CBT Therapy : Trauma (PTSD)
Effective Treatment For: Anxiety
What Is Post Traumatic Stress Disorder or PTSD?
Post Traumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.
PTSD has been known by many names in the past, such as “shell shock” during the years of World War I and “combat fatigue” after World War II. But PTSD does not just happen to combat veterans. PTSD can occur in all people, in people of any ethnicity, nationality or culture, and any age. PTSD affects approximately 3.5 percent of U.S. adults, and an estimated one in 11 people will be diagnosed PTSD in their lifetime. Women are twice as likely as men to have PTSD.
People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.
A diagnosis of PTSD requires exposure to an upsetting traumatic event. However, exposure could be indirect rather than first hand. For example, PTSD could occur in an individual learning about the violent death of a close family. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.
- Symptoms and Diagnosis
Symptoms and Diagnosis
Symptoms of PTSD fall into four categories. Specific symptoms can vary in severity.
- Intrusive thoughts such as repeated, involuntary memories; distressing dreams; or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes.
- Avoiding reminders of the traumatic event may include avoiding people, places, activities, objects and situations that bring on distressing memories. People may try to avoid remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
- Negative thoughts and feelings may include ongoing and distorted beliefs about oneself or others (e.g., “I am bad,” “No one can be trusted”); ongoing fear, horror, anger, guilt or shame; much less interest in activities previously enjoyed; or feeling detached or estranged from others.
- Arousal and reactive symptoms may include being irritable and having angry outbursts; behaving recklessly or in a self-destructive way; being easily startled; or having problems concentrating or sleeping.
Many people who are exposed to a traumatic event experience symptoms like those described above in the days following the event. For a person to be diagnosed with PTSD, however, symptoms last for more than a month and often persist for months and sometimes years. Many individuals develop symptoms within three months of the trauma, but symptoms may appear later. For people with PTSD the symptoms cause significant distress or problems functioning. PTSD often occurs with other related conditions, such as depression, substance use, memory problems and other physical and mental health problems.
(See information on Acute Stress Disorder below.)
Acute Stress Disorder
Acute stress disorder occurs in reaction to a traumatic event, just as PTSD does, and the symptoms are similar. However, the symptoms occur between three days and one month after the event. People with acute stress disorder may relive the trauma, have flashbacks or nightmares and may feel numb or detached from themselves. These symptoms cause major distress and cause problems in their daily lives. About half of people with acute stress disorder go on to have PTSD.
An estimated 13 to 21 percent of survivors of car accidents develop acute stress disorder and between 20 and 50 percent of survivors of assault, rape or mass shootings develop it.
Psychotherapy, including cognitive behavior therapy can help control symptoms and help prevent them from getting worse and developing into PTSD. Medication, such as SSRI antidepressants can help ease the symptoms.
*From Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
“Before I had CBT Therapy I was so anxious as I just couldn’t stop worrying about my children. It was causing problems for me and them. I was texting them all the time to see if they were safe. Thanks to the CBT Therapy I learned to manage my worry and worry less. Things are so much better now for me and my kids. I’m so much less anxious and my children are free again to live their lives.”
Sue, IT Manager
2: Do I have GAD?
Symptoms – Generalised anxiety disorder in adults
Generalised anxiety disorder (GAD) can affect you both physically and mentally.
How severe the symptoms are varies from person to person. Some people have only a few symptoms, while others have many more.
Psychological symptoms of GAD
GAD can cause a change in your behaviour and the way you think and feel about things, resulting in symptoms such as:
- a sense of dread or fear
- feeling constantly “on edge”
- difficulty concentrating
Your symptoms may cause you to withdraw from social contact (seeing your family and friends) to avoid feelings of worry and fear.
You may also find going to work difficult and stressful and may take time off sick. These actions can make you worry even more about yourself and increase your lack of self-esteem.
Physical symptoms of GAD
GAD can also have a number of physical symptoms, including:
- a noticeably strong, fast or irregular heartbeat (palpitations)
- muscle aches and tension
- trembling or shaking
- dry mouth
- excessive sweating
- shortness of breath
- stomach ache
- feeling sick
- pins and needles
- difficulty falling or staying asleep (insomnia)
Citation: NHS Website
GAD does not have a single cause. Your genes, social environment and life experiences all play a role, and interact with each other. If you have a close family member with GAD, you are four to six times more likely to develop an anxiety disorder. However, no single gene causes anxiety disorders. Instead, multiple genes, each having a small effect, interact to increase your risk.
Psychological treatments for Generalised Anxiety Disorder (GAD):
Both Cognitive Behavioural Therapy (sometimes shortened to CBT Therapy) and Applied Relaxation involve weekly meetings with a CBT Therapist for about 3 to 4 months.
CBT Therapy helps you to understand how your problems, thoughts, feelings and behaviour affect each other. It can also help you to question your negative and anxious thoughts and do things you would usually avoid because they make you anxious.
Applied Relaxation involves learning how to use muscle relaxation techniques when you are feeling anxious or in situations that could make you feel anxious. Your healthcare professional will help you to gradually encounter and cope with these situations.
If you do not think that the course of CBT Therapy or applied relaxation has helped you, you should be offered medication.
Intolerance of Uncertainty
Positive Beliefs About Worry
Generalised anxiety disorder F41.1
21. The essential feature is anxiety which is not restricted to any particular environment
or stressful event. The anxiety symptoms are often said to be “free-floating” in this
situation. There is pervasive worry with ideas such as fear of illness in the sufferer or
in members of their family. In addition there are feelings of nervousness and
apprehension with physical symptoms such as light-headedness, muscular tension,
inability to relax, palpitations, dizziness and sweating.
22. The diagnostic criteria in ICD-10 in brief are:
22.1. That there must be a period of at least 6 months in which there has been
prominent tension, worry and apprehension about everyday problems.
22.2. In addition there are at least four of the symptoms of anxiety listed in
paragraph 10.1-10.4 above.
22.3. In addition there is muscle tension, restlessness and inability to relax, feeling
“on edge” or tense, a sensation of a lump in the throat or difficulty
swallowing. There may also be an exaggerated response to being startled,
difficulty concentrating, persisting irritability and difficulty getting to sleep
because of worrying.
22.4. Similar symptoms can be caused by physical disorders such as
hyperthyroidism, the consumption of amphetamines or withdrawal from
benzodiazepines. To be diagnosed as generalised anxiety disorder none of
these physical disorders must be present.
22.5. The sufferer must have the symptoms on most days, for at least several
weeks at a time (and usually for several months).
23. The disorder also appears in DSM-IV. However at least six symptoms must be
present (as opposed to four in ICD-10). It has also been noted that the condition is
very difficult to diagnose, different diagnosticians varying greatly in their opinions as
the symptoms are very common in many other psychiatric disorders.
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CBT Therapist London
This article was curated by Alistair Bond – Senior CBT Therapist in London. He is the Clinical Director of the CBT Clinic London and he specialises in treating Generalised anxiety Disorder (GAD) with CBT Therapy.
If you or a loved one are struggling with Generalised anxiety Disorder (GAD), please get in touch with us. You can call our friendly reception team on 0207 157 9924, email firstname.lastname@example.org or simply fill out our new patient registration form and we’ll get back to you.
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