I’ve heard countless stories of people who lost their jobs, moved, lost their loved ones at COVID-19 in last year’s pandemic year, and felt the whole world confused by this restriction and blockade. The world has been imposed on us all. These people are constantly stressed and sometimes reach their limits. They aren’t working well. They are frustrated, depressed and anxious. They can’t eat and sleep very little. They have little desire to do something and lose the joy they felt for almost everything. They come to see me, talk about them, and tell me what they think the problem is and what I need to treat them for.
“I have PTSD,” they tell me, this is the diagnosis that this pandemic has plagued them, as well as one or two drugs that fix things, to recovery and mental health. I’m sure I’ll take them on the fast road. But wait, is it really PTSD, or should they be the ones they are suffering from, as the diagnosis most people know is simply related to trauma?
This week I would like to talk about two types of stress reactions that are very confusing. Most of the information I’m trying to share with you can be found in UpToDate, a medical resource that brings together the latest research and knowledge on a variety of topics and illnesses.
The first disorder is ASD, or acute stress disorder. ASD is an acute stress response that occurs within a month of the traumatic event that causes it. The prevalence of this disorder is 5-20%. What trauma can lead to ASD? 13% of those who had a serious car accident, 16% of the victims of the assault, and, most horrifyingly for all of us in the last month or two, 33% of those who witnessed the shooting Experience Risk factors for developing ASD include being a woman, having a variety of existing mental and physical illnesses, having a history of previous trauma, and being exposed to more serious trauma in the first place. included. Trauma experienced by someone can cause a very temporary reaction, not ASD, and return to normal very quickly. On the other hand, it can lead to ASD and then return to normal pre-traumatic life within a month. However, some groups can develop PTSD, or post-traumatic stress disorder. As we will see later, these people may suffer from long-term life-changing effects.
What are the symptoms of ASD? As with anxiety, re-experiencing traumatic events is common. Nightmares and vibrant dreams can affect sleep. Repetitive thoughts and heightened fear can occur. Sometimes there is hypervigilance that protects you from further threats. You may avoid people, places, things that remind you of trauma, and flat features begin emotional paralysis. Separation, isolation, and social avoidance from others complete the picture of someone who feels terrible but has a great deal of difficulty communicating and sharing this, along with others, they are most Even close people.
Good news? Most people who experience different types of traumatic events have a short period of symptoms and adaptation, then adapt within days to weeks and return to their previous functional level. Some studies have shown that 40-80% of people with ASD continue to develop PTSD. The bright side, of course, is that almost half are not.
How is ASD diagnosed? Simply put, there must be some necessary symptoms. The first is exposure to trauma, either directly as a witness or being informed about dangers or injuries to loved ones. Intrusive symptoms include dreams, memories, and flashbacks. I feel negative. There may be dissociative episodes. Avoidance seeks to prevent recurrent trauma. Finally, arousal leads to decreased sleep, irritable bowel syndrome, and increased startle reflexes. ASD may begin shortly after trauma, but it is usually best to diagnose it after 3 days or more.
How about PTSD? How is it different? Diagnosed after 4 weeks of symptoms after a traumatic event. The two types of events most likely to lead to PTSD are 33% sexual trauma (which may include child sexual abuse, rape and domestic violence) and 30% interpersonal trauma (spouse). Death or child). The lifetime prevalence of PTSD can be as high as 6-9%. In one sample of 5,692 adults in the United States, 83% were exposed to severe traumatic events, but only 8.3% developed lifelong symptoms of PTSD. Very specific groups, such as Native Americans and refugees from other countries with endemic abuse and stress, are at increased risk of PTSD. Gender, age, education level, history of previous abuse, and inadequate social support can also increase the risk of developing PTSD. Women are four times more likely to suffer from PTSD than men. The more severe the symptoms at 1 month, the more likely they are to predict more severe PTSD symptoms after 6 months.
Diagnosis of PTSD is similar to ASD, requiring exposure to traumatic events, often with intrusive symptoms such as re-experience and flashback, and avoidance. Depression, diminished interest in activity, guilt, and disconnection from others are often seen. People feel awkward, reckless and frustrated, and tend to behave dangerously and make bad decisions. There may be more severe depersonalization, derealization, or even some amnesia in traumatic events.
PTSD tends to be a chronic disorder in many people. One-third recovers with one year of follow-up, while another one-third may remain symptomatic 10 years after trauma. Some studies have shown that patients with PTSD have inadequate social support, increased disability, and are unable to meet their higher education goals.
Now, what does this mean for dozens, if not hundreds, of people who told me they have PTSD because they are traumatized and anxious because of a pandemic? ?? The very good news is that the majority of us will feel the initial anxiety when traumatized in this way, but most of us will recover in a very short time. I hope to return to my pre-COVID life someday and I am very much looking forward to it. Those who continue to develop more severe anxiety and other related symptoms of PTSD should, of course, seek treatment as needed for what can be a chronic and debilitating illness.