– PTSD/CPTSD

Traumatic events, such as military combat, an assault, an accident or a natural disaster, can have long-lasting negative effects. Sometimes our biological responses and instincts, which can be life-saving during a crisis, leave people with ongoing psychological symptoms because they are not integrated into consciousness.

PTSD effects 3.5% of the U.S. adult population – about 7.7  million Americans – While PTSD is being identified more and more it is still immensely underreported for various reasons such as utilizing mental health services is seen as weakness in the first responder communities. In a recent survey it found that only 55% of respondents had ever received any information or education about PTSD, and only 13% of respondents sought treatment for their symptoms.

According to the National Fallen Firefighters Foundation, firefighters are three times more likely to die by suicide than a line of duty death. From a study published in the Journal of Emergency Medical Services, researchers found that first responders (EMS) in the United States were approximately 10 times more likely to have suicidal ideations and/or attempt suicide compared to the CDC national average.

Symptoms

The symptoms of PTSD fall into the following categories:

• Intrusive Memories:
  Which can include flashbacks of reliving the moment of trauma, bad dreams and scary thoughts.
• Avoidance:
  Which can include staying away from certain places or objects that are reminders of the traumatic event. A person may also feel numb, guilty, worried or depressed or having trouble remembering the traumatic event.
• Dissociation:
  Which can include out-of-body experiences or feeling that the world is “not real” (derealization).
• Hypervigilance:
  Which can include being startled very easily, feeling tense, trouble sleeping or outbursts of anger.

Diagnosis

Symptoms of PTSD usually begin within 3 months after a traumatic event, but occasionally emerge years afterward. Symptoms must last more than a month to be considered PTSD. PSTD is often accompanied by depression, substance abuse or another anxiety disorder.

Treatment

• Medications
  There is not one medication that will treat all cases of PTSD. The effective combination of psychotherapy and medication should be used together to reduce its symptoms. Given the common co-occurrence of depression, related anxiety disorders, aggression and impulsivity, selecting medications that address these related problems is recommended. Common categories of medications include antidepressants, antipsychotics and mood stabilizers.
• Psychotherapy
  People with PTSD respond better to select, structured interventions than to unstructured, supportive psychotherapy. In addition to the following therapies, research is being conducted on dream revision therapy, also known as Imagery Rehearsal Therapy (IRT).
• Cognitive behavioral therapy
  (CBT) helps change the negative thinking and behavior associated with depression. The goal of this therapy is to recognize negative thoughts and replace them with positive thoughts, which leads to more effective behavior.
• Eye Movement Desensitization and Reprocessing
  (EMDR) is an eclectic psychotherapy intervention designed for trauma that employs exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with an individual certified to perform EMDR.
• Exposure therapy 
  Helps people safely face what they find frightening so that they can learn to cope with it effectively. For example, virtual reality programs allow a person to experience the situation in which he or she experienced trauma.

Other forms of therapy include the use of services dogs and support groups.

Complementary and Alternative Methods

Recently, many health care professionals have begun to include alternative treatments into their regimens.

Some methods that have been used for PTSD include:

• Yoga
• Aquatic therapy, such as floatation chambers and surfing
• Acupuncture
• Mindfulness and meditation