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Physical Health and Post Traumatic Stress Disorder
The presence of trauma in post traumatic stress disorder overly stimulates the activity of the sympathetic nervous system (Shalev, 2000), resulting in abnormal levels of the neurotransmitters norepinephrine, epinephrine, and dopamine (Yehuda & others, 1992), not only in the brain, but also within the body, as evidenced by the presence of noradrenaline in urine samples of people with PTSD (Davidson & Baum, 1986). Over activation of the sympathetic nervous system in post traumatic stress disorder is also related to increased heart rate and high blood pressure. Thus, people with post traumatic stress disorder are at risk of several heart problems, including heart attack and heart failure. Furthermore, these measures are also easily induced. In one study, combat veterans with PTSD were played war tapes, and they reported increased subjective distress, and showed higher heart rate, blood pressure, and epinephrine levels (McFall, Murburg, Ko & others, 1990). [See also: How Does Stress Affect Health?]
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Mental Health and Post Traumatic Stress Disorder
Patients with post traumatic stress disorder exhibit a pattern of psychological deterioration, especially those who received severe physical and mental abuse (Siegel, 1984). First, they attempt to fight the stressor, but the defensive reactions are mostly weak, inappropriate, and may even be exaggerated. Then, they become desperate. Coupled with altered brain metabolism, they may experience hallucinations and delusions. If the stressor persists, they may become violent, and then become apathetic, that is, a feeling of desensitization over the stressor.
Nightmares are also profoundly affected in PTSD. Post traumatic stress disorder caused by traumatic events that are related to physical harm, such as natural disasters, accidents and violence tend to result in nightmares revolving around the theme of the trauma. For example, college students who experienced the 1989 Loma Prieta earthquake in San Francisco significantly had more nightmares (and these nightmares are often about earthquakes) than did a control sample (Wood & others, 1992). Martin (not his real name), who survived a jet crash, also reported dreams closely related to the accident (Perlberg, 1979).
PTSD can also precipitate the development of other disorders, such as clinical depression and substance abuse (Brown, Stout & Mueller, 1999). Around 16 percent of people with PTSD have a comorbid disorder, and around 54 percent have three or more other comorbid disorders (Kessler & others, 1995). This is because the trauma in PTSD can serve as a predisposition to further stress (Mazure, 1998; Metalsky & others, 1982). Indeed, people with PTSD are characteristically irritable and short-tempered (Marks, Yule & De Silva, 1999). This low tolerance for stress can precipitate alcohol abuse in people with PTSD (Rutledge & Sher, 2001).
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The Trauma in PTSD
Other health effects of post traumatic stress disorder are specific to the type of trauma experienced. Common traumatic events that precipitate PTSD are death of a loved one, rape, and war and military combat.
Post traumatic stress disorder resulting from the sudden and unexpected death of a loved one (Kim & Jacobs, 1995) is often associated with negative health effects, such as eating problems (loss of or increased appetite) and suicidal thoughts (Prigerson, Bierhals, Kasl, Reynolds & others, 1997). The fact that the stressor is irreversible, that is, one cannot bring back the dead, could mean that the only way to cope is to let the time pass away. For some people, time is enough to heal, as with cases of unipolar depression resulting from PTSD (Monroe & Hadjiyannakis, 2002) that lasts for at least a year; but for some, depression can last for even 5 years (Boland & Keller, 2002).
Post traumatic stress disorder in rape victims, particularly women, showed marked deficits across a range of functioning (McCann & others, 1988). Rape victims are often physically disturbed, and report feeling anxious for most of the day. They also tend to be emotionally unstable, are often depressed, and tend to exhibit low self-esteem. Their cognitive ability is also diminished; most report an inability to concentrate due to intrusive thoughts stemming from the attack. They are also more likely to view themselves and others negatively, or more aptly, helplessly, thinking that anyone is susceptible to rape. Antisocial behaviors, such as shows of aggression and hostility, and substance abuse, are also common. Lastly, rape victims are also prone to having relationship problems, especially concerning sex and power distribution.
Combat-related post traumatic stress disorder varies according to the level (or type) of exposure in war. Civilians living in war zones can also develop PTSD, and the most common symptom associated with it is anxiety (Zeidner, 1993; Schwarzwald & others, 1993; Weizman & others, 1994). Post traumatic symptoms associated with exposure to combat violence include intrusive thoughts, anxiety, apathy, and cognitive problems, such as concentration and memory difficulties; and these symptoms, including depression, are present in those who were not only exposed to violence, but also participated in it (Laufer, Brett & Gallops, 1985). Soldiers who handled corpses, on the other hand, tend be more angry, anxious, and complain of physical problems (McCarroll, Ursano & Fullerton, 1995). Prisoners of war are at higher risk for developing severe post traumatic stress symptoms. Besides the symptoms associated with war, POWs typically sustain severe damage in both physical and psychological functioning, including headaches (mostly due to head injuries), sexual impotency (as a result of contracting infectious diseases, diarrhea (mostly caused by malnutrition), suppressed immunity, and severe adjustment problems, such as low tolerance to stress, substance abuse, and inability to control anger (Barrett, Resnik, Foy & Dansky, 1996; Chambers, 1952; Goldsmith & Cretekos, 1969; Hunter, 1978; Sigal & others, 1973; Strange & Brown, 1970; Warnes, 1973; Wilbur, 1973). POWs are also nine times more likely to die from tuberculosis, four times more likely to die from gastrointestinal problems, and two times more likely to die from cancer, heart disease, and suicide, in the first six years after release, compared to typical civilians (Wolff, 1960).
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There are several treatment methods for PTSD (or stress in general) that are currently available. In short-term crisis therapy, the potential PTSD client is given emotional support and encouraged to talk about the experiences during the crisis. The therapy is brief and focuses only on the crisis as the stressor. Research shows that short-term crisis therapy can open the gates for easier stress adjustment (Butcher & Hatcher, 1988).
Post disaster debriefing sessions are usually for delayed PTSD clients. The results of these sessions are still immeasurable and controversial because most are supervised or facilitated with people who do not have sufficient mental health background, although some reported that the sessions were helpful.
Direct-exposure therapy is beneficial for people with established PTSD. In this process, the client is forced to face the object of fear, a stimulus associated with the traumatic incident (McIvor & Turner, 1995). Telephone hotlines serve as a means to an end. They aim to convince the caller to seek professional help. The good thing about telephone hotlines is that they provide the anonymity that people with PTSD need, as they tend not to seek any sort of treatment for their problem (Weisaeth, 2001). Lastly, antidepressants may be prescribed to relieve such symptoms of PTSD as depression, intrusive thoughts and nightmares, and social avoidance (Marshall & Klein, 1995; Shaley, Bonne & Eth, 1996).
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