Post-Traumatic Stress Disorder(PTSD)
POST-TRAUMATIC STRESS DISORDER (PTSD) is a disabling psychiatric disorder that survivors of disorders may suffer. It can manifest itself even several years after the disaster. It is estimated 50 to 80 per cent of the survivors of a major disaster suffer from this disorder.
One of the main features of PTSD is re-experiencing the past trauma in nightmares or as flashbacks. The patient may feel guilt, humiliation, rejection, or face acute anxiety or panic attacks, disturbed sleep and lack of concentration.
Another feature is emotional numbness where they develop a feeling of detachment and estrangement from others.
A third feature is autonomic reactivity, which results in angry outbursts, difficulty in sleeping and hyper excitability.
The main cause for onset of PTSD is, of course, the disaster. Another factor is the personality of the patient. A third factor is the availability of social support. With the backing of family, social agencies and religious groups, the onset of PTSD can be prevented or the symptoms minimised.
The most important aspect of management is prevention. Active counselling and social support during the immediate post-disaster period is essential. Once PTSD is diagnosed, it needs active treatment by a specialist.
The main line of treatment is psychotherapy. First, a therapeutic relationship is made and a rapport is established. The patient is encouraged to freely talk about his trauma, which will facilitate emotional ventilation.
Psychotherapeutic procedures such as breathing exercises and desensitisation are useful. Counselling for a group of patients is also effective. Family support and help from social agencies also facilitates treatment. Hospitalisation may become necessary if the patient becomes worse and if there is risk of violence or suicidal tendencies.
Dr. ABRAHAM VERGHESE
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