North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon Tel: Fax:

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1 North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon Tel: Fax: Post-Traumatic Stress Disorder (PTSD) Post-traumatic stress disorder (PTSD) is a reaction to witnessing or being involved in a very stressful event. The event usually involves actual or potential injury or a life threatening experience. It causes strong feelings of fear, helplessness, or terror. After such an event, many people have insomnia, nightmares or intrusive memories of the event. They may feel emotionally numb and disconnected from other people. For most people, these feelings stop within a month or so after the stressful event. At times the symptoms can continue and this becomes post-traumatic stress disorder. How does it occur? It is not fully clear why some persons involved in something terrible (robbery, rape, or severe accident) develop PTSD while others do not. Some factors that appear lead to PTSD include: a history of a mental health problem the severity of the event a family history of mental illness a lack of family and social support One to 14% of people will have PTSD for some period in their lives, at least in a very mild form.

2 PTSD can occur at any age. Symptoms can start immediately after the stressful event, but sometimes they begin 3 months or more afterwards. PTSD symptoms for up to a month after a stressful event is normal. It is called acute stress disorder. When symptoms last more than a month, it is becomes PTSD. What are the symptoms? PTSD symptoms fall into 4 areas. Re-experiencing the stressful event repetitive thoughts, emotions, and images of the event recurrent dreams about the event feeling as if the event is happening again panic attacks when things happen that reminiscent of the event. Avoiding things related to the stressful event avoiding conversations, thoughts, or places that remind you of the event not being able to remember important parts of the event Feeling detached or emotionally empty feeling and acting uninvolved with others close to you having fewer and diminished emotional feelings than you had feeling hopeless about the future. Being hyper or over alert all or most of the time having difficulty falling or staying asleep feeling irritable or having angry outbursts difficulty concentrating easily startled at sudden noises feeling suspicious or paranoid

3 How is it diagnosed? Usually by a physician, nurse or other health professional on the basis of the symptoms and history. There is no lab test for PTSD. Tests may be used to rule out other medical problems. How is it treated? PTSD is usually treated with psychotherapy, medicine, or both. Medicines Several prescription medicines can help treat PTSD: SSRIs or selective serotonin reuptake inhibitors such as sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil) antidepressant medicines. While no nonprescription medicines are available to treat PTSD, some herbal substances such as Comfrey may help one become calmer and more relaxed. Therapy Seeing a psychiatrist or other psychotherapist can help when you are having symptoms of PTSD. Types of psychotherapy sometimes used to treat PTSD are cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). CBT is a way to help you identify and change thoughts that lead to PTSD symptoms. Replacing negative thoughts with more positive ones can help you to control your symptoms. EMDR is a fairly new psychotherapy technique that uses eye movement to activate the brain while you remember the stressful

4 event and your feelings about the experience. The therapy is designed to release "trapped" emotional experiences from the stressful event. Dealing with these experiences may help you to have more peaceful, calm feelings. Other practitioners have found that actually using mental imaging techniques to revisit the stressful event and desensitize oneself to it can be helpful. Other Natural and Alternative Treatments Herbs and Supplements. Claims have been made that certain herbal and dietary products (kava root, lemon balm, lavender, passion flower, valerian) help PTSD. None have been proven to help PTSD. Biofeedback. During biofeedback one learns to control body functions such as heart rate, blood pressure, muscle tension, or brain wave patterns. This can help relieve tension and anxiety. It is an effective treatment for anxiety disorders. There is limited research supporting its effectiveness for treatment of PTSD. Massage Therapy. Massage therapy may help reduce stress and muscle tension. These may be helpful as a secondary treatment tension and anxiety symptoms that may accompany PTSD. Relaxation Therapies. Relaxation methods, along with medication and psychotherapy, can help reduce tension, irritability, and insomnia. Yoga and meditation may also be helpful. Hypnotherapy. Hypnosis has not been tested as a treatment for PTSD. If a therapist is trained in this technique, this may help. Art and Music Therapies. Some people find art and music therapy, along with other treatment, to be helpful. These therapies may a person

5 express difficult feelings and memories when it is difficult to do so with words. How long does PSTD last? For approximately half of persons with PTSD, it stops within 3 months. For others, the symptoms last for more than a year. What can I do? Maintaining a healthy lifestyle is important as well as seeking professional treatment: Exercise for at least 20 minutes every day. participate in activities make you feel better. Talk with family and friends. Eat a healthy diet. Avoid caffeine, cocaine, amphetamines and alcohol. Get enough sleep. Keep a regular schedule Practice breathing exercises, relaxation techniques, or yoga. Many communities have support groups. Look in the telephone book under Support Groups or ask your local community mental health center. Get immediate help if: you or a loved one has thoughts of suicide, violence toward, or harmful feelings toward others. Also seek immediate help if you have severe chest pain or trouble breathing. Modified from: Dewleen Baker, MD; Naakesh A. Dewan, MD; and Gayle Zieman, PhD.