Post Traumatic Stress Disorder

Difficult situations are part of life. We all must cope with tough circumstances, such as bereavement or conflict in our personal and professional relationships, and learn to move on. Sometimes people experience an event which is so unexpected and so shattering that it continues to have a serious effect on them, long after any physical danger involved has passed. Individuals with this kind of experience may suffer flashbacks and nightmares, in which they re-live the situation that caused them intense fear and horror. They may become emotionally numb. When this condition persists for over a month, it is diagnosed as post-traumatic stress disorder (PTSD).

What causes it?

PTSD is caused by a psychologically traumatic event involving actual or threatened death or serious injury to oneself or others. Such triggering events are called 'stressors'; they may be experienced alone or while in a large group.

Violent personal assault such as rape or mugging, car or plane accidents, military combat, industrial accidents and natural disasters such as earthquakes and hurricanes, are stressors which have caused people to suffer from PTSD. In some cases, seeing another person harmed or killed, or learning that a close friend or family member is in serious danger has caused the disorder.

What are the signs?

The symptoms of PTSD usually begin within 3 months of the traumatic event. However, sometimes they surface many years later. The duration of PTSD and the strength of the symptoms vary. For some people, recovery may be achieved in 6 months; for others, it may take much longer.

There are three categories of symptoms.

• The first involves re-experiencing the event. This is the main characteristic of PTSD and it can happen in different ways. Most commonly the person has powerful, recurrent memories of the event, or recurrent nightmares or flashbacks in which they re-live their distressing experience. The anniversary of the triggering event, or situations which remind them of it, can also cause extreme discomfort.
• Avoidance and emotional numbing are the second category of symptoms. The first occurs when people with PTSD avoid encountering scenarios which may remind them of the trauma. Emotional numbing generally begins very soon after the event. A person with PTSD may withdraw from friends and family, they may lose interest in activities they previously enjoyed and have difficulty in feeling emotions, especially those associated with intimacy. Feelings of extreme guilt are also common. In rare cases, a person may enter dissociative states, lasting anywhere from a few minutes to several days, during which they believe they are re-living the episode, and behave as if it is happening all over again.
• The third category of symptoms involves changes in sleeping patterns and increased alertness. Insomnia is common and some people with PTSD have difficulty concentrating and finishing tasks. Increased aggression can also result.

How is PTSD treated?

Medication can help with the depression and anxiety often felt by people with PTSD, and assist them in re-establishing regular sleep patterns.

Cognitive-behavioral therapy and group therapy are generally felt to be more promising treatments for PTSD. They are often performed by therapists experienced in a particular type of trauma, such as rape counsellors. Exposure therapy, in which the patient re-lives the experience under controlled conditions in order to work through the trauma, can also be beneficial.

Research into the causes of PTSD and its treatment is ongoing. Determining which treatments work best for which types of trauma is currently under study.

(Source: The above content is extracted from documents produced by Canadian Mental Health Association)

「精神受創後壓迫症」

因境是人生的一部份。我們都要面對艱難的處境，如憂傷或在個人及專業關係上的衝突，並學習繼續前進。但是有些時候，人所經歷的事是無法預料及令人崩潰以致對他們帶來嚴重及持續的影響，即使危害身體的事已經過去。有此種經歷的人可能會倒閃(flash back)及做惡夢，那個令他們產生畏懼及恐慌的情境不斷重複地逞現在他們眼前。他們可能在情緒上變得麻木。當此種情形持續超過一個月之久，這種病徵就被診斷為「精神受創後壓迫症」。

甚麼引起「精神受創後壓迫症」?

「精神受創後壓迫症」是由一件涉及真實或恐嚇死亡或嚴重傷害自己或別人的心理創傷事件激發而起。這些導引的事件被稱為「引發成因」(stressors) ，可能由個人或集體所經歷。

遭受個人的暴力欺壓，如：強姦或行兇搶劫、汽車或飛機意外、軍事戰鬥、工業意外及天災，如：地震，颶風都是引發成因能導致人們經歷「精神受創後壓迫症」。 在一些個案中，目擊別人遭受傷害或被殺，或知悉密友或家人陷於極之危險的境況中都會引發此病。

「精神受創後壓迫症」的病徵是甚麼?

「精神受創後壓迫症」通常於創傷事件發生三個月內開始。然而，有些時候症狀會在多年才浮現出來。「精神受創後壓迫症」的為期及程度各有不同。有些人六個月內就可以痊癒，但是有些人則需要較長的時間。

此病有三個類別的病徵：

• 第一種是重新經歷事件的發生。這是「精神受創後壓迫症」最主要特徵，並可以在不同情況下發生。最普遍的是當事人對那慘痛的經歷記憶猶新，並重覆地作夢及回閃事發過程，以致他或她重活在悲痛中。任何能使當事人想起那慘痛經歷或情況的週年，都會令他或她感到極之不自在。
• 逃避及情緒上的麻木是第二種病徵。前者發生於「精神受創後壓迫症」病患者逃避接觸一些可能會令當事人想起他或她傷痛的事件。在情緒上感到麻木的病徵，一般於事發後不久便開始。「精神受創後壓迫症」病患者可能會脫離朋友及家人，他們也可能會對某些以前所喜愛的活動失去興趣，並且難於感受情緒，尤其與親暱有關的行為。感受極度的罪咎感也是很普遍。在某些罕有的個案中，當事人可能會進入持續數分鐘至數日之久的分離狀態，而在那段期間，當事人相信歷史正在重演，以致他們表現得像事發當時的情形。
• 第三種的病徵涉及睡眠規律的變化及警覺性提高。失眠是很普遍的，而有些「精神受創後壓迫症」的病患者感到在工作上或完成任務上難以專注。同時也可以引致侵略性行為的增加。

怎樣治療「精神受創後壓迫症」

藥物能幫助「精神受創後壓迫症」病患者常感受到的憂鬱及焦慮，並能輔助病人重整正常的睡眠規律。

認知行為治療法及集體治療法似乎對「精神受創後壓迫症」病患者較為見效。這些治療法通常由對某種創傷有治療經驗的治療師執行，如負責強姦個案的輔導員。揭露治療法也是有益的。病患者在受控制的環境下再度經歷受創的過程以面對此創傷。

「精神受創後壓迫症」的起因及治療的研究不斷在進行中。決定那些療法最適用於治療某類創傷亦正在研究中。

(資料來源: 以上內容採納自加拿大精神健康協會所提供的資料)