What the heck is PTSD? And what do I do if I have it?

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1 What the heck is PTSD? And what do I do if I have it? Dr. Dion Goodland, Psychologist Goodland Psychology November 2015

2 Outline for today What is Posttraumatic Stress Disorder (PTSD)? How do I get it? Can I get rid of it? Stigma

3 PTSD It has been written about for centuries There have been many names used PTSD in the DSM is relatively new 1980 Much research has been done about causes and treatments

4 PTSD The DSM-5 identifies several criteria required for a diagnosis: A. Trauma B. Re-experiencing/Intrusion C. Avoidance D. Negative alterations in cognitions and mood E. Hyperarousal F. Duration > 1 month G. Symptoms cause impairment in functioning H. Symptoms are not related to physiological effects of a substance or medical condition

5 Trauma Exposure to actual or threatened death, serious injury, or sexual violence To you Witnessing, in person, events happen to others Learning it happened to your loved ones *Repeated or extreme exposure to aversive details of traumatic events*

6 Re-experiencing/Intrusion Re-experiencing unpleasant parts of the trauma Recurrent distressing memories of the event(s) Recurrent distressing dreams/nightmares Flashbacks Psychological and/or physiological reactions to reminders

7 Avoidance Because we are human, we try to avoid feeling badly and seek feeling good Pleasure Principle Re-experiencing/Intrusion is unpleasant, so people try to avoid Avoid thoughts, feelings, and memories about trauma Avoid people, places, conversations, and things that remind of trauma

8 Negative alterations of cognition/mood Because of the significance of the experience, effects on how one thinks and feels are possible. Inability to recall some aspects of the events Persistent and exaggerated negative beliefs (self, world, others) Persistent and distorted thoughts about the cause (self-blame) Persistent negative emotional state (fear, horror, anger, guilt, shame) Decreased interest Feeling emotionally detached from others (family, friends) Inability to experience positive emotions

9 Hyperarousal Often described as the switch gets flicked on but can t turn it off Irritable and/or angry outbursts Reckless or self-destructive behaviour Hypervigilance Exaggerated startle Poor concentration Sleep disruptions

10 The other stuff Symptoms have to be present more days than not for over 1 month Symptoms must cause clinical impairment in functioning Sometimes the start of symptoms can be delayed Sometimes dissociative symptoms can be present

11 Complications/Comorbid Conditions Depression Anxiety Substance abuse Chronic pain

12 Co-morbidity with PTSD Comorbidity (%) Males Females Major depressive episode GAD Panic disorder Social anxiety disorder Agoraphobia Alcohol abuse/dependence Drug abuse/dependence

13 Who can get PTSD? Anyone and everyone!

14 Myths about PTSD Only weak people get PTSD PTSD makes you violent and/or dangerous Bad things only happen to bad people I m alone People should just get over it by now. I should be able to handle this myself Only military veterans get PTSD Nothing can be done to treat PTSD (stay tuned)

15 Asking for help Is difficult! Takes courage!

16 How do I find out if I have it, officially? Assessment by a licensed professional Most often the assessment is done by a psychologist or a psychiatrist VAC can help with the process Assessment can take several hours Clinical interview Psychological testing sometimes Spouse/partner sometimes asked to participate

17 The Dr. confirmed what my friends/family have been telling me. Now what? This is the first step to getting better! Treatment tends to be successful Often treatment is a combination of psychotherapy ( talk therapy ) and medication Treatment takes time

18 Psychotherapy Talk therapy Sessions tend to be weekly and typically last 60 to 90 minutes Cognitive Behavioural Therapy (CBT) Including Prolonged Exposure Cognitive Processing Therapy (CPT) Eye Movement Desensitization and Reprocessing (EMDR)

19 Medication Can be prescribed by family physician or a psychiatrist Some commonly prescribed medications: Sleep medication Medication to reduce dreaming/nightmares (e.g., prazosin, nabilone) Anti-depressants Anxiolytics

20 Other strategies Mindfulness-based psychotherapy Service dogs Equine therapy Yoga Marijuana Logosynthesis Virtual Reality Neurofeedback

21 For the spouses Often the first to see the changes Often have to deal with the symptoms more than anyone else Save face at work and more irritable at home One of the most often heard statements: Walking on eggshells

22 Spouses Challenges because often not allowed to talk with others keep the secret! Feeling isolated Important to take care of you and your needs Cell phones/oxygen masks on airplanes Research has shown that there are impacts from living with someone suffering with chronic illness/ptsd Caregiver Burnout Vicarious Traumatisation

23 Stigma Often the reason people do not seek help Fear of being identified Fear of consequences Fear of being labelled Exists because people Are uninformed/misinformed Are afraid

24 Summary If you are wondering if your friends/family are right, ask for help. If you are diagnosed, then you can be treated. If you get treated, life can become more enjoyable and fulfilling again.