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jeudi 23 octobre 2014

Criteria For Telepsychiatry For Post Traumatic Stress Disorder

By Young Lindsay


It was then called shell shock, combat exhaustion, nostalgia, railroad spine. History has given it so many names, but all described the same set of behavior when a person has experienced or witnessed a very traumatic event. Now, it is recognized as a medical condition and in some countries, people who have the disorder are considered legally invalid or disabled.

When the official term for long term trauma entered the vocabulary in 1980, so did the many interventions designed to manage the condition. In recent years, telepsychiatry for post-traumatic stress disorder is used to bridge connections and treat hard to reach patients and contact further support. But let us take a look at the syndrome itself in order to understand and to determine whether someone we know needs help.

Witnessing or experiencing something terrible such as a crime or an accident is enough fuel for some people to have PTSD. Surviving catastrophes, such as earthquakes or typhoons, or being in a war zone will also cause people to be at risk, although some people are more resilient than others. Resiliency signs include effective coping strategies, calm in the face of harm, having great social support, and the ability to respond well to dangerous situations. Those who are prone to PTSD are more likely to feel helpless, anxious, extremely fearful, and have little or no help after a traumatic event.

Scientists have been focusing on genes and brain areas in their roles in dealing with fear and trauma. Stathmin, for example, is a protein in genes that are needed in the formation of fear memories. During an experiment, mice who have no stathmin are less prone to freeze when in danger, and show lesser fear compared to their stathmin producing fellows.

Certain brain areas are also in charge of dealing with trauma and fear. When we our afraid, our amygdala takes care of what kind of emotion, learning, and memory will be produced. Meanwhile, when it comes to judgment and resolutions, our prefrontal cortex acts as the frontier. Studying genes and the human brain is the key to unlocking the probability of PTSD before it can be developed or triggered.

For someone to qualify for diagnosis, one should have at least one reexperiencing symptom. This includes very vivid flashbacks and nightmares, extremely scary and terrible thoughts, and reliving the experience from time to time. These symptoms are triggered even by the most non suspicious object, word, or situation, as long they remind the person of the traumatic event.

Avoidance symptoms such as being numb emotionally, staying away from objects or places that remind them of the terrible experience, feelings of guilt, anxiety and depression, and such can make a patient modify his daily routine in order to keep himself away from all the reminders. He might also lose interest in the things he used to enjoy before the traumatic event. He may also have trouble in recalling the details of the said event.

Hyperarousal symptoms consist of always feeling on the edge, tension, being surprised or startled easily, experiencing outbursts, and insomnia. These are constant symptoms and do not need triggers to happen. A person with PTSD may have trouble accomplishing daily tasks such as sleeping, concentrating, and even eating. Because these signs are normal after a tragic event, they can be called acute stress disorder rather than PTSD.

People who have reached all three requirements for diagnosis must undergo therapeutic sessions, most notably cognitive behavioral therapy. Psychiatrists may also prescribe the approved drugs such as sertraline and paroxetine. For utter prevention, critical incident stress debriefing has been imposed immediately after a traumatic event to halt the possibility of PTSD.




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