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Post-traumatic stress disorder (PTSD) was initially recognised from military psychiatry. It follows exposure to a traumatic event that is often exceptionally threatening to themselves or others.
PTSD may develop following one or repeated exposures to traumatic events.
It is characterised by having recurrent distressing memories or flashbacks of the event(s).
3 in 100 people may develop PTSD during their life.
PTSD usually begins within 6 months following the event.
The most common symptoms involve re-experiencing the event via flashbacks, nightmares or intrusive memories.
Additional symptoms include:
By definition, PTSD is caused by experiencing extreme trauma. It is much more common in certain groups including fire-fighters, military personnel and rape victims.
Risk factors include:
PTSD is diagnosed from speaking to a patient to understand their symptoms in full.
Questionnaires are a commonly used tool to assess the severity of PTSD. They are also useful in monitoring response to treatment.
Post-Traumatic Stress Disorder (PTSD) Treatment
Simple approaches including exercise, improved sleep hygiene, and self-help can improve symptoms and reduce the impact on quality of life, particularly for mild symptoms.
Most patients will also benefit from an element of psychological therapy, including counselling, cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR).
Medical management primarily involves the use of anti-depressants (e.g. paroxetine, mirtazepine). Benzodiazepines (e.g. diazepam) are occasionally used to reduce heightened anxiety states.
Medicinal cannabis can be considered when first line therapies have not achieved adequate benefit in symptoms or quality of life.
