During or immediately after an unusual and traumatic situation, many people become highly anxious and depressed. For some, however, anxiety and depression persist well after the situation is over. These people may be suffering from acute stress disorder or posttraumatic stress disorder, distinct patterns that arise in reaction to a psychologically traumatic event. The event usually involves actual or threatened serious injury or threatened death to the person or to a family member or friend.
Unlike other anxiety disorders, which typically are triggered by objects or situations that most people would not find threatening situations that cause acute stress disorder or posttraumatic stress disorder-com bat, rape an earthquake, an airplane crash-would be traumatic for anyoneAccording to DSM-IV if the anxiety-linked symp toms begin within four weeks of the traumatic event and last for less than a month, the pattern is diagnosed as acute stress disorder.
If the symptoms continue longer than a month a diagnosis of posttrau matic stress disorder is appropriate. The symptoms of posttraumatic stress disorder may begin either shortly after the traumatic event or months or years afterward. Aside from the differences in onset and duration, these two anxiety disorders are almost identical, and include the following symptoms.
1. Reexperiencing the traumatic event They have recurring recollections, dreams or might about the event. A few relive the event so vind their minds that they think they are back in the matic situation person
2. Avoidance The person will usually avoid active situations that are reminiscent of the traumatic and will try to avoid thoughts, feelings, or conditions associated with it
3 Reduced responsiveness Reduced responsiveness the external world often called “psychic numbing “emotional anaesthesia may begin during or s ter the traumatic event The person feels detached estranged from other people or loses interest in a ties enjoyed previously The ability to experience intimate emotions as tenderness and sexuality is impaired Reduced responsiveness is partici prominent in acute stress disorder, where it may ther include signs of dissociation, or emotional sep tion dazedness, loss of memory, derealization ded that the environment is unreal or strange), or depenalization (feeling that one’s thoughts or body are real or foreign).
4. Increased arousal, anxiety, and guilt. People with these disorders may experience hyperalertness, an exaggerated startle response, sleep disturbances, or othe signs of increased arousal, and may also have trouble concentrating or remembering things. They may le extreme guilt because they survived the traumatic event while others did not. Some also feel guilty about what they may have had to do to survive.
We can see these symptoms in the recollections of Vietnam combat veterans years after they returned home.
An acute or posttraumatic stress disorder can occur at any age, even in childhood, and can impair one’s personal, family, social, or occupational functioning (Jordan et al., 1992). Clinical surveys show that approximately 0.5 percent of the total population experi ence one of these disorders in any given year, at least 13 percent will suffer from one of them within their lifetime (Davidson et al., 1991). As many as 15 percent of all people experience some of the symptoms of these disorders.
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