PTSD

PTSD, Posttraumatic Stress Disorder Treatment in Baltimore

PTSD formally refers to persistent distressed responses to horrific, unimaginable traumas, such as war trauma or sexual assault.  However, I often see a PTSD pattern in response to other types of life traumas, stressors, or losses, such as divorce, job loss, coping with children with significant struggles or adversity, or multiple or consecutive significant life stressors that test a person’s natural resiliency, their ability to keep bouncing back. A fluctuating or constant undercurrent of tension and anxiety develops, along with a sense of waiting for the other shoe to drop, the sense of what’s going to go wrong next. In these circumstances, people can find it hard to get negative experiences out of their minds. They may feel keyed up and develop a sudden clutch of tension or anxiety, bracing themselves when they anticipate bad news. An overall persistent negative emotional state can ensue, and people may become avoidant and more withdrawn than usual because they can feel like it’s just too much to deal with things. In a sense, people go into a kind of self-protection mode to avoid being traumatized, hurt, or disappointed again.  An overall negative view of the world, people, or even themselves can occur. Feelings of detachment or estrangement from others and persistent inability to experience positive emotions may also develop. These reactions often occur when one feels they have no direct or marked influence on their stressful circumstances (sometimes referred to as “learned helplessness”).

The coronavirus (COVID-19) pandemic is an example of an event of the type that can lead to a PTSD-like reaction that wasn’t specifically under consideration when the PTSD criteria were developed. This pandemic has certainly caused direct trauma and loss for many, and, even without being directly affected by it, there can be a sense of learned helplessness that develops given the nature of the virus, as well as an effect of being traumatized by many factors, including how much of our lives and routines have changed, and being consumed by traumatizing news about it.

There are effective ways of managing PTSD with treatment. Treatment includes therapy, including cognitive-behavioral therapy. Sometimes people with stressful earlier life experiences can be particularly susceptible to PTSD because their reactions have become primed to respond in a certain way physiologically (like the Fight-or-Flight reaction, which I discuss in my blog “Anxiety and the Fight or Flight Reaction” and/or with automatic negative thoughts. For others, their lives were uneventful prior to the distressing, or string of distressing, event(s).

Depending on the individual and the nature of the event, it can also be helpful to acknowledge that the stressors are real, but also help to frame the healthiest possible perspective and response to the stress in order to reduce distress, and learn how to have as healthy a day as possible every day in the context of the circumstances. In some ways, the coronavirus (COVID-19) pandemic is an example of where this might come into play. As per the original intent of PTSD, some traumas are so extreme that no one would dispute their relevance or impact. It is also, however, important to recognize that everyone’s stress is different and everyone reacts differently, so it is at the same time important to put the stress in perspective, yet not discount your stress or how you are reacting to it because doing otherwise can actually make you feel worse. People may be telling you that everything’s OK or to just deal with it or get over it, but if it were that easy you wouldn’t be feeling the way you are. Also, there may have been a traumatic event that you seemed to handle at first, perhaps by going into crisis mode, or, alternatively, because you employed the psychological defense mechanisms of suppression or repression (sometimes referred to as denial), but it may have had an underlying effect that built up over time, causing a delayed PTSD syndrome.

There are also medications that when used in a judicious, informed, targeted way can help reduce distress. In fact, there are medications that are officially FDA-approved for PTSD and others that an experienced psychopharmacologist will know about that can be equally effective, expanding the options of what might be most effective in a customized way for you.

Just know that there is help.