Post traumatic stress disorder

Also called battle fatigue syndrome, post traumatic stress disorder or PTSD can occur in a person after severe physical injury/abuse. This entails lasting consequences from some kind of a trauma - physical or mental. Trauma could mean anything from death of a loved one to natural disaster to physical hurt or abuse.

Most often people facing a trauma may experience fear, panic, shock, anger, nervousness and these conditions settle down on their own after sometime. However a person experiencing PTSD suffers persistent reactions. It may even appear as if the reactions are increasingly getting stronger. This was more commonly noticed in war veterans and hence was referred to as battle fatigue syndrome. This condition is also noticed in people who have experience physical or sexual abuse. About 5.2 million people across the world suffer this condition.

Symptoms of PTSD

Symptoms of PTSD depend upon the duration of the illness or trauma. It may vary from person to person and also depends upon the type of abuse. In general people have been classified into three categories depending on how they react and behave.

Reliving or re-experiencing: These people relive the trauma repeatedly, as though it has just happened. Reliving can happen through flashback, nightmares and hallucinations. They experience additional stress when certain triggers remind them of the entire trauma.

Avoiding: The person tries to avoid places, people or things that may have caused the trauma or remind them of it. Such people may cut off contact from their family and friends and would prefer spending time in isolation. They may feel completely detached and may also stop enjoying activities once they loved doing.

Increased arousal: The person may experience increased emotions, worsening inter-personal relations, irritability, sudden outbursts of anger, trouble staying focused and difficulty in concentration. A few physical symptoms such as increased heart rate, muscle tension, increased blood pressure and rapid breathing may show up.

Though there is no particular lab test or diagnosis for PTSD, it can be diagnosed by examining the patient and understanding the conditions that might have led to this. With no relevant physical complication, the patient may be referred to a mental healthcare professional like a psychiatrist or psychologist. These professional use specially designed tests to identify the level of stress and offer treatment accordingly. Treatment will depend upon the level of disorder and will include therapy and medications. Depending on the severity, treatment may include:

Psychotherapy: Therapy will guide the person to develop skills so as to manage the stress. These include cognitive behavior therapy, group therapy, psycho dynamic therapy, family therapy and exposure therapy. Depending on the intensity and requirement, therapy is chosen for the person.

Medications: Medications include antidepressants and anti-anxiety drugs. Depending on the severity, drugs are prescribed.

EMDR

EMDR is an acronym for Eye movement desensitization and reprocessing. It's an exercise as well as a psychotherapy used widely to deal with psychological issues, particularly trauma that may stem after military combat, physical assault, rape or car accidents. The aim of EMDR is to reduce the stress, resolve the trauma and shift from negative to positive outlook.

EMDR Principle

The technique was developed in 1987 by Dr. Sharpine Shapiro. She observed that eye movements can reduce the intensity of disturbing thoughts; gradually the stress reaction too diminishes. Thus, the EMDR principle stresses the importance of using eye movements to stimulate certain parts of the brain to release emotional experiences that are stored in memory and deeply rooted in the nervous system. The aim is to help individuals liberate from the past and enjoy calm, productive emotional health. In other words, EMDR helps 'unlock' negative memories and helps the brain to successfully process the experience and march forward with a balanced emotional health.

EMDR is used in the treatment of PTSD (Post Traumatic Stress Disorder) and trauma. EMDR is recommended as effective treatment for trauma in the Practice Guidelines of the American Psychiatric Association and in Departments of Defense, Veterans Affairs and The International Society for Traumatic Stress. Addiction treatment is yet another area where EMDR is widely used. High degree of effectiveness has been shown in applying EMDR to conditions such as:

• Trauma
  
• Bereavement
  
• Pain disorders
  
• Disturbing memories
  
• Excessive grief
  
• Fear (Assault, crime, robbery, natural disaster etc)
  
• Illness
  
• Childhood abuse
  
• Sexual abuse
  
• Performance anxiety
  
• Depression
  
• Phobia
  
• Low-self esteem
  
• Relationship issues
  
• Insomnia

Forensic Psychiatrist

Forensic psychiatry is a sub specialty of psychiatry and specialists of forensic psychiatry undergo special training in psychiatry and later in forensic psychiatry and relate psychiatric facts to queries raised by the legal constitution. Forensic psychiatrists put together medicinal experience, medical know how, mental health and neuroscience and structure free opinions. This opinion formulated is used as a principal advice in court room testimony. Forensic psychiatrists can practice in hospitals too. Forensic psychiatrists are specialists in diagnosing and treating mental illness or strain:

• Forensic psychiatrist attend to people who are disturbed mentally while in custody and treat conditions called Post-Traumatic Stress Disorder (PTSD). They can understand the in-depth personality of a person and can easily differentiate between original and false trauma.
  
• They are trained professionals in the area of psychological autopsy to establish the reason of the death.
  
• They handle patients who complain of sexual harassment by their health provider and handle cases of medical malpractice too.
  
• They can certify criminals who are truly mentally unstable and help the court in approaching a conclusion on sentence of the criminal. They also help in determining whether any criminal is falsely claiming a crime that he has not committed at all.
  
• Forensic psychiatrists are good in witness assessment, managing client, choosing adjudicators, training a witness, and finally in witness trustworthiness.

A forensic psychiatrist has to undergo specialized qualifications apart from the qualifications of being a psychiatrist.

• Should complete medical school and hold a degree.
  
• Should complete four years of specialized training in the field of psychiatry.
  
• Apart from this, a forensic psychiatrist should hold additional qualification in forensic psychiatry.
  
• Should hold a valid license and should be certified by a certified board.

Choose the right forensic psychiatrist

Forensic psychiatrists are generally found to be associated with the law and its associates. They do not practice in clinics like other specialists do. When the law is looking for forensic psychiatrists to work with the criminals and accused, they have to ensure

• The person chosen is a certified forensic psychiatrist and has the ability to assess the criminal/accused and relate it in the terms of the law.
  
• The psychiatrist should hold a valid license.
  
• The psychiatrist should be a member of a recognized and certified board.
  
• The person should have additional qualifications in clinical issues to handle sexual harassment cases, child custody cases etc.
  

Tags: #Post traumatic stress disorder #EMDR #Forensic Psychiatrist