Acute stress reaction and post-traumatic stress disorder (PTSD)

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What is it about ?

Anxiety is a normal reaction when real danger threatens. Anxiety is accompanied by physical manifestations. These are due to the activation of the autonomic nervous system, because the body is preparing to fight or to flee (“fight or flight” in English). The heart rate and breathing quicken, the muscles contract, you have specific thoughts such as “I’m going to die” or “something horrible is happening to me” and certain stereotypical behaviors, for example you remain petrified (“freeze Or you run away.

Traumatic events can cause psychological reactions. These are classified into two categories: stress reactions and stress related disorders.

  • A stress reaction is a normal reaction to a very traumatic event. It does not always require medical help.
  • A person who suffers from a stress-related disorder usually needs medical attention.

the post-traumatic stress disorder (PTSD) is characterized by reliving a traumatic event in a persistent manner. People who suffer from PTSD consistently have the same nightmares or memories of the trauma, for example. Often they will avoid the situations, thoughts and people that relate to the trauma. PTSD can be associated with symptoms such as increased irritability, temper tantrums, exaggerated fear reactions, and decreased concentration.

Where do we meet them and what is their frequency?

Stress-related disorders affect people of all ages, including children. The causes can be, for example, serious accidents, acts of war or violence or rape of which one is a witness or a victim.

It is estimated that around 50-90% of all people involved in a major disaster go on to experience acute stress reaction.

In the general population, 1 to 11% of people would one day or the other develop a post-traumatic stress disorder.

How to recognize them?

Acute stress reaction

When you are going through a stressful experience, you may present with both physical and emotional symptoms, such as those of ‘generalized anxiety disorder’, for example irritability, tendency to be overly afraid, decreased concentration and fits. of quick anger. In the case of a “normal” reaction to stress, these symptoms usually subside within 8 hours of exposure to stress and most often disappear within 3 days.

Post-traumatic stress disorder (PTSD)

In post-traumatic stress disorder (PTSD), you relive the traumatic event over and over again (in your thoughts, in your nightmares, in flashbacks). The slightest stimulation that suggests some aspect of the trauma can trigger intense physical and emotional anxious reactions. Often times, you avoid the situations, thoughts and people that relate to the trauma. You may isolate yourself from the world around you. PTSD can be associated with symptoms such as increased irritability, temper tantrums, exaggerated fear reactions, and decreased concentration.
We talk about PTSD if the symptoms last at least 4 weeks and the traumatic event occurred less than 6 months ago.

How is the diagnosis made?

The diagnosis is often made only after several consultations. This is because many people with anxiety symptoms will not spontaneously talk about their anxieties. They often consult first for physical problems (associated or not with mental problems).

The doctor will think of an anxiety disorder in the following cases:

  • Persistent vague problems, such as tension, irritability, emotional instability, problems concentrating, listlessness or sleeping problems;
  • Physical symptoms with no apparent physical cause;
  • Alcohol or drug problems;
  • Request for prescription of sleeping pills or sedatives;
  • Depressive symptoms;
  • Personal or family history of anxiety disorder.

Having experienced a traumatic event within 6 months can also set the doctor on the path to PTSD.

What can you do ?

Share your anxieties with someone you trust. It is important to find support from those around you. You can also keep a journal, in which you will write down your thoughts and facts about your anxiety:

  • Have you had a traumatic experience?
  • Describe your anxieties and nightmares.
  • What do you think about when you feel anxious? What do you feel, what are you afraid of and how do you react to it?
  • Plan how you will react during your next anxiety episode and write it down; for example, you can phone someone, go for a walk, breathe calmly, etc.

What can your doctor do?

The first care after a traumatic event should preferably be provided by qualified and specialized professionals. In principle, it is the psychiatrist and / or psychologist who supports people with PTSD through psychotherapy, often in the form of cognitive behavioral therapy (CBT) or the EMDR (eye movement desensitization and reprocessing) (desensitization and reprogramming by eye movements).

Antidepressants can be helpful in combination with this psychotherapy. Keep in mind, however, that these drugs don’t really start to work until after about six weeks. At the start of treatment, they can cause side effects such as dry mouth, gastrointestinal problems, drowsiness or, conversely, insomnia and decreased libido. The anxiety symptoms may also increase a little at the start of treatment.

In the face of intense anxiety symptoms and / or serious sleep problems, sedatives (benzodiazepines) may be of temporary help. However, these drugs can cause dependence and drowsiness. They can therefore only be used very briefly and with close monitoring by the doctor.

Want to know more?

Are you looking for more specialized help?

Source

Foreign clinical practice guide ‘Acute stress reaction and post-traumatic stress disorder (PTSD)’ (2000), updated on 25.08.2017 and adapted to the Belgian context on 11.03.2019 – ebpracticenet


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