Discussion: NURS 6640 Posttraumatic Disorder

Discussion: NURS 6640 Posttraumatic Disorder

Discussion: NURS 6640 Posttraumatic Disorder

NURS6640 Psychotherapy With Individuals

Week 5 Discussion

Posttraumatic
Stress Disorder

It is
estimated that more than 6% of the U.S. population will experience
posttraumatic stress disorder (PTSD) in their lifetime (National Center for
PTSD, 2010). This debilitating disorder often interferes with an individual’s
ability to function in daily life. Common symptoms of anxiousness and
depression frequently lead to substance abuse issues and even physical
ailments. For this Discussion, as you examine the Thompson Family Case Study in
this week’s Learning Resources, consider how you might assess and treat clients
presenting with PTSD.

PTSD can be a tricky illness to identify because not only can some of the symptoms be attributed to other illnesses, but it is also an illness that largely plays out in your brain and mind. Depending on the severity of the disorder and the trauma experienced, people may also have physical reactions. For instance, if someone was in a plane accident, they may break out in a sweat or have a panic attack when faced with the idea of flying somewhere or getting into a plane again.

But once you decide to see a doctor, they will have a detailed conversation with you and will begin by ruling out other possible causes for the symptoms experienced by you. Through a series of physical and medical evaluations, things like addiction, tumors, other illnesses, etc. will be excluded before they start to look at PTSD.

According to DSM 5, Post Traumatic Stress Disorder diagnosis is rendered when at least one or more symptoms from each of the criteria below are met.

Stressor
What caused the trauma? This criterion looks at how and in what way the individual was exposed to the traumatic event. Were they:

Directly involved? The victim?
Did they witness the traumatic event?
Did the trauma happen to a family or a loved one?
Were they indirectly exposed as a result of external factors such as their job? For example, police officers, doctors, veterans, etc.

Discussion: NURS 6640 Posttraumatic Disorder
Intrusion
When the individual experiences or re-lives the trauma repeatedly as a result of or through:

Nightmares and flashbacks;
Intrusive memories they can’t shake off;
Experiencing emotional and physical distress when they encounter something that reminds them of the trauma. Sometimes anniversaries of the traumatic event can also act as triggers.
Only one symptom is required in this criteria; for example, it is possible to have nightmares but no flashbacks and vice versa. Or have neither but have panic attacks when confronted with a reminder of the trauma.

Avoidance
When the individual avoids anything related to the trauma they endured. The avoidance can be emotional (refusing to think about it or blocking out the event), or they can be people, places, or things, which bring to mind what they went through. Avoidance to a degree is expected, but when it starts to get in the way of the individual living their life or is the only way they can get through their day, it’s a problem.

Cognition And Mood Symptoms
Thoughts, emotions, and feelings, which got worse or only started after the traumatic event occurred, such as:

Lack of interest in social or daily activities;
Increased sense of isolation;
Becoming detached from others;
Feeling negative and down about themselves and everything else around them;
Having a hard time thinking of positive things or feeling positive in general;
Difficulty remembering key details surrounding the traumatic event;
Blaming your self or others for the traumatic event.
At least two of the symptoms discussed above to be met in these criteria.

Reactivity And Arousal Symptoms:
Reaction related to the trauma, which got worse or only started after the traumatic event occurred. At least one of the following symptoms have to be present:

Demonstrating aggressive or irritable behavior;
Has problems with sleeping;
Has problems with concentration and focusing;
Engaging in unusual and destructive behavior that is risky or dangerous;
Increased vigilance and constantly feeling a sense of danger or feeling like someone might attack and hurt them;
Prone to being easily startled or shaken up.
Impairment:
The symptoms experienced by the individual is causing them distress and getting in the way of their ability to function properly or get through their day as they would normally have.

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Duration

All of the symptoms mentioned above will need to have persisted for at least a month or more to meet the criteria of PTSD.

Once symptoms from each criterion have been met, the doctor will provide a diagnosis and look at what treatment options best suit your needs.

Post Traumatic Stress Disorder treatment is focused largely around psychotherapy. Depending on the situation, medication can also be prescribed to help the patient through a rough patch or to enhance the effectiveness of talk therapy.

When starting talk therapy, the mental health professional has three specific goals:

Decrease or get rid of your PTSD symptoms;
Provide you with the right tools to manage your symptoms;
Bring back your confidence and self-esteem;
The most successful form of psychotherapy for treating PTSD falls under the umbrella of Cognitive Behavioral Therapy (CBT), because CBT “…focuses on the relationship among thoughts, feelings, and behaviors; targets current problems and symptoms; and focuses on changing patterns of behaviors, thoughts and feelings that lead to difficulties in functioning.”

Discussion: NURS 6640 Posttraumatic Disorder

CBT can be done in an individual session or group therapy, and at just 12-16 sessions, it’s a short term commitment, and results don’t take long to appear. During the sessions with the therapist, they will encourage you to talk about your experiences and work with you to identify your negative thoughts and patterns. Over time the negative behaviors are turned into positive ones.

Prolonged Exposure Therapy (PET) is another technique frequently used to treat PTSD. Throughout eight to fifteen sessions, which last for about an hour and a half, the patient is taught breathing and relaxation techniques and taught to confront their traumatic event as well as any reminders of them. The therapist gets the patient to face their emotions and fears step by step. The goal is to desensitize the patient to these reminders and decrease the symptoms of avoidance.

Another type of CBT technique also used for Post Traumatic Stress Disorder is Eye Movement Desensitization and Reprocessing (EMDR). Some people might prefer this option since you don’t necessarily have to talk about what you went through. The purpose of EMDR is to focus internally on the traumatic event while you watch your therapist doing things like making sounds or moving their arms etc. EMDR requires weekly sessions for approximately three months, and the goal at the end of the three months will be to think of positive things whenever the trauma comes to mind.

Medications like anti-depressants or medications, which will change your brain chemistry may also be prescribed. This is done to make you feel better, more positive, or more like your usual self. Certain medications will also help you sleep better and stop having flashbacks and nightmares. Keep in mind; the medication will not serve to cure you; it’s a short-term solution only and acts more like a numbing effect to suppress the immediate physical and emotional problems. However, it can be very helpful to your overall treatment plan. Decreasing the symptoms of PTSD even temporarily can help you be more focused in your psychotherapy treatment as you learn how best to manage your symptoms for the long term.

Conclusion

PTSD can leave you feeling crippled and your life in total shambles. It can ruin your professional life, deeply impact your relationships, and make you feel very isolated and alone. It’s also a condition that can turn dangerous as symptoms begin to worsen; it cannot be managed without external help.

PTSD is not an illness you have to live with forever, with the right treatment plan and a commitment on your end to see it through; the disorder can be treated and managed successfully.

Like with any illness, the sooner you get treatment, the better the outcome and the quicker you’ll feel better. Having said that, it is never too late to get help for PTSD. You may feel that you’ve waited too long and you are beyond help.