Advice To Counselors: Universal Screening And Assessment
Only people specifically trained and licensed in mental health assessment should make diagnoses trauma can result in complicated cases, and many symptoms can be present, whether or not they meet full diagnostic criteria for a specific disorder. Only a trained assessor can distinguish accurately among various symptoms and in the presence of co-occurring disorders. However, behavioral health professionals without specific assessment training can still serve an important role in screening for possible mental disorders using established screening tools . In agencies and clinics, it is critical to provide such screenings systematicallyfor each clientas PTSD and other co-occurring disorders are typically under diagnosed or misdiagnosed.
Advice To Counselors: Using Information About Biology And Trauma
- Educate your clients:
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Frame reexperiencing the event, hyperarousal, sleep disturbances, and other physical symptoms as physiological reactions to extreme stress.
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Communicate that treatment and other wellness activities can improve both psychological and physiological symptoms . You may need to refer certain clients to a psychiatrist who can evaluate them and, if warranted, prescribe psycho-tropic medication to address severe symptoms.
- Increased charitable giving and volunteerism.
When Should I Seek Immediate Care
If you think about hurting yourself or someone else, tell somebody right away. You can tell a healthcare provider, a friend or a family member.
You can also contact the National Suicide Prevention Lifeline:
- 800.273.TALK
Youre not alone. Theres always somebody who wants to help.
A note from Cleveland Clinic
PTSD is a mental health issue that lasts long after a traumatic event. It can make you feel negative and anxious. It can also cause you to re-experience the event or avoid certain things. If you have symptoms of PTSD, talk to a healthcare provider. Medication and specific kinds of counseling can help. If you feel like you might hurt yourself or someone else, seek help immediately.
Last reviewed by a Cleveland Clinic medical professional on 01/20/2021.
References
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Which Brain Regions Are Involved In Ptsd
Key brain regions involved in PTSD are the amygdala, which regulates emotion and processes fear the hippocampus, which stores and retrieves memories and the prefrontal cortex, which governs planning and . A traumatic event can disrupt communication among these three regions the brain fails to properly process and control memories of the trauma.
People With Mental Disorders
MDD is the most common co-occurring disorder in people who have experienced trauma and are diagnosed with PTSD. A well-established causal relationship exists between stressful events and depression, and a prior history of MDD is predictive of PTSD after exposure to major trauma .
Many survivors with severe mental disorders function fairly well following trauma, including disasters, as long as essential services arent interrupted. For others, additional mental health supports may be necessary. For more information, see Responding to the Needs of People With Serious and Persistent Mental Illness in Times of Major Disaster .
Co-occurrence is also linked with greater impairment and more severe symptoms of both disorders, and the person is less likely to experience remission of symptoms within 6 months.
Generalized anxiety, obsessivecompulsive, and other anxiety disorders are also associated with PTSD. PTSD may exacerbate anxiety disorder symptoms, but it is also likely that preexisting anxiety symptoms and anxiety disorders increase vulnerability to PTSD. Preexisting anxiety primes survivors for greater hyperarousal and distress. Other disorders, such as personality and somatization disorders, are also associated with trauma, but the history of trauma is often overlooked as a significant factor or necessary target in treatment.
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Getting Professional Help For Ptsd
If you suspect that you or a loved one has post-traumatic stress disorder, its important to seek help right away. The sooner PTSD is treated, the easier it is to overcome. If youre reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.
Its only natural to want to avoid painful memories and feelings. But if you try to numb yourself and push your memories away, PTSD will only get worse. You cant escape your emotions completelythey emerge under stress or whenever you let down your guardand trying to do so is exhausting. The avoidance will ultimately harm your relationships, your ability to function, and the quality of your life.
Why you should seek help for PTSD
Early treatment is better. Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.
PTSD symptoms can change family life. PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.
Genetic Risk Factors For Ptsd
Studies on the genetics of PTSD have been hampered by a variety of factors, such as genetic heterogeneity and incomplete phenotypic penetrance . Despite these confounds, there is accumulating evidence that risk for PTSD is heavily influenced by genetic factors. Evidence from family and twin studies has long suggested a heritable contribution to the development of PTSD. In addition, there is evidence for heritable contributions to some of the neurobiological endophenotypes of PTSD as discussed above, such as decreased hippocampal volume or exaggerated amygdala reactivity. Although it is beyond the scope of this review to comprehensively discuss the genetics of PTSD, it should be noted that there is an emerging literature on genetic variations in those neurobiological systems that drive responses to trauma and, consequently, risk versus resilience to develop PTSD.
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First World War: Shell Shock
The prolonged duration of the First World War, and the enormous casualty rate, saw the birth of military psychiatry.At that time, the Canadian medical profession was heavily influenced and shaped by the United States and United Kingdom. Combat-related emotional trauma became known as shell shock or lhypnose des batailles. The term shell shock capturedBritish ambivalence about whether the symptoms found in soldiers who did not show obvious wounds were of a physical or psychological nature. Dr. Donald Campbell Meyers , a neurologist who opened a psychiatry ward at the Toronto General Hospitalin 1906, came to view shell shock as a functional or traumatic neurosis.
Ptsd Causes And Risk Factors
Everyone reacts to traumatic events differently. Each person is unique in their ability to manage fear, stress and the threat posed by a traumatic event or situation. For that reason, not everyone who has a trauma will develop PTSD. Also, the type of help and support a person receives from friends, family members, and professionals following the trauma may impact the development of PTSD or the severity of symptoms.
PTSD was first brought to the attention of the medical community by war veterans hence the names shell shock and battle fatigue syndrome. However, anyone who has had a traumatic event can develop PTSD. People who were abused as children or who have been repeatedly exposed to life-threatening situations are at risk for developing PTSD. Victims of trauma related to physical and sexual assault face the greatest risk for PTSD.
You may be more likely to develop PTSD after a traumatic event if you have a history of other mental health problems, have blood relatives with mental health problems, or have a history of alcohol or drug abuse.
How common is PTSD?
About 3.6% of adult Americans — about 5.2 million people — have PTSD during the course of a year, and an estimated 7.8 million Americans will develop PTSD at some point in their lives. PTSD can develop at any age, including childhood. Women are more likely to develop PTSD than men. This may be due to the fact that women are more likely to be victims of domestic violence, abuse, and rape.
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Support Is Important For Recovery
Many people experience some of the symptoms of PTSD in the first two weeks after a traumatic event, but most recover on their own or with the help of family and friends. For this reason, formal treatment for PTSD does not usually start for at least two or more weeks after a traumatic experience.
It is important during the first few days and weeks after a traumatic event to get whatever help is needed. This may include accessing information, people and resources that can help you to recover. Support from family and friends may be all that is needed. Otherwise, a doctor is the best place to start to get further help.
Supporting Someone With Ptsd
Research has shown that support from family and friends is important in helping someone overcome the debilitating effects of PTSD. Couples or family therapy can help to fix damaged relationships. In some cases, family members may need to seek support of their own.
For detailed information on the most effective treatments for PTSD, see The Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder.
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How Is Ptsd Treated In A Child
Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is.
PTSD can be treated. Early diagnosis and treatment is very important. It can ease symptoms and enhance your childs normal development. It can also improve your childs quality of life.
Treatment may include:
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Cognitive behavioral therapy. A child learns skills to handle his or her anxiety and to master the situation that led to the PTSD.
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Medicines for depression or anxiety. These may help some children feel calmer.
Recovery from PTSD varies. Some children recover within 6 months. Others have symptoms that last much longer. Recovery depends on the childs inner strengths, coping skills, and ability to bounce back. It is also affected by the level of family support. Parents play a vital role in treatment.
International Classification Of Diseases
The International Classification of Diseases and Related Health Problems 10 classifies PTSD under “Reaction to severe stress, and adjustment disorders.” The ICD-10 criteria for PTSD include re-experiencing, avoidance, and either increased reactivity or inability to recall certain details related to the event.
The ICD-11 diagnostic description for PTSD contains three components or symptom groups re-experiencing, avoidance, and heightened sense of threat. ICD-11 no longer includes verbal thoughts about the traumatic event as a symptom. There is a predicted lower rate of diagnosed PTSD using ICD-11 compared to ICD10 or DSM-5. ICD-11 also proposes identifying a distinct group with complex post-traumatic stress disorder , who have more often experienced several or sustained traumas and have greater functional impairment than those with PTSD.
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Signs And Symptoms Of Ptsd
PTSD develops differently from person to person because everyones nervous system and tolerance for stress is a little different. While youre most likely to develop symptoms of PTSD in the hours or days following a traumatic event, it can sometimes take weeks, months, or even years before they appear. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell.
While everyone experiences PTSD differently, there are four main types of symptoms.
Are Some Women More Likely To Develop Ptsd
Yes, although most women who go through trauma wont get PTSD. But you may be more likely to develop PTSD if you:
- Were directly exposed to the trauma as a victim or a witness. As many as half of women who are raped develop PTSD.10
- Were seriously hurt during the traumatic event
- Went through a trauma that lasted a long time or was very severe
- Have another mental health condition like depression or anxiety
- Drink a lot of alcohol
- Dont have a good support network
- Experienced trauma during childhood
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Do You Need More Help
Contact a community organization like the Canadian Mental Health Association to learn more about support and resources in your area. Find your local CMHA here.
Founded in 1918, the Canadian Mental Health Association is the most established, most extensive community mental health organization in Canada. Through a presence in hundreds of neighbourhoods across every province, CMHA provides advocacy and resources that help to prevent mental health problems and illnesses, support recovery and resilience, and enable all Canadians to flourish and thrive.
Gender Differences And Risk For Ptsd
Women more frequently suffer from PTSD than men for reasons that are not entirely clear. Women and men are, in general, subjected to different types of trauma, though the differences in PTSD frequency arc unlikely to be explained solely on the basis of exposure type and/or severity alone. In addition to those findings by Ressler described above, a number of gender-related differences in the neurobiological response to trauma have been documented. Rodent studies suggest that females generally exhibit greater magnitude and duration of HPA axis responses to stress than males, though findings in humans are not entirely consistent. Sex differences in neuroendocrine stress responses have been attributed to direct effects of circulating estrogen on CRH neurons. Sex steroids also interact with other neurotransmitter systems involved in the stress response, such as the serotonin system. Progesterone has been implicated in modulating these systems as well. However, gender differences in HPA responses to stress have also been observed independent of acute gonadal steroid effects.
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Advice To Counselors: Working With Clients Who Are Self
Counselors who are unqualified or uncomfortable working with clients who demonstrate self-harming, self-destructive, or suicidal or homicidal ideation, intent, or behavior should work with their agencies and supervisors to refer such clients to other counselors. They should consider seeking specialized supervision on how to manage such clients effectively and safely and how to manage their feelings about these issues. The following suggestions assume that the counselor has had sufficient training and experience to work with clients who are self-injurious. To respond appropriately to a client who engages in self-harm, counselors should:
Counselors can also help the client prepare a safety card that the client can carry at all times. The card might include the counselors contact information, a 24-hour crisis number to call in emergencies, contact information for supportive individuals who can be contacted when needed, and, if appropriate, telephone numbers for emergency medical services. The counselor can discuss with the client the types of signs or crises that might warrant using the numbers on the card. Additionally, the counselor might check with the client from time to time to confirm that the information on the card is current.
However, as with self-harming behavior, self-destructive behavior needs to be recognized and addressed and may persistor worsenwithout intervention.
Consumption of substances
Self-medication
Avoidance
Other Effects Of Ptsd
If you are experiencing symptoms of PTSD, you might also find that you have difficulty with some everyday aspects of your life, such as:
- looking after yourself
- remembering things and making decisions
- your sex drive
- coping with change
- simply enjoying your leisure time.
If you drive you may have to tell the DVLA that you have PTSD. For more information on your right to drive, including when and how to contact the DVLA, see our legal pages on fitness to drive.
“My behaviour changed and became erratic. I would alternate from wanting to shut myself away and not see or talk to anyone to going out to parties in the middle of the week and staying out late.”
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Ptsd: National Center For Ptsd
Available en Español
PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. During this kind of event, you may not have any control over what’s happening, and you may feel very afraid. Anyone who has gone through something like this can develop PTSD.
It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after a traumatic event . At first, it may be hard to do daily activities you are used to doing, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months. For some people, PTSD symptoms may start later, or they may come and go over time.
If it’s been longer than a few months and thoughts and feelings from the trauma are upsetting you or causing problems in your life, you may have PTSD.
Video
How I Knew I Had PTSD
When you have PTSD, the world feels unsafe. You may have upsetting memories, feel on edge, or have trouble sleeping. You may also try to avoid things that remind you of your traumaeven things you used to enjoy.
