju ima elemente traumatskog događaja. Javljaju se, kao i u odraslih, smanjenje aktivnosti i odnosa s realnim svijetom realitetom i suženje afekta što djeca obično ne mogu iskazati, pa je to važnije praćenje njihova stanja od roditelja ili nastavnika. Jedan od simptoma PTSP-a u djece može biti i bitna promjena stava prema budućnosti. Djeca mogu izgubiti pozitivan odnos prema onome što ih u budućem životu očekuje, ili se može javiti vjerovanje kako mogu predvidjeti buduće događaje. Mogući su i tjelesni simptomi kao što su bolovi u želucu, glavobolje i sl.

PTSP često prate simptomi depresije i anksioznosti, katkad izraženi do te mjere da se treba postaviti dijagnoza depresivnog i/ili anksioznog poremećaja. Može se javiti impulzivno ili disocijativno ponašanje što se manifestira naglom promjenom mjesta boravka, neobjašnjivim nestankom ili nekom drugom promjenom stila života. Mogu se javiti i smetnje što asociraju na organski mentalni poremećaj kao što su oštećenje memorije, koncentracije i emocionalna labilnost.

Zamršene niti tjelesnih, emocionalnih i spoznajnih percepcija

Simptomi poremećaja javljaju se vrlo brzo nakon traume, ali mogu se javiti i s odgodom od nekoliko mjeseci ili godina, premda se i tada vrlo rano može zapaziti izvjesno izbjegavajuće ponašanje. Simptomi mogu biti relativno blagi i ne moraju znatnije ometati život, ali mogu biti i vrlo izraženi i bitno narušavati mogućnost realna funkcioniranja s brojnim štetnim posljedicama. Mogu se povući nakon kratkog vremena, ali mogu potrajati i godinama.

Što je traumatsko zbivanje bilo jače, što je više povezano s ostalim pratećim traumatskim zbivanjima i što dulje traje, to je vjerojatnost pojavljivanja posttraumatskog stresa veća. U tom slučaju razvija se reakcija satkana od zamršenih niti tjelesnih, emocionalnih i spoznajnih percepcija u konceptu tzv. neispravne prilagodbe, te je posve poremećen prijašnji pojam pojedinca o njegovoj sigurnosti u svijetu i okruženju u kojem živi. Oblikuje se trajna struktura straha. Osoba koja je živjela u uvjerenju sigurnosti i zaštite postaje nesigurna, ima osjećaj kako je stalno izložena opasnosti i boji se novih traumatskih zbivanja.

Kod akutnih slučajeva simptomi se razvijaju u roku šest mjeseci i traju do šest mjeseci. Većina simptoma spontano nestane. Najčešće je riječ o posljedicama relativno blagog stresora. Ako poremećaj traje dulje od šest mjeseci, govori se o kroničnom poremećaju čija je prognoza nepovoljnija i može rezultirati težim, pa i trajnim oštećenjima ličnosti. Socijalno funkcioniranje osobe nije uvijek sukladno izraženosti simptoma.

Traumatski doživljaj u pravilu je izvan žrtvine kontrole. Mogu se pojaviti iskrivljeni mehanizmi svladavanja posljedica i preuzimanja odgovornosti za vlastiti život. Posljedica produbljivanja depresivnih osjećaja može biti suicidalno (samoubojstveno, autodestruktivno) ponašanje i suicid (samoubojstvo), a anksioznost može predstavljati podlogu za razvijanje ovisnosti o alkoholu i drogama, što komplicira tijek bolesti.

Traumatski događaji također mogu poremetiti uobičajen modus fiksiranja za druge ljude. Prvo, događaji poput prirodnih katastrofa narušavaju veze unutar obitelji i širih zajednica. Drugo, neki su stresori toliko bolni da je razumljivo kako se žrtva želi povući od drugih ljudi i tako izbjeći situacije koje podsjećaju na događaj. To osobito dolazi do izražaja nakon nasilja, a posebno kada je počinitelj odgovoran za brigu o žrtvi (npr. incest), gdje osjećaj izdaje može navesti žrtvu da se još više izolira. Sve to pomalo surovo ilustrira koliko su zapravo krhke međuljudske spone. Kada žrtva napokon odluči uspostaviti nove socijalne kontakte, drugi ljudi često se uplaše nasilja shvativši da bi i oni lako mogli postati traumatizirani. Da bi uspostavili osjećaj kontrole, počinju kriviti žrtvu za slučajni traumatski događaj kao da ga je sama izazvala. Tako netraumatizirane osobe stječu iluziju o mogućoj kontroli potencijalnog incidenta, ali ta ih potreba vodi u povlačenje od žrtve, pa se i dalje narušava ostvarivanje međuljudskih veza.

Terapijski postupci primjereni simptomatologiji

Evidentno je da se simptomatologija posttraumatskoga stresnog poremećaja razlikuje u pojedinih osoba, ali se isto tako može razlikovati u iste osobe tijekom vremena. U pojedinom slučaju ili vremenskom intervalu mogu prevladavati simptomi straha, prekomjerne podražljivosti, anksioznosti, prisilna nametanja prisjećanja traumatskih zbivanja, samoozljeđivanja, izbjegavajuće ponašanje, psihotičnost ili depresivnost. U svemu tome vrlo će važnu ulogu imati i okolna zbivanja.

Iz svega navedenoga možemo zaključiti kako se terapijski postupci, da bi bili uspješni, trebaju u najvećoj mogućoj mjeri prilagoditi aktualnoj simptomatologiji. U početku terapijski pristup napose ovisi o tome je li riječ o akutnom ili kroničnom poremećaju. Kod akutnog poremećaja indicirana je primjena tzv. površinskih psihoterapijskih tehnika s ograničenim trajanjem, dok se kod kroničnog poremećaja može planirati dugotrajnije liječenje. Najoptimalniji rezultati postižu se kombiniranim liječenjem u kojem podjednako važnu ulogu imaju i psihoterapija i farmakoterapija, a odnos između tih dviju metoda liječenja proistjecat će iz objektivnih i subjektivnih činjenica. Jedan od osnovnih i najnepovoljnijih problema kod oboljelih jest nevoljko prihvaćanje liječenja, ali i vrlo učestalo već spomenuta superponirana zlouporaba alkohola i droga koja dodatno komplicira tijek bolesti te nepovoljno utječe na liječenje i socijalnu rehabilitaciju.

Mnogim ljudima pomaže već samo pružanje mogućnosti da kroz duge razgovore ponovno prožive traumatska iskustva na emocionalan i racionalno zreliji način. Individualno ili grupno rasterećivanje s osobom u koju imaju povjerenja, a koja će ih dugo i strpljivo slušati, bit će ponekad dovoljna terapija. Najuspješniji će pritom biti oni terapeuti koji i sami imaju iskustva sa zbivanjima koja su izazvala traumu. No, vrlo često to nije dovoljno. Mnogi koji su doživjeli traumatska iskustva i dugotrajno bili izloženi stresorima, prihvatili su takvu strategiju življenja koja im nakon povratka u normalan život onemogućuje prilagodbu na promijenjenu situaciju - tzv. model neizbježivog šoka ili naučene bespomoćnosti. Takvim su osobama potrebni složeniji psihoterapijski postupci uz primjenu psihofarmaka (lijekova).
Ciljevi farmakoterapije načelno su sljedeći: smanjiti strah i anksioznost, smanjiti prekomjernu podražljivost, smanjiti simptome izbjegavanja i prisilnog prisjećanja, smanjiti depresiju i poboljšati raspoloženje te kontrolirati psihotične simptome.

Iako se preporučuje pacijente s manifestnim PTSP-om liječiti izvanhospitalno, postoje situacije kada su nužni hospitalizacija i stacioniran tretman (npr. suicidalnost, agresija). U tom se slučaju inzistira na što bržem otpustu.
Kao dugoročni program pomoći preporučuje se grupna terapija, obiteljska terapija, profesionalno savjetovanje, edukacija s ciljem prevencije uporabe alkohola i ostalih psihoaktivnih tvari te rekreativna terapija. Programi zaštite moraju obuhvatiti medicinsko-psihijatrijske i psihološke rehabilitacijske aspekte, s konačnim ciljem koji obuhvaća uspješno i što optimalnije uklapanje pojedinca u obiteljsku, socijalnu i radnu sredinu.
Koliko će trajati terapija, može se samo načelno procijeniti na temelju aktualne kliničke slike, tj. stupnja povlačenja simptoma, nuspojava i podnošenja lijeka, stabilnosti životne situacije, podrške obitelji i socijalne sredine, mogućnosti javljanja novog stresa, vitalne snage i tzv. psihičkog imuniteta bolesnika, kao i njegove suradnje.

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Temeljna osobina posttraumatskog poremećaja karakteristični su simptomi koji slijede psihološki stresni događaj i nadmašuju uobičajeno ljudsko iskustvo Laici su prije stručnjaka prihvatili činjenicu da jaka (psiho)trauma može izazvati određene psihičke tegobe koje imaju kvalitetu psihičkog poremećaja.

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From eccentric and introverted to boisterous and bold, the human personality is a curious, multifaceted thing. We each have a unique mix of characteristics, and value different traits in ourselves and others.

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Obiteljsko stablo