All You Need To Know About PTSD And How To Deal With It

WHAT IS POST TRAUMATIC STRESS DISORDER (PTSD)?

All humans are endowed with a biological and psychological stress response system. Our genetic “Fight or Flight” response is designed for crisis management. This life-saving response causes the body to release stress hormones to fight or get out of harm’s way (flight). It also automatically pumps the heart faster, directing blood, as a resource, to muscles and other areas,  Many are able to move on with life after traumatic events, but for some this response lingers and the body is unable to return to normal state. IT IS NOT A SIGN OF WEAKNESS.

 IS PTSD SYNONYMOUS WITH ANXIETY?

Yes, PTSD is classified as an anxiety disorder. Anxiety is classically defined as a sense of worry, fear, uneasiness, apprehension or nervousness. PTSD has specific symptoms.

 ALTHOUGH COMMONLY LINKED WITH THOSE SERVING IN THE MILITARY, WHAT ARE SOME OTHER TYPES OF TRAUMA WHICH COMMONLY CAUSE PTSD?

This condition is not limited to combat veterans. It can occur in anyone who has been exposed to a traumatic threat or upsetting event(s). It can occur at any age. Examples include: military combat, domestic violence, sexual assault/abuse, abandonment, death of a loved one, natural disasters, community violence, poverty or medical issues.

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 WHAT CLASSIFIES SOMETHING AS A “TRAUMA”? CAN YOU EXPERIENCE A TRAUMA INDIRECTLY AND STILL BE AFFECTED?

Trauma refers to any event that threatens the life, integrity or sense of safety of an individual or loved one. Exposure to trauma creates stress which can cause emotional, mental or physical symptoms. The stress may be immediate, short-lived or chronic.

While we do not fully understand who will develop this disorder, but there are certain risk factors which make an individual more likely to have struggles: exposure to prior trauma, poor social supports and lack of resilience. It can be direct or indirect.  Indirect trauma can be experienced by those who deal with or work with trauma victims.

HOW IS A TYPICAL REACTION TO TRAUMA DIFFERENT FROM PTSD?

Not all people exposed to traumatic events will develop this disorder. The range of responses is varied.  Most will have no residual problems. It is common to have nightmares/flashbacks for the first few weeks after exposure. While most people will recall the fear experienced during the trauma, PTSD can actually make the person feel as they are experiencing or re-living the event. 50-70% of all people will experience at least one traumatic experience in their lifetime (American Psychiatric Association) of those about 20% will develop the disorder.

PTSD becomes an emotional and mental disorder when, after exposure to a traumatic event, the individual begins to experience difficulties with the management of daily activities. For examples: struggles with work performance, and relationship problems.

WHAT ARE THE SYMPTOMS OF PTSD?

RE-EXPERIENCING:

• These are often thoughts, mental images or memories which are involuntary, and not under the control of the individual.
• They may present as unpleasant, frightening thoughts
• These experiences are often a great source of stress for the person.
• These intrusions can present as nightmares or flashbacks.

AVOIDANCE:

• There may be a tendency to stay away from places, persons or situations which may serve as a reminder of the traumatic event.
• Avoidance of thoughts related to the traumatic event.

THOUGHTS AND EMOTIONS:

• Trouble recalling details of the event
• Negative thoughts.
• The person may experience a host of emotions: guilt, numbness, depressed/sad/ irritable mood, concentration problems.
• Loss of interest
• The person may be predisposed to experience life as an out-of-body experience, called derealization; where the person describes living life in a dream-like unreal state. Another explanation is that they may experience life as if they were observing from above.

AROUSAL SYMPTOMS:

• Hypervigilance – an enhanced state of stimulation to sensory input (sight, sound, taste, smell and touch)
• Easily startled
• Angry outbursts or irritability
• Sleep problems

 WHAT IMPACT DOES LONG-TERM TRAUMA HAVE ON THE BODY AND BRAIN?

Everyone responds differently:

The Brain:

• Persistent fearful, hyper-aroused states can wear down the brains neuron pathways, leading to chemical imbalances and other conditions such as depression.
• Certain areas of the brain show heightened activity in trauma survivors.
• Trauma can lead to problems with brain development in children.
• May leave an individual to experience harmless situations as scary or threatening
• Brain changes may not be permanent and may improve over time with psychotherapy and supportive/stable environment.

The Body:

• More likely to suffer stroke
• Greater risk of heart disease
• Greater risk of dying from heart attack
• More likely to suffer from chronic Fatigue Syndrome, Irritable bowel syndrome and Fibromyalgia
• Increase risk of adult cancer

 HOW COMMON IS PTSD? DOES IT AFFECT MEN OR WOMEN MORE?

Very common in adults over 18. Common in teens and children. Rare under the age of 5.

• It is not limited to military veterans
• In the U.S., about 8 million people experience PTSD (Veterans’s Administration)
• 7 out of every 100 people will have PTSD in their lifetime.
• 10 of every 100 women and 4 or every 100 men.
• It can occur in victims, as well as those who witness a traumatic event
• Studies show that adverse childhood experiences are not only common, but that most adults have experienced two or more traumatic events during childhood.

 WHAT SHOULD YOU DO AFTER EXPERIENCING A TRAUMA?

Turn to natural supports, such as family and friends to process and talk about what happened

• Consult with clergy
• Join a support group – often being around people who have similar experiences is grounding and normalizes the person’s emotions
• Healthy and positive coping strategies: meditation, yoga
• Distractions: arts/cultural experiences, music, exercise
• Practice mindfulness: grounding experiences to guide the person’s thoughts back to the present moment – uses the body’s senses such as touching a fabric, breathing deeply, sniffing a strong scent
• AVOID: drugs and alcohol to cope with overwhelming feelings

 HOW DO YOU PROVIDE HELP FOR OTHERS?

Provide a calm, safe environment:

• Minimize fighting or raised voices
• Give support and reassurance: remind the person that they are safe now
• Create a safety plan if the trauma is related to domestic violence
• Provide support and assistance when facing non-dangerous situations to help them learn how to approach it
• Encourage use of healthy coping skills: deep breathing and relaxation, distraction (such as music)

 HOW DO YOU KNOW WHEN TO SEEK TREATMENT?

Symptoms of this disorder typically begin within three months after exposure to the traumatic event. On occasion, the symptoms may not begin until years later.  

• If symptoms and emotions have not returned to normal after one month
• If coping skills and distractions have not reduced the symptoms or emotions after one month
• Discuss with primary care physician and seek mental health referral when needed

WHAT ARE THE TREATMENT OPTIONS?

 Treatment Options

• Cognitive-Behavioral Therapy (CBT) – helps the person recognize negative or damaging thoughts and teaches how to replace them with positive and helpful ones.
• Eye Movement Desensitization and Reprocessing (EMDR)– newer treatment which focuses on exposure to the traumatic event by different stimuli, such as eye movement.
• Exposure Therapy – Helps the person to safely face fears related to the trauma and teaches ways to cope.
• Imagery Rehearsal Therapy (IRT) – newer treatment to reduce intensity and frequency of nightmares.
• Help Yourself: find educational programs

  IS PTSD CURABLE?

PTSD is certainly treatable.  For many it can be cured. For others symptoms can reappear intermittently throughout life, but may not present with the same intensity or frequency.

 IS THERE A SUPPORT GROUP FOR FAMILY MEMBERS WHO ARE DEALING WITH PTSD?

Contact various organizations for internet assistance and referrals:

American Psychiatric Association – www.psychiatry.org/

American Psychological Association – www.apa.org/

Black Psychiatrist of America – www.bpaincpsych.org/

National Alliance on Mental Illness – www.nami.org

Veteran’s Administration National Center for PTSD – www.ptsd.va.gov/

It’s important to recognize that caregivers can become traumatized and my need assistance as well

 ARE THERE PROGRAMS AVAILABLE TO HELP CAREGIVERS WITH EXPENSES?

Caregiver support networks:  VA 855-260-3274

The National Alliance on Mental Illness (NAMI): 800-273-8255

WHAT QUESTIONS AND TESTS SHOULD A PERSON ASK THEIR DOCTOR IF THEY BELIEVE THEY’RE SUFFERING FROM PTSD?

• What are the symptoms of PTSD?
• Who can get PTSD?
• Is PTSD treatable? Can is go away on its own?
• How will I know if I am better?
• I think I may have PTSD. What should I do?
• Will my health insurance cover the cost of treatment?
• Are there organizations which provide assistance?

IS PTSD OFTEN MISDIAGNOSED?

A: Yes. It can be misdiagnosed for:

• • Mood disorder, such as depression
  • Personality disorders
  • Malingering (faking for secondary gain)

Dr. Dodd is a board-certified psychiatrist who specializes in forensic psychiatry, trauma informed treatment and women’s issues.She is the Chairperson of the state’s forensic board which provides oversight and management of patients found Not Guilty by Reason of Insanity. She also provides expert witness testimony for the state’s legal system. In addition, Dr. Dodd practices general psychiatry as the Medical Director of Huron Valley Consultation Center and lectures doctors in training about various topics in general and forensic psychiatry.

Dr. Dodd attended is a graduate of Howard University. She received her medical degree from the University of Michigan Medical School and was a Gaughn fellow in forensic psychiatry at Harvard University.

Dr. Dodd answers your “Text Tom” questions on the next page.

 Good morning. I believe my best friend is experiencing PTSD. He’s 29 years old and is not himself anymore. He gets admitted to a mental hospital, comes out and is fine but in 2 weeks he’s back to flipping out. I’m so scared he is going to try to kill himself what should I do?

Greetings, I can appreciate your concern for your friend.  Safety issues first.  If not already done, you might consider speaking to your friend about passive thoughts of death/dying or even thoughts of self-harm.  If at all possible, seek to enter a verbal agreement with him that he will contact you or someone else if he cannot ensure his own safety. A safety plan may also help.

 In regards to your concern about PTSD, it is certainly within the realm of possibilities that his multiple hospitalizations could related to unresolved trauma and undiagnosed PTSD.  The question is does he follow up with out-patient recommendations once released from inpatient treatment?  If so, encourage him to open up and be honest with his therapist.

This will require that he is first honest with himself. That can be difficult, as for some individuals.  If trauma is at issue, it may be too painful to discuss.  He could benefit from journaling or writing  his feelings down.  He may then decide to share them with a trusted therapist.  Please advise him not to give up and to educate himself.  Please consider contacting one of the many resources listed in this article.

Tom I deal with PTSD after being raped at a young age and acar accident. Because of this, I go through depression and anxiety. What is the real bad part is that I have a child from the rape and I see him every day and try to deal with it but it is very hard.

Thoughts of support go out to you. You have gone through a horrific experience. Please know that YOU DID NOT DESERVE it.  It is not your fault. I would suppose that your love for your child can also serve as a reminder of this heinous act.  My suggestion is to not go it alone!!! Your depression and anxiety are signs that you may need help.

Please find a trusted therapist and do not give up on your search until you find a match.  Please use this article for treatment resources. It is treatable! One method is based on the premise that your thoughts will influence your behavior.  It focuses on negative or unhelpful thoughts that cause depression and anxiety and teaches ways to replacement them with more positive and helpful thoughts. Remember, you are the role model for your child. Get the help that you need so that he/she can model a loving/positive parent.

I’m still suffering from PTSD after making the decision to remove my mother off life-support, 26 years ago.

Wow. What a difficult decision that must have been.  Firstly, let me normalize your feelings. Your response is totally understandable. It took courage to come to that conclusion.  If it still feels raw and real 26 years later, you may need to tap into that same courage to deal with the residual feelings. It’s a quality of life issue.  If you are not living your best life, you may want to consider getting into therapy. Don’t be afraid of it. Many participate and are helped. Please reach out to family, primary care physicians and refer to help resources in this article.

I’ve been seeing someone for depression. I have always thought I suffered from PTSD. I held my best friend while he died. I grew up in constant defense mode, always fighting. I’ve been shot at. A knife was put to my throat by my mother’s boyfriend when I was 17. He’s pulled a gun on me as well. I have isolated myself from people I grew up with. It just reminds me of a horrible past. I was adopted and grew up in a not-so-friendly neighborhood. I experience pretty much all of the symptoms the doctor mentioned.

So you know first-hand that trauma is real ! Like many people, it sounds like you’ve experienced multiple traumas throughout your life. You are not alone. What will be important is to focus your thoughts on being a SURVIVOR! After you dealt with the past trauma, it will be important to put it behind you and focus on grounding in the present moment, where I hope you can feel a sense of safety and security in knowing that those perpetrators can no longer bring harm to you. Stick with it… don’t give up on therapy. Also consider seeing a psychiatrist to determine if medications may also be a part of the solution.

I suffer from PTSD from 3 police brutality incidents and a head-on car accident. I can’t watch car accidents or police brutality incidents on social media or in real time. I can’t sleep after watching or riding in a car. I panic at cars that get too close. I tried to watch the Central Park Five. Can’t watch. While I was in a jail cell, the police thought I was dead. I thought I saw someone that was not there in the cell. I suffer anxiety and fear even while driving with Lyft. The flashbacks are terrible.

My sympathies for your injuries. I hope you have taken the opportunity to make sure that you did not suffer from a traumatic brain injury due to the car accident. This is relevant, because it could leave you with residual cognitive (thinking), behavioral and emotional challenges.  This could make dealing with the trauma more difficult.

This scenario of police brutality is playing too many times in our communities. It leaves the victim traumatized with feeling a sense of insecurity in the world. You can improve the quality of your life by seeking assistance.  Please refer to the references listed in this article. There are online resources, apps that you can download to help and other agencies who can provide guidance. Consider ways to help yourself with meditation, deep breathing, and staying present in the moment (mindfulness).The point is, get help!

Good morning, Ask the Dr. about PTSD in regards to police and corrections officers, I’ve heard they suffer with it in high numbers.

Thanks so much for bringing attention to this issue, as we did not have time to address it during the morning show interview.  Yes, you are correct. The prevalence of PTSD is very high in law enforcement, fire fighters, corrections officers and all first responders. In addition, with implicit racial bias, one of the problems, as I see it, is the lack of general awareness on wellbeing in law enforcement.

I have found that they are a closed group who rely on each other for support. If there is no attention given to the emotional wellness of our officers, you get disturbed and short-tempered people who become limited in their commitment to protect and serve. Congress is addressing the issue of changing benefits and coverage for those who are identified as having PTSD. The problems is that so many of them have experienced trauma and have no awareness of the emotional toll it can have. I am of the belief that there need to be more emphasis on professionally trained peer mental health support to assist our first responders.

I can’t go anywhere without being able to see the exit. I jump in my sleep. I saw my uncle killed and countless other tragic events growing up in New Orleans. I believe I have PTSD – what do you think?

Yes, it sounds like it. Your point is well taken, you don’t need to be a victim; you can suffer from PTSD if you witness a tragedy as well. Your symptoms are classic: heightened sense of arousal, sleep problems and avoidance behaviors. If available, please reach out to your support network, such as family and friends to help process this unfortunate accident.

If that is not an option, seek assistance by a trained therapist.  It is not a sign of weakness to see a therapist who can assist in helping you to move forward with a healthy mindset and peach of mind. Please refer to the multiple references above for help. 

My 16-year-old daughter was diagnosed with PTSD after witnessing her aunt shot 3 times and her grandmother being killed in the same domestic violence incident. She was 7 at the time.

Unfortunately, PTSD is common in children and teenagers. I assume that she received treatment, as it appears that someone provided the diagnosis. You did not mention if she is still struggling with symptoms.  If so, it is also common that people can struggle for years. If not still in treatment, consider do so, as we have more treatment options than when she was first diagnosed 9 years ago. Continue to provide love and support.

After I came home from Iraq, I didn’t know I had PTSD until I divorced and my family members and friends started to avoid me. I just take it one day at a time. It is absolutely a stigma in the Black community.

What better person to deal with mental health stigma than someone who has experienced it! Welcome to my world as a mental health professional. Stigma is as real as PTSD. It keeps people from seeking needed treatment, but you may be surprised by who is or has been in treatment with a therapist. Your response of isolating yourself is classic. And it’s unfortunate that your relationships did not survive. I heard one military veteran explain, “It makes you lose your humanity.”

It’s important that we start to educate ourselves on the topic of mental wellbeing.  The stigma related to mental illness in the Black community is significant. We are improving, but there is much work to do.  I typically educate my patients that symptoms do not equal weakness. I also believe that if you have a brain, it can happen to you! Carry that message! Taking it one day at a time is CRITICAL! You’ve mastered that concept. 

GM Fam, I served in the Marines & my wife in the Army. We both suffer with PTSD so crazy knows crazy but we always balance each other out.

I am glad that you have each other.  The outcome for full recovery is better for those who have a solid and loving support system. I encourage you to continue to provide support for each other and will use YOUR word; while “crazy knows crazy,” at least you two are not NUTS! As you can see, humor is a useful coping tool.

What about the images that we as Black people see on a daily basis of being killed by the police, having the police called on us for living our day-to-day lives, having anxiety about walking down the street in your own neighborhood and feeling unsafe around white people?

You tap into a significant area, that we did not have time to discuss during the morning show interview.  The issue of racial trauma is also real. I and so many others, live with it on a daily basis. We need to speak about it more.

 Make a choice to live in the light, with positivity and love. It is always there even in the darkest and most difficult times!!!      Doc Shane

PHOTO: Dr. Dodd Courtesy

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