Overview of PSTD

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.

Post-traumatic stress disorder used to be called “shell shock” during World War I. Symptoms of PTSD can include:

Flashbacks. While you’re experiencing them, flashbacks feel very real. They may make you feel like you’re back in the original traumatic situation. Flashbacks can last from a few seconds to several minutes and may occur while you’re asleep or awake.

Nightmares. Nightmares are dreams that cause feelings of terror, fear or horror when you wake up from them. You may also experience other symptoms, such as sweating and shaking, after a nightmare about the traumatic event occurs.

Intense distress after exposure to reminders of the event — such as people or places — or otherwise reliving what happened in your mind (known as “reliving”). This usually happens when someone who has experienced trauma is exposed to details that trigger memories of their experience.

Symptoms and Diagnosis

The symptoms of PSTD vary depending on the type of PSTD. However, there are some symptoms that will be similar for all types of PSTD. The most common symptoms include:

• Sore throat
• Fatigue (tiredness)
• Swollen glands (lymph nodes) in the neck, armpits or groin
• Pain when swallowing (dysphagia)
• Hoarseness or change in voice quality
• Painful or swollen joints (arthralgia)
• Headaches and muscle aches
• Weight loss and low energy level

The main symptoms of PSTD are an increase in the frequency of bowel movements, diarrhea, cramps and pain. If you experience these symptoms, or if you want to know more about them, see your doctor as soon as possible.

A physical exam and a medical history can help your doctor determine if you have PSTD. Tests may include a blood test to measure the level of antibodies in your body, a stool test to look for parasites and an endoscopy (where a tube is put down the throat into the stomach) to check for damage to the lining of your stomach or intestines.

If you have PVD and have been diagnosed with celiac disease, it’s important that you get tested for celiac disease every year — even if you’re following a gluten-free diet.

Related Conditions

Acute Stress Disorder

Acute stress disorder is a temporary mental health condition that happens when you are exposed to a traumatic event.

It’s normal to feel upset, scared or angry after a traumatic event. But if your symptoms last longer than four weeks, you may have acute stress disorder.

Acute stress disorder can affect anyone, regardless of age or gender. However, it’s more common in teens and young adults than older adults. It’s also more likely to occur in people who have been through a prior trauma.

People who experience acute stress disorder may have:

• Intrusive thoughts about the traumatic event (flashbacks)
• Nightmares about the traumatic event
• Avoidance of reminders of the traumatic event
• Heightened anxiety

The symptoms of acute stress disorder include:

• Intense anxiety and emotional shock after the traumatic event, which may come and go suddenly. You may be startled by any loud noise or sudden movement.
• Disturbed sleep (insomnia or nightmares).
• Intense feelings of sadness, guilt, or worry about what happened.
• A feeling of being detached from others and your surroundings.
• Physical symptoms such as headaches, stomach pain, and muscle tension.

Symptoms usually start within 3 weeks of the traumatic event but sometimes occur right after it happens. They usually disappear within 2 months without treatment. If they continue longer than 2 months, you may have PTSD instead of ASD

Adjustment Disorder

Adjustment disorder is a mental health condition in which you have difficulty adjusting to a major life event or stressor, such as a death of a loved one, divorce or job loss. You may be unable to function normally because of the symptoms that result from this stress.

Adjustment disorder usually develops within three months after the stress begins and lasts no more than six months. If your symptoms last longer than six months, you may have a different mental health condition called post-traumatic stress disorder (PTSD). People with adjustment disorder may experience:

• Difficulty sleeping
• Irritability
• Feeling depressed or hopeless
• Loss of interest in activities you normally enjoy

Disinhibited Social Engagement Disorder

Disinhibited Social Engagement Disorder is a relatively new diagnosis added to the DSM-5. It was previously known as disruptive mood dysregulation disorder, and is characterized by a lack of social inhibition and emotional lability, leading to inappropriate social behavior that makes it difficult for the person with the condition to sustain relationships.

Disinhibited Social Engagement Disorder is often misdiagnosed as attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). These other disorders share some symptoms with Disinhibited Social Engagement Disorder, such as poor eye contact and poor language skills. The main difference between these conditions and Disinhibited Social Engagement Disorder is that people with Disinhibited Social Engagement Disorder tend not to have a history of ADHD or ASD in their family history.

People with Disinhibited Social Engagement Disorder are also less likely than those with ADHD or ASD to be able to focus on tasks requiring attention or concentration, although they may show moments of intense focus when engaged in an activity that interests them.

Reactive Attachment Disorder

Reactive Attachment Disorder (RAD) is an uncommon condition that begins in infancy. It is characterized by a lack of attachment to caregivers, and a failure to develop healthy relationships with other people.

Children with RAD may have difficulty relating to others. They may be withdrawn, fearful, or aggressive. They may also exhibit problem behaviors such as self-injury or aggression toward others.

RAD is thought to occur in 1% to 2% of children and adolescents. It’s diagnosed more often in boys than girls, and it’s more common among children who have experienced trauma or abuse during their early years.

The signs and symptoms of reactive attachment disorder usually develop during the first three years of life, but they can begin anytime before age 5. Most children outgrow RAD by age 10, although some continue to experience problems into adolescence and adulthood.

Treatment

PSTD Treatment is provided in various ways, including:

Psychotherapy – The goal of psychotherapy is to help you understand yourself and the reasons for your symptoms. By understanding your problem, you can learn to cope with it more effectively. Psychotherapy may include individual counseling, family therapy or group counseling. It may also include behavioral therapy, which teaches you new ways to respond to situations that cause emotional distress.

Medications – Medications are often used to treat depression, anxiety and other symptoms of post-traumatic stress disorder (PTSD). Some of these medications include antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medications affect chemicals in the brain that may be unbalanced in people with PTSD. Other medications are often prescribed along with psychotherapy for PTSD.

Medications

PSTD medications are taken to help you relax and to help you sleep. They may also be called anxiolytics or sedatives, or they may be a combination of these two types of medications.

The most common PSTD medications include:

Benzodiazepines, like diazepam (Valium) and lorazepam (Ativan). Benzodiazepines work by slowing down brain activity. They are usually prescribed for short-term use only because they can become habit-forming.

Antidepressants, like amitriptyline and imipramine. Antidepressants help to restore balance in the brain chemistry that causes depression and anxiety disorders. The antidepressants that are most often used for this purpose are called tricyclic antidepressants (TCAs). These drugs can take up to six weeks before they begin working well. It is important not to stop taking your antidepressant suddenly without consulting your doctor first because doing so could cause withdrawal symptoms such as dizziness, nausea, vomiting, irritability, restlessness or insomnia.