Definition
Post-traumatic
stress disorder (PTSD) is a psychiatric illness that can occur following a
traumatic event in which there was threat of injury or death to you or someone
else.

Causes, incidence,
and risk factors
(PTSD) may
occur soon after a major trauma, or can be delayed for more than six months
after the event. When it occurs soon after the trauma it usually resolves after
three months, but some people experience a longer-term form of the condition,
which can last for many years.
PTSD can
occur at any age and can follow a natural disaster such as flood or fire, or
events such as war or imprisonment, assault, domestic abuse, or rape. The
terrorist attacks of Sept. 11, 2001, in the U.S. may have caused PTSD in some
people who were involved, in people who witnessed the disaster, and in people
who lost relatives and friends. These kinds of events produce stress in anyone,
but not everyone develops PTSD.
We do not
know what causes PTSD, but psychological, genetic, physical, and social factors
are involved. PTSD alters the body s response to stress by affecting stress
hormones and neurotransmitters (chemicals that transmit information between our
nerves). Previous exposure to trauma may increase the risk, which suggests that
this kind of a reaction may be a learned response.
Having good
social support helps to protect against developing PTSD. In studies of Vietnam
veterans, those with strong support systems were less likely to develop PTSD
than those without social support.
People with
PTSD re-experience the event again and again in at least one of several ways.
They may have recurrent distressing dreams and recollections of the event, a
sense of reliving the experience (referred to as flashbacks), and/or become
very distressed around the time of events that symbolize the event (such as
anniversaries).

Symptoms
Symptoms of PTSD fall into three
general categories:
1. Repeated "reliving" of
the event, which disturbs day-to-day activity
- Recurrent distressing memories of the event
- Recurrent dreams of the event
- Flashback episodes, where the event seems to be
recurring
- Bodily reactions to situations that remind them
of the traumatic event
2. Avoidance
- Inability to remember important aspects of the
trauma
- Lack of interest in normal activities
- Feelings of detachment
- Sense of having no future
- Emotional "numbing", or feeling as
though they don t care about anything
- Reduced expression of moods
- Staying away from places, people, or objects that
remind them of the event
3. Arousal
- Irritability or outbursts of anger
- Sleeping difficulties
- Difficulty concentrating
- Exaggerated response to things that startle them
- Hypervigilance
Other
symptoms that may be associated with this disease include a sense of guilt
about the event (including "survivor guilt"), and the following
symptoms, which are typical of anxiety, stress, and tension:
- Paleness
- Feeling your heart beat in your chest, called palpitations
- Headache
- Fever
- Fainting
- Dizziness
- Agitation, or excitability

Signs and tests
There are
no tests that can be done to make the diagnosis of PTSD. The diagnosis is made
based on a certain set of symptoms that persist after a history of extreme
trauma. Your doctor will do psychiatric and physical examinations to rule
out other illnesses.

Treatment
The aim of
treatment is to reduce symptoms by encouraging the affected person to recall
the event, to express feelings, and to gain some sense of mastery over the
experience. In some cases, expressing grief helps to complete the necessary
mourning process. Support groups provide a setting where people who have had
similar experiences can share feelings, and are very helpful.
Depression,
alcohol or substance abuse (which commonly occur with PTSD), or associated
medical conditions, may need to be treated before symptoms of PTSD can be
effectively addressed. Behavioral therapy, a type of talking therapy, may be
used to treat avoidance symptoms. This can include graded exposure and flooding,
which means that the person is frequently exposed to the object that triggers
symptoms, until he/she becomes accustomed to it, and no longer avoids it.
Medicines
that act on the nervous system may be used to reduce anxiety and other
associated symptoms. Anti-depressants, including selective serotonin reuptake
inhibitors (SSRIs) such as fluoxetine (Prozac) have been found to be
effective in treating PTSD, although a doctor must monitor their use as they
can have side effects. Sedatives can help with sleep disturbance.
Anti-anxiety medicines may be useful, but some types, such as benzodiazepines, can be
addictive.

Expectations
(prognosis)
The best
prognosis, or outcome, depends on how soon the symptoms develop after the
trauma, and on early diagnosis and treatment.

Complications
- Depression, anxiety,
and phobia, or fear of things
that are not usually frightening to other people, may accompany this
disorder
- Alcohol abuse and/or drug abuse

Calling your
health care provider
While
traumatic events like the September 11 tragedy can cause distress, not all
feelings of distress are symptoms of PTSD. You should talk about your feelings
with friends and relatives. If your symptoms persist longer, or are worse, than
those of your friends, you should contact your doctor.
You should
seek help immediately by going to the emergency room or calling the local
emergency number (such as 911) if you are feeling overwhelmed by guilt, if you
are impulsive, thinking of hurting yourself, unable to contain your behavior,
or if you are experiencing other very distressing symptoms of PTSD.
You can
also contact your doctor for help with ongoing problems such as recurrent
thoughts, irritability, and problems with sleep.

Prevention
Counseling
and crisis intervention soon after the event are important for people who
have experienced extremely stressful situations. They could help prevent
longer-term forms of PTSD and should be part of public health responses to
groups at risk, such as disaster victims.
Source: http://www.healthline.com/adamcontent/post-traumatic-stress-disorder
Support Groups
Additional
information about post-traumatic stress disorder and coping with a national
tragedy is available from the American Psychiatric Association.
Orgz and other Resources
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California Cannabis Research Medical Group (CCRMG) * (ORG, inf) Winter/Spring 2005 - O'Shaughnessy's; Journal of the California Cannabis Research Medical Group. Letter from a Soldier - Is Cannabis Recommended for
PTSD? - Hello Dr. Mikuriya, I have recently returned home
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News
and Information
California Cannabis
Research Medical Group (CCRMG)
| (ORG, Articles) O'Shaughnessy's - Spring
2006 - Journal of the California Cannabis Research Medical Group
... PTSD and Cannabis: A Clinician Ponders Mechanism of Action, By David Bearman, MD. One often
intractable problem for which cannabis provides relief is post-traumatic stress
disorder (PTSD). I have more than 100 patients with PTSD. Among those reporting that cannabis
alleviates their PTSD symptoms are veterans of the war in Vietnam, the first
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victims of family violence, rape and other traumatic events, and children
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Visit: http://www.ccrmg.org/journal/06spr/perspective2.html
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PTSD follow-up ? Is PTSD an anxiety syndrome best treated by cannabis? ...
In that connection, an NPR report on PTSD
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News and Facts * "PTSD Rates for Current Wars May Top Vietnam," Cox News
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The Razor Wire, Vol. 8, No. 3: In
The News * Cannabis for PTSD - To help treat returning Iraqi
combat soldiers, California's Dr. Tod Mikuriya gave this online advice to a
returning Iraq War vet for coping with Post Traumatic Stress Syndrome or
PTSD: "Medically, cannabis is the
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http://www.november.org/razorwire/2005-02/InTheNews.html
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MAPS in the Media: Recent and
Archival * Doblin speculates on the possibility of conducting MDMA /
PTSD research with tsunami victims
The press release mentioned MAPS-sponsored
research evaluating MDMA-assisted therapy as a treatment for posttraumatic
stress disorder (PTSD)
visit: http://www.maps.org/media/
Cannabis as Medicine
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