Post-traumatic stress: symptoms, duration, what is it?

Definition: what is post-traumatic stress disorder?

Post-traumatic stress (stress after a trauma) is a syndrome (set of symptoms) resulting from theexposure of a subject to an extreme situation of which he was the victim or only the witness: rape, scenes of war, attacks, serious accidents, etc. It manifests itself by a great anxiety, insomnia and depression. This syndrome is diagnosed when the patient is significantly disturbed by obsessive memories having a direct impact on his social, emotional and professional life. Women are twice as exposed as men.

Complex post-traumatic stress syndrome

It’s about a special form of STSP. “Complex STSP results from repeated traumatic events which did not necessarily confront the person with a feeling of horror or helplessness. Complex traumatic personalities trigger counter-attitudes of rejection towards caregivers.” explains the psychologist. STSP is manifested by somatic disorders varied often in the form of chronic pain : “digestive disorders, sexuality disorders, obstetrical disorders, fibromyalgia, cardio-respiratory disorders, headaches, etc., without anyone generally making the link with the traumatic events suffered.” says the specialist It is often responsible for psychological disorders affecting the personality :

• Difficulty managing emotions (altered emotional regulation, impulsiveness, aggressiveness)
• Alteration Self-perception: Lack of confidence in oneself and in any form of possible help, devaluation, guilt, feeling of incomprehension, abandoned experience.
• Behavioral disorders repeating the initial trauma: self-destructive behavior, self-aggression (drug addiction, alcoholism, suicidal behavior, risky sexuality)
• Depressive state with risk of acting out.
• Impaired attention and consciousness, amnesia (traumatic), dissociative episodes, dissociative disorders.

Chronic post-traumatic stress syndrome

Post-traumatic stress disorder becomes chronic if it persists more than 3 months. Chronicization factors can be:

• A lack of social recognition
• A lack of information on the symptoms and therefore late or even non-existent treatment
• Value judgments about the person, their ability to react
• Absence or too early cessation of support from relatives, caregivers, etc.
• The traumatic aspect of the procedure and its duration

After a traumatic event, the memory returns and imposes itself constantly.

What are the causes of post-traumatic stress?

Post-traumatic stress occurst after a traumatic event, that the person directly experiences or witnesses. It is generally an extreme event, during which the physical integrity (of oneself or of others) is actually or potentially threatened: serious accident, rape, aggression, domestic violence, attack, violent death, natural disaster. “We are talking about feeling of fear of imminent death and feeling of helplessness“ adds the psychologist. People repeatedly exposed to dramatic situations (police forces) are also prone to post-traumatic stress. “What you have to understand is that after a traumatic event, the memory comes back and imposes itself constantly. There is a hippocampal hyperactivity which generates stress excessive secretion of cortisol. The hippocampus activates the amygdala in cascade, which manages emotions without being able to play its regulatory role. This would explain, among other things, the reactions of intrusive memories as well as the state of constant hyper-vigilance. Advances in neuroimaging have shown that the brains of people exposed to a traumatic event are not similar to those of non-traumatized people.“explains Johanna Rozenblum.

What are the symptoms of post-traumatic stress?

Post-traumatic stress most often results in:

• of the feelings of fear, horror and helplessness.
• intrusion symptoms: the person relives the traumatic event through nightmares, repetitive and intrusive memories, and through distress in the face of elements reminiscent of the event.
• symptoms of avoidance of memories and people or places reminiscent of the trauma
• emotional alterations: decreased interest in daily activities, decreased concentration, difficulty in feeling tenderness or sexual desire,
• sleeping troubles,
• irritability,
• hypervigilance,
• guilt.

As the psychologist explains “the patient fails to integrate that the danger has passedhe is in permanent state of alert, this is called hyper-vigilance. It is not uncommon to see somatic symptoms that can be disabling such as tension headaches or chronic pain that comes on top of the sleep disorder. Finally, in the most severe cases, “A dissociative symptom leads the person to a altered state of consciousness to extract oneself psychologically and physically from the horror at the very moment when the event is taking place: the mind is “detached” from the body, the person no longer feels anything “adds the psychologist. The appearance of symptoms varies between individuals. They can occur shortly after the event or later.

“Depression and anxiety add the social risk of isolation and withdrawal”

Usually this happens within three months. It also happens that the symptoms do not appear until several years after the event. In all cases, it is common to observe a persistence of symptoms over time. In some, addictions can be added, a recourse to the consumption of psychoactive substances (alcohol, cannabis, etc.)the victim seeks to anesthetize affects that are too painful, too present. Depression and anxiety add the social risk of isolation and withdrawal, once again reinforcing the malaise (inability to go out, to work, to see people, to go to an enclosed place, etc. ).“describes Johanna Rozenblum.

DSM-5 Post Traumatic Stress Disorder Test

The DSM, Diagnostic and Statistical Manual of Mental Disorders (DSM for “Diagnostic and Statistical Manual of Mental Disorders”) is published by the American Psychiatric Association. It is used worldwide as a reference for diagnoses of mental (or psychiatric) disorders. The latest version of DSM-5 was released in May 2013. It categorize these mental disorders, describes their diagnostic criteria and provides various information such as their prevalence. A specific test to STSP called: “adult post-traumatic stress disorder symptom severity scalewas published by American psychiatrist Dean G. Kilpatrick in 2014. It assesses the presence and severity of this disorder in relation to the DSM-5 diagnostic criteria. It was published by American psychiatrist Dean G. Kilpatrick in 2014 .

What are the treatments for post-traumatic stress disorder?

“Two drugs have marketing authorization for the treatment of post-traumatic stress disorder. These are selective serotonin reuptake inhibitors (SSRIs): paroxetine and sertraline.“The psychotherapeutic treatments of PTSD are based on the cognitive-behavioral therapies (CBT), eye movement desensitization (EMDR)And hypnosis. “Whatever the therapeutic technique adopted, it is necessary to develop a relationship of trust that allows the traumatic scenario to be rewritten. It will be necessary to listen to one’s own experience, to hear the suffering to help accept the consequences and learn to live with.” explains the clinical psychologist.

Cognitive-behavioral therapies (CBT)

This is cognitive behavioral therapy (CBT) trauma-focused. The principle of CBT is the same as in the treatment of other forms of anxiety disorders. For patients, life will never be the same again. There is always a “before” and an “after” trauma. As the psychologist explains “It is an observation that is often very hard for patients to accept. A large part of the treatment will consist of a progressive modification of this deficit vision to arrive at the conception that it is possible to resume the course of one’s life, certainly in a different way”.

EMDR for post-traumatic stress

Eye Movement Desensitization and Reprocessing (EMDR) therapy is a cognitive therapy of psychotraumatic disorders, based on mental exposure to the painful memory coupled with regular eye movements and aimed at emotional desensitization. “EMDR is one of the techniques used to soothe particularly debilitating symptoms Post Traumatic Stress Disorder and reduce the intensity of negative affects” says the specialist.

Hypnosis to cure post-traumatic stress disorder

“Hypnosis focuses on the traumatic element inducing dissociation and acts directly on the processing of information. The process of awareness is relaunched so that, this time, all the steps take place as they should. The traumatic event is “digested”, the subject is freed from the consequences that the trauma may have had on his daily life.” summarizes Johanna Rozenblum. Therapeutic hypnosis techniques can be beneficial for certain symptoms.

Thanks to Johanna Rozenblum, clinical psychologist in Paris.