Note: This story first appeared in the mental health issue of Grayson Magazine.
Though Post Traumatic Stress Disorder is most commonly associated with individuals who have been in active military service, the anxiety disorder can affect anyone. As many as 8 million Americans are currently living with PTSD, and local experts say that for some, treatment can be life long.
Psychiatrist Jawad Riaz said that for many people who have dealt with a traumatic experience, a lot of the symptoms are not immediate. It can take days, weeks and in some cases months for symptoms to become evident.
“Anyone can get it,” Riaz says. “Military people, veterans — that is the most common scenario. Many of them have dealt with an obvious traumatic experience like being in combat. In reality, PTSD, as the name suggests, can be associated with any kind of trauma. (Any trauma) that you witness can cause you to have symptoms of PTSD.”
PTSD can affect people of any age and often looks different in each person, but Riaz said individuals can have an acute stress reaction after experiencing something traumatic for the body or the mind.
“That is where an individual will kind of get into a ‘zone’ where they are not able to have any kind of emotions or feelings about the trauma they have suffered,” he explains. “That is actually a common thing. That is the body’s response. It numbs your feelings and emotions. It is common to see patients take on an extremely traumatic experience and stay in the zone and not have feelings or emotions related to the trauma. That can last days or even weeks.”
Then with time, one of two things can happen to the person. One, they can work through the trauma and resolve their symptoms of PTSD, or two, the person is unable to process the experience and trauma can return and cause a myriad of symptoms.
“It can vary from several months to several years,” Riaz says of how long a person can be dealing with PTSD and not know it. “They can react to the symptoms of PTSD, and it causes emotional or psychological distress.”
The diagnosis of PTSD is centered around trauma. Therefore, if someone in a family or friend group has gone through an experience that is recognizable as traumatic, others should watch out for symptoms of PTSD. The definition of trauma can vary from person to person and any kind of acute stress can result in PTSD.
“It can include going through a severe medical illness or going through an experience of being in the ICU (for example), that can come back and affect an individual,” Riaz says. “For a person to go through a loss or a shooting or something like that, it can result in PTSD. For most, it is about recognizing the traumatic experience.”
The most common symptoms include issues sleeping, nightmares related to the trauma or experience and increased anxiety and nervousness.
“They may tremble, and certain experiences can be triggers,” Riaz says of more PTSD symptoms. “Like someone that has been in the ICU, going back to a hospital can trigger a person to go through certain experiences. Individuals may make a conscious effort of being in certain situations and scenarios. Someone that has been in a motor vehicle accident may avoid being in a vehicle or driving.”
Anxiety, nervousness and flashbacks of the experience, depression and hyper-vigilence, startling easily, extreme depression and nervousness are all symptoms of PTSD.
“PTSD, if it is very severe, can be associated with psychosis,” Riaz says. “A person can start hallucinating or hearing voices. They may hear things that happened during the traumatic experience. Women that have been through a sexual assault may commonly experience hearing the voice of the person that assaulted them or see their face.”
Treatment of PTSD can be just as multifocused as its symptoms.
“The psychopharmacology, the use of medication, is the most common treatment available,” Riaz explains of different ways he has helped his patients live a more normal life while being treated for PTSD. “We use medication that focuses on the symptoms of PTSD, like antidepression medications that address anxiety and depression. If there are hallucinations, we use antipsychotic medications in conjunction with antidepression medications. The pharmacuetical treatments focus on the symptoms.”
Psychotherapy and individual counseling focuses on processing information or processing the experience to help resolve more symptoms of PTSD. The most common therapy is cognitive behavioral therapy. Riaz generally uses a combination of medications and cognitive therapy with his patients.
“Other non-pharmicological treatments that are available include transcranial magnetic stimulation,” he says. “That is where we give a layered stimulation to the brain, and by stimulating the brain, the hope and theory is that we can reset neurons in the brain and help with the anxiety and depression.”
This treatment has not been FDA approved to treat PTSD, but Riaz explains there are studies that this, along with medication, is a very effective treatment.
Treatment length depends on the individual.
“Some patients need to stay on medications for years, if not lifelong,” Riaz says. “On the other hand, there are individuals who are able to resolve and get over the traumatic experience pretty quickly.”
On an average, the recommendation made by the American Psychiatric Association is usually if the patient ends up needing to be hospitalized, treatment should last three to five years. For more than two hospitalizations, it is recommended the patient has longer treatment.