DEFINITION

Post-Traumatic Stress Disorder is a psychological reaction that may occur when an individual has been exposed to a traumatic situation, involving feelings of fear, horror or helplessness.

DESCRIPTION

Post-Traumatic Stress Disorder is believed to have existed for some time and has previously been known as shell-shock, war neurosis and "irritable heart of the soldier". It follows exposure to a particularly traumatic event, in which the person either experienced or witnessed events involving actual or potential death or serious injury to themselves or others. This may include war, armed robbery, assault or murder, rape or serious accidents. Some time after the event, the person displays symptoms falling into three categories: re-experiencing, avoidance/numbing and hyperarousal phenomena. Re-experiencing - Recurrent thoughts, images or nightmares about the event. - Acting as though the event were occurring again, including flashbacks, hallucinations and delusions. - Physical and emotional distress when exposed to cues that resemble the event (e.g. sounds of gunfire on the TV). - In children, nightmares, agitation and re-enacting the trauma during play may occur. Avoidance/numbing - Attempts to avoid thoughts, feelings or conversations about the event (often involving the use of alcohol or drugs). - Inability to remember an important part of the event. - Loss of enjoyment of usual activities and inability to have "loving" feelings. Hyperarousal - Difficulty falling or staying asleep. - Irritability or outbursts of anger. - Startles very easily. - Hypervigilance (constantly "on the lookout" for danger).

These symptoms continue for more than a month and significantly interfere with a person's normal lifestyle. Post-Traumatic Stress Disorder can affect every aspect of the person's life, including work, family and social relationships. Up to 80% of people with the condition will develop a secondary condition such as depression, alcoholism, drug abuse, self-harm or suicidal thoughts.

PREVENTION

The following tips may help reduce the severity of Post-Traumatic Stress Disorder. 1) Seek counselling immediately if you or someone you know has witnessed a traumatic event. Early intervention may help stop the condition from developing. 2) Quit smoking. Smoking increases the risk of developing an anxiety disorder. 3) Reduce alcohol intake. Alcohol and recreational drugs can worsen the symptoms of Post-Traumatic Stress Disorder. 4) Exercise can help improve symptoms of anxiety and/or depression. See the Exercising for Health topic for more information. 5) Reduce caffeine intake (tea, coffee, cola and energy drinks). Caffeine may trigger anxiety and can interfere with some medications. Drink water, fruit juice and herbal or decaffeinated drinks.

TREATMENT OPTIONS

Always consult your Doctor for diagnosis and advice. In no way is this information intended to replace the advice of a medical practitioner. Post-Traumatic Stress Disorder is a serious condition requiring intensive psychological and medical management.

Post-Traumatic Stress Disorder can be treated with psychological therapies and medication. Medication is usually required to address depression, substance abuse, sleep disorders and anger. It is important to realise that medication alone will not "cure" the problem. Medications are used to reduce the severity of hallucinations, flashbacks and nightmares, allowing the person to focus on psychological therapy. Psychological therapy can help the patient come to terms with the traumatic event and learn new ways to cope.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice. 1) Follow the diet hints. A healthy diet will help you to cope better with stress. 2) If you have any queries about your medication ask your Pharmacist. To avoid unpleasant drug interactions, be sure your Pharmacist knows what medications you are already taking. 3) Exercise regularly. Exercise can help improve mood and stress tolerance. 4) Expert advice is required to treat Post-Traumatic Stress Disorder. Consult a Health Professional trained in the condition or Crisis management. 5) If headaches are a problem, ask your Pharmacist about suitable pain relief. 6) Nutritional supplements may be of benefit if dietary intake is inadequate. See the Vitamins/Minerals/Herbs section of this topic and ask your Pharmacist for advice.

DIET HINTS

- See the Depression Diet topic on the Healthpoint. - Avoid caffeine, which may make anxiety worse and interferes with normal sleep patterns. Common sources of caffeine include coffee, tea, cola drinks and products containing guarana. - Alcohol should be kept to a minimum or avoided completely.

VITAMINS/MINERALS/HERBS

Always consult your Doctor or Pharmacist before using vitamin or herbal remedies. Many "natural" remedies may cause serious drug interactions when combined with prescription medications. - St. John's Wort may be of benefit in mild to moderate depression, especially when associated with anxiety. - B group vitamins and folic acid deficiency can produce symptoms of depression and anxiety. - Vitamin B6 may improve mood and increase stress tolerance. - Borage, valerian, chamomile, skullcap, oats and ginseng have been traditionally used for anxiety and nervous tension.

ORGANISATIONS and SUPPORT GROUPS