After people experience a very stressful event, they may feel that they should be able to move on and "just handle it" or "get over it." Some experiences, however, are so traumatic that people have serious problems coping and functioning in their daily lives afterward. They may have posttraumatic stress disorder (PTSD). The August 2, 2006, issue of JAMA includes articles about PTSD among adults and children affected by natural disasters. This Patient Page is based on one previously published in the August 1, 2001, issue of JAMA.
Posttraumatic stress disorder is the development of characteristic and persistent symptoms along with difficulty functioning after exposure to a life-threatening experience.
Intrusion—memories of the trauma or "flashbacks" that occur unexpectedly; these may include nightmares or physical reactions such as a racing heart
Avoidance—avoiding people, places, thoughts, or activities that bring back memories of the trauma; this may involve feeling numb or emotionless, withdrawing from family and friends, or "self-medicating" by abusing alcohol or other drugs
Hyperarousal—feeling "on guard" or irritable, having sleep problems, having difficulty concentrating, feeling overly alert and being easily startled, having sudden outbursts of anger
People with military combat experience or civilians who have been harmed by war
People who have been raped, sexually abused, or physically abused
People who have been involved in or who have witnessed a life-threatening event
People who have been involved in a natural disaster, such as a tornado or an earthquake
Cognitive behavioral therapy with a trained psychiatrist, psychologist, or other professional can help change emotions, thoughts, and behaviors associated with PTSD and can facilitate managing panic, anger, and anxiety.
Certain medications can reduce symptoms such as anxiety, impulsivity, depression, and insomnia and decrease urges to use alcohol and other drugs.
Group therapy can help patients learn to communicate their feelings about the trauma and create a support network.
Becoming informed about PTSD and sharing information with family and friends can create understanding and support during recovery.
American Psychiatric Associationhttp://www.psych.org/public_info
Anxiety Disorders Association of Americahttp://www.adaa.org
National Center for Posttraumatic Stress Disorderhttp://www.ncptsd.org
National Institute of Mental Health/Anxiety Disorders Education Programhttp://www.nimh.nih.gov
Posttraumatic Stress Disorder Alliancehttp://www.ptsdalliance.org
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com.
Sources: American Psychiatric Association, Anxiety Disorders Association of America, National Center for Posttraumatic Stress Disorder, National Institute of Mental Health, Posttraumatic Stress Disorder Alliance, Sidran Foundation
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: POSTTRAUMATIC STRESS DISORDER
Stevens LM, Lynm C, Glass RM. Posttraumatic Stress Disorder. JAMA. 2006;296(5):614. doi:10.1001/jama.296.5.614