Dr. Enrique Guerra Gómez, specialist in Psychiatry, explains what post-traumatic stress disorder is and what it consists of, as well as breaking down its ins and outs and its possible treatment.
What is post-traumatic stress disorder?
Post-traumatic stress is post-traumatic stress when the following requirements are met:
- Exposure to (unnatural) death, serious injury or sexual violence, either in actual or threatened form. ( essential criteria).
In addition to meeting one or more of these other criteria:
- Presence of repeated or involuntary distressing memories, related distressing dreams, reactions in which the subject feels or acts as if the trauma is being repeated.
- Continuous avoidance of stimuli associated with the trauma.
- Alterations of mood and/or cognitive faculties associated with the traumatic event.
- Constant state of hypervigilance and emotional reactivity associated with the traumatic event.
It should be noted that the duration of these symptoms should last for at least one month, although it may begin later than six months after the trauma.
What is the difference between post-traumatic stress and emotional stress?
This expression is used especially in colloquial language, not in scientific language.
However, it can be said that emotional stress would be the type of stress that is always accompanied by some kind of emotion: sadness, joy, apathy, irritation, etc.
What are the most common traumatic situations?
These situations vary and depend on the historical moment, as well as social and cultural factors.
In Western culture they can be multiple, although the most common are some of the following:
- Natural disasters
- Attacks
- Traffic accidents with serious consequences for oneself and/or others
- Violations
However, it is important, when establishing whether post-traumatic stress is involved, to assess the nature of the stimulus and not the subjective perception of what is a trauma. For example, a person who is particularly sensitive may consider failing a competitive examination as a trauma (this expression is used in colloquial language). Although this generates a stressful situation, it would not be post-traumatic stress, since such a situation occurs frequently in everyday human experience.
When does chronic post-traumatic stress begin?
It is not possible to establish a time or period, since post-traumatic stress varies according to the type of trauma. For example, in the case of post-traumatic stress caused by a natural catastrophe such as a tsunami, its duration may be many years.
The only way to establish its chronicity is through the statistical mean, that is, if the duration is considerably longer than the average of the population suffering an identical or similar situation.
Treatment of post-traumatic stress
Apart from social support – a fundamental aspect – there are two types of treatment, drug treatment and psychotherapy.
- Drug treatment: there are two drugs with specific indications, which are Paroxetine and Sertraline, in case of no response Venlafaxine would be used.
Depending on the symptoms and signs that appear, anxiolytics, antipsychotics in small doses or beta-blockers may be needed.
- Psychotherapy: the modalities in which there is a greater number of rigorous scientifically proven research are cognitive-behavioral therapy in its multiple variants (systematic desensitization, virtual exposure…) and the so-called systematic desensitization and reprocessing by eye movement.
Some dynamic therapies have also proved effective, such as interpersonal therapy, therapies derived from psychoanalysis or psychodrama.
The setting can be individual or group for psychotherapies to be more effective, the authors recommend that the duration of treatment should not be excessively long, as this would not increase the improvement achieved.
If a person is in this situation, he/she should first consult directly with a psychiatrist (regardless of whether other mental health professionals are also involved in the treatment).