Post traumatic stress disorder

Anxiety disorders

Clinicals - History

Fact Explanation
Flashbacks The patient feels as though the traumatic event is repeating itself and that he is reliving the experience. It occurs in the form of a visual experience. It is due to spreading activation in the pathological network of memory. This network is easily triggered and the activation of a component of the trauma memory will in turn activate the entire network including emotional aspects. Flashbacks
The patient feels as though the traumatic event is repeating itself and that he is reliving the experience. It occurs in the form of a visual experience. It is due to spreading activation in the pathological network of memory. This network is easily triggered and the activation of a component of the trauma memory will in turn activate the entire network including emotional aspects.
Nightmares Nightmares are often related to the traumatic event. It occurs as a result of activation in the pathological network of memory. When the component of the trauma memory is activated, it will in turn activate the entire network, including emotional aspects. Nightmares
Nightmares are often related to the traumatic event. It occurs as a result of activation in the pathological network of memory. When the component of the trauma memory is activated, it will in turn activate the entire network, including emotional aspects.
Intrusive thoughts Recurrent distressing thoughts of the traumatic experience occur in the mind of the person despite his attempts to stop them. This phenomenon occurs due to the spreading activation in the pathological network of memory. Intrusive thoughts
Recurrent distressing thoughts of the traumatic experience occur in the mind of the person despite his attempts to stop them. This phenomenon occurs due to the spreading activation in the pathological network of memory.
Avoidance Patients try to push memories of the event out of their minds and avoid thinking about it. Thus it will maintain the conditioned fear response to the reminder of the traumatic event. Avoidance
Patients try to push memories of the event out of their minds and avoid thinking about it. Thus it will maintain the conditioned fear response to the reminder of the traumatic event.
Hyper arousal symptoms: Irritability, Difficulty in sleeping, Anxiety It's due to enhanced secretion of adrenaline and noradrenaline to stress. As a result the sympathetic nervous system of the patient is activated, giving rise to the mentioned symptoms. Hyper arousal symptoms: Irritability, Difficulty in sleeping, Anxiety
It's due to enhanced secretion of adrenaline and noradrenaline to stress. As a result the sympathetic nervous system of the patient is activated, giving rise to the mentioned symptoms.
Traumatic life events This condition results as a direct consequence of exposure to a traumatic event. However not all individuals develop it. Those with risk factors are at a greater risk of developing it. The risk factors can be categorized into environmental, demographic , prior psychiatric disorders and cognitive.

Environmental- Previous exposure to chronic stress, Poor social support

Demographic- Being a female

Previous psychiatric disorders- Anxiety,
Substance abuse, Personality disorders

Cognitive- Low IQ .
Traumatic life events
This condition results as a direct consequence of exposure to a traumatic event. However not all individuals develop it. Those with risk factors are at a greater risk of developing it. The risk factors can be categorized into environmental, demographic , prior psychiatric disorders and cognitive.

Environmental- Previous exposure to chronic stress, Poor social support

Demographic- Being a female

Previous psychiatric disorders- Anxiety,
Substance abuse, Personality disorders

Cognitive- Low IQ .

Clinicals - Examination

Fact Explanation
Appearance and behavior - Exaggerated startled response, Agitation, Hypervigilance This is due to the enhanced secretion of adrenaline and noradrenaline to stress. The sympathetic nervous system is activated as a result of this. Appearance and behavior - Exaggerated startled response, Agitation, Hypervigilance
This is due to the enhanced secretion of adrenaline and noradrenaline to stress. The sympathetic nervous system is activated as a result of this.
Mood - Depressed Depressed mood is common among PTSD patients due to repeated re-experiencing of the traumatic event in everyday life. Mood - Depressed
Depressed mood is common among PTSD patients due to repeated re-experiencing of the traumatic event in everyday life.
Speech - Unaffected. Speech is not usually affected unless the patient is suffering from a concomitant affective disorder. Speech - Unaffected.
Speech is not usually affected unless the patient is suffering from a concomitant affective disorder.
Perception - Illusions, Hallucinations Illusions and hallucinations with relation to the traumatic event may occur as a form of re-experiencing. Perception - Illusions, Hallucinations
Illusions and hallucinations with relation to the traumatic event may occur as a form of re-experiencing.
Cognition - Lack of concentration and attention This is due to the enhanced secretion of adrenaline and noradrenaline to stress. Cognition - Lack of concentration and attention
This is due to the enhanced secretion of adrenaline and noradrenaline to stress.

Management - Supportive

Fact Explanation
Psychological - Stress management Helps in coping with stresses. Psychological - Stress management
Helps in coping with stresses.
Psychological - Psychodynamic therapy Improves patients' understanding of the influence on their past on present behavior. Psychological - Psychodynamic therapy
Improves patients' understanding of the influence on their past on present behavior.
Pharmacological - Benzodiazepines: Clonazepam These agents are effective against anxiety, insomnia and irritability, but they should be used with great caution owing to the high frequency of co-morbid substance dependence in patients with PTSD. Pharmacological - Benzodiazepines: Clonazepam
These agents are effective against anxiety, insomnia and irritability, but they should be used with great caution owing to the high frequency of co-morbid substance dependence in patients with PTSD.
Patient education Nearly every patient can benefit from education, which is started at the time of diagnosis. It helps in better coping with their current stresses. Patient education
Nearly every patient can benefit from education, which is started at the time of diagnosis. It helps in better coping with their current stresses.
Social management Social support is an important initial intervention to engage the patient and reduce the impact of the traumatic event. Local support groups may help to destigmatize the mental health diagnosis and make him realize that the symptoms of PTSD involve more than simply a reaction to stress and that the patient requires treatment. Support from family and friends encourages understanding and acceptance that may reduce survivor guilt. Social management
Social support is an important initial intervention to engage the patient and reduce the impact of the traumatic event. Local support groups may help to destigmatize the mental health diagnosis and make him realize that the symptoms of PTSD involve more than simply a reaction to stress and that the patient requires treatment. Support from family and friends encourages understanding and acceptance that may reduce survivor guilt.

Management - Specific

Fact Explanation
Psychotherapy - Trauma focused cognitive behavioral therapy It addresses the lack of control and the unpredictability inherent in traumatic situations. Thus patients improve their symptoms and behavior as they begin to think and act more realistically with regard to their situational and psychological difficulties. Psychotherapy - Trauma focused cognitive behavioral therapy
It addresses the lack of control and the unpredictability inherent in traumatic situations. Thus patients improve their symptoms and behavior as they begin to think and act more realistically with regard to their situational and psychological difficulties.
Psychotherapy - Eye movement desensitization and reprocessing It helps to activate a cognitive network that helps patients differentiate real threats from imagined threats. Psychotherapy - Eye movement desensitization and reprocessing
It helps to activate a cognitive network that helps patients differentiate real threats from imagined threats.
Pharmacotherapy - Selective serotonin reuptake inhibitor (SSRI) : Paroxetine, Sertralin It reduces the symptoms of the condition, reduces comorbid symptoms and improves the quality of life. SSRI is the 1st line agent used. Paroxetin and Sertralin are the preferred agents. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses. Also if non responding to a particular group, may have to combine with other groups of antidepressants. Pharmacotherapy - Selective serotonin reuptake inhibitor (SSRI) : Paroxetine, Sertralin
It reduces the symptoms of the condition, reduces comorbid symptoms and improves the quality of life. SSRI is the 1st line agent used. Paroxetin and Sertralin are the preferred agents. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses. Also if non responding to a particular group, may have to combine with other groups of antidepressants.
Pharmacotherapy - Mono amine oxidase inhibitor: Phenelzine It reduces the symptoms of the condition. Phenelzine is the preferred agent. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses. Pharmacotherapy - Mono amine oxidase inhibitor: Phenelzine
It reduces the symptoms of the condition. Phenelzine is the preferred agent. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses.
Pharmacotherapy - Tricyclic antidepressants: Amitriptyline It reduces the symptoms of the condition. Amitriptyline is the preferred agent. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses. Pharmacotherapy - Tricyclic antidepressants: Amitriptyline
It reduces the symptoms of the condition. Amitriptyline is the preferred agent. It takes 6 to 8 weeks for these antidepressants to act and patients should be prescribed for at least 1 year to prevent relapses.

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