The Treatment of Posttraumatic Stress Disorder

Introduction

It is necessary to mention that Posttraumatic Stress Disorder (PTSD) is a condition that affects an enormous percentage of the population in the United States. It would be appropriate to review peer-reviewed articles on this subject matter to get a better understanding of the topic.

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Definition

PTSD can be defined as a mental disorder that develops as a result of the exposure to a particular situation or information that may endanger a person’s life and can lead to a lethal outcome. Some of the most common symptoms of this condition are thoughts and ideas related to such events. Distress associated with PTSD is also significant most of the time and could have an enormous impact on a person’s life because individuals are more likely to avoid situations that would remind them of the traumatic experience. The duration of such symptoms is at least one month most of the time (Warner, Appenzeller, & Hoge, 2013).

Diagnostic Criteria

A person may be diagnosed with PTSD if he or she has witnessed events related to death, were threatened. Exposure and threats of sexual violence also may lead to the development of this condition. Similar information about a close relative also can provoke such symptoms. A person exposed to particular details of tragic events also is vulnerable to PTSD. Intrusion, avoidance of situations related to the trauma, changes in cognition, and arousal also are viewed as crucial diagnosis criteria.

Such symptoms are likely to remain persistent and can lead to enormous distress and limit the ability to perform necessary functions. One of the points focused on fear and horror was removed from the last edition. Additionally, a person may not be diagnosed with PTSD if it was caused by the abuse of medications, substance, or other conditions (Warner et al., 2013).

Incidence/Statistics

One of the studies suggests that the prevalence of lifetime PTSD in the United States is close to 8.3%. The estimated percentage of individuals that suffer from this condition during the past twelve months is 4.7, and close to 3.8 percent of the population had to deal with PTSD over half of the year. Also, it is suggested that women are affected by this condition at least twice as much as men. Moreover, it is necessary to mention that diagnosis criteria also have an enormous impact on the results, and it is noted that disease classifications are getting stricter every year (Kilpatrick et al., 2013).

Residual Impact

It is suggested that PTSD may have a long-lasting impact on the health and well-being of an individual. One of the issues is that individuals suffering from this illness are much more likely to develop associated mental disorders that others. Such conditions as anxiety and depression are noted as particularly problematic. Moreover, changes in eating behavior could hurt a person in the long-term if the diet is not healthy. Additionally, the release of stress hormones increases the risks related to physical health. Unhealthy behaviors such as the abuse of tobacco and alcohol are also incredibly harmful. Insomnia may also be quite persistent and complicate recovery (DeViva, Zayfert, Pigeon, & Mellman, 2005).

Maladaptive Patterns

Maladaptive patterns related to PTSD should be discussed. First of all, dependence/incompetence can be quite problematic for individuals because it affects their ability to perform day-to-day activities, and they are extremely reliant on others. Abandonment/Instability causes people to alienate close ones because of their frequent changes in behavior and unpredictability. Mistrust/Abuse schema is also can be applied in such situations, and it leads to a reduction in trust levels.

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Individuals are less likely to believe others because of the situation that has occurred. Defectiveness/Shame is associated with changes in self-esteem and mood. Victims may blame themselves and think that a particular incident is their fault. Moreover, one of the recent studies has shown that maladaptive patterns in PTSD patients are affected by the onset of the illness (Ahmadian, Mirzaee, Omidbeygi, Holsboer-Trachsler, & Brand, 2015).

Treatment of PTSD

One of the guidelines suggests that pharmacotherapy is the most efficient method. Optimized therapy needs to be utilized to determine the medicine that fits the needs of the patient. Citalopram is a first-line agent that is commonly used in such situations, and the recommended starting dosage is 20mg every day. Such alternatives as fluoxetine and paroxetine are also available. Non-SSRI depressants may also be considered in some situations, and most of them are taken before bedtime. The use of mood stabilizers and other agents can be justified depending on the severity of illness. Psychotherapy is viewed as less useful but should be offered. Most techniques are focused on the elimination of particular symptoms and associated conditions (Warner et al., 2013).

Interventions

It is suggested that interventions should be focused on the overall reduction of distress. A recent study indicates that the lack of evidence related to PTSD prevention is quite problematic. Researchers argue that debriefing does not have a positive impact on patients and may not have a significant effect on the severity of illness. One of the biggest problems is that individuals that suffer from PTSD are more likely to commit suicide.

Therefore, the provision of counseling is crucial and could prevent tragic events. Cognitive-behavioral therapy (CBT) is an approach that is commonly used, and it is suggested that it is more efficient than supportive counseling (SC) because it may affect the severity. Collaborative care produces better results than standard approaches when a person has to go through hospitalization. Another rather interesting aspect is that researchers argue that the evidence to support the use of pharmacologic techniques is insufficient (Gartlehner et al., 2013).

Moving Beyond Trauma

It may be difficult for individuals to forget about traumatic events. However, a set of approaches that could improve the situation can be considered. For instance, it is reasonable to seek other occupations. Moreover, changes in lifestyles are suggested, and the focus on healthy behavior would help to improve the mood. Substance abuse is frequently associated with PTSD, and it would be appropriate to avoid such activities. Healthy long-term relationships are recommended in such situations, and they would help to overcome most of the difficulties. An individual may experience problems at work, but the support offered by close ones should help a person to recover (Troop & Hiskey, 2013).

Other Considerations

It is necessary to understand that the support of families is one of the most important aspects of the therapy. However, the problem occurs when traumatic events are associated with some of the members. Therefore, it is reasonable to conduct throughout interviews and eliminate factors that could provoke the symptoms. It is necessary to make appropriate decisions in case of crisis and come up with efficient intervention strategies that would not cause other complications. Therefore, a healthcare professional has to be qualified to make an appropriate assessment of the situation.

Conclusion

In summary, it is possible to state that the treatment of PTSD is rather complicated most of the time because most methods of treatment are underdeveloped and in need of improvement. Currently, the biggest challenge is that the illness is not easily diagnosed because it has various manifestations and changes in diagnostic criteria are also common.

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References

Ahmadian, A., Mirzaee, J., Omidbeygi, M., Holsboer-Trachsler, E., & Brand, S. (2015). Differences in maladaptive schemas between patients suffering from chronic and acute posttraumatic stress disorder and healthy controls. Neuropsychiatric Disease and Treatment, 11(1), 1677-1684.

DeViva, J., Zayfert, C., Pigeon, W., & Mellman, T. (2005). Treatment of residual insomnia after CBT for PTSD: Case studies. Journal of Traumatic Stress, 18(2), 155-159.

Gartlehner, G., Forneris, C. A., Brownley, K. A., Gaynes, B. N., Sonis, J., Coker-Schwimmer, E.,…Lohr, K. N. (2013). Interventions for the prevention of posttraumatic stress disorder (PTSD) in adults after exposure to psychological trauma. Comparative Effectiveness Reviews, 109(1), 1-15.

Kilpatrick, D., Resnick, H., Milanak, M., Miller, M., Keyes, K., & Friedman, M. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. Journal of Traumatic Stress, 26(5), 537-547.

Troop, N., & Hiskey, S. (2013). Social defeat and PTSD symptoms following trauma. British Journal of Clinical Psychology, 52(4), 365-379.

Warner, C. H., Appenzeller, G. N., & Hoge, C. W. (2013). Identifying and managing posttraumatic stress disorder. American Family Physician, 88(2), 827-834.

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