Post Traumatic Stress Disorder: Diagnosis & Current treatments

In light of the Marathon Monday bombings, fires in Texas, the Sandy Hook School shooting, the devastation of hurricane Sandy, along with other horrific and traumatic events have occurred recently, there have been many people experiencing Post Traumatic Stress Disorder symptoms, including me, the first few days after the bombing. Post Traumatic Stress Disorder (PTSD) is frequently associated with combat veterans coming back from war, but it is also associated with other traumatic events, and is commonly misunderstood.  There are many side effects, some subtle and some not so, but the average person tends not to really understand this disorder, what sufferers go through, and the current available treatment options.

What is PTSD?

PTSD is the bodies stress response after some sort of traumatic event, usually where people feel their lives (or others around them) are in danger.  Some events that can result in PTSD are: exposure to live combat (i.e. war veterans), serious accidents (car accidents, plane crashes), physical and/or sexual abuse (especially during childhood), large-scale or national disasters (terrorist attacks, school shootings), after a loved one’s suicide or traumatic loss of life, and natural disasters (tornadoes, forest fires, hurricanes).  Basically any major traumatic event will lead to some form of PTSD, which can be transient, in that the symptoms come and go, or are experiences for a short period of time then go away and never come back, while some people experience the symptoms for the rest of their lives.

one of the many reasons for PTSD

one of the many reasons for PTSD

Who will get PTSD?

It is truly unknown why some people experience symptoms and others don’t.  You can put two people in the exact same situation and they will respond differently, and it is very difficult to predict who will have more severe symptoms.  Usually the experience itself determines if people have symptoms and the length of time. Some other factors that may lead to a more intense PTSD reaction:

-If the event was fatal (people died)

– How close the survivor was to the event (i.e. someone who actually had a gun aimed at them during en event and were not shot would have more risk of long-term symptoms vs. their significant other would be effected by the event but have a lesser risk for long-term symptoms)

– If a person was injured during and event or lost someone close to them

– The control you felt during the event(s) or lack thereof

– If treatment, therapy, assistance was sought out after the event

What are the symptoms of PTSD?

As I stated earlier, some of these symptoms are more subtle than others, and most people who survive traumatic events will have some of these symptoms immediately, then they can go away, or continue on. I was in a state of hyper-arousal for a few days following the bombing and definitely having nightmares, but I also felt like I was in a fog and very forgetful, so I appreciated people being understanding with me. Once the symptoms last more than 4 weeks continuously and start to effect your personal life and work life, or cause you great distress consistently, you fit the criteria for PTSD as a diagnosis. The four main symptoms of PTSD are: 1. Reliving the event (having nightmares, constantly thinking about the events during the day causing you to be unable to concentrate). 2. Avoiding similar situations (If you were in a traumatic car or plane accident, no longer riding in cars or planes). 3. Inability to feel (many PTSD victims have a lack of experiencing true feelings after the event, they describe themselves as being “numb”  or having “dulled” feelings). 4. Constant hyper-arousal (always anxious and expecting something bad to happen, constantly looking over their shoulders, worried). These symptoms can lead to behaviors by the victims to try to combat them.  Some people drink or take drugs to slow their minds so they aren’t constantly thinking about the event, while some become severely depressed leading to suicidal thoughts/actions or extreme anger, or acting out and being very promiscuous to try to get their mind off of the event. These are all coping skills that are not healthy and can lead to problems at work, in relationships, suicide, and addiction.  There are ways to help and alleviate the symptoms of PTSD.


What are the Treatments?

Some people are treated with Selective Serotonin Reuptake Inhibtors (SSRIs) to help with depression.  Psychotherapy (counseling) in conjunction with SSRIs can help to alleviate the symptoms of PTSD and help people to get back to their mental state (basically) from before the event.  Cognitive Behavioral Therapy (CBT) is the most effective type of therapy to help victims to work through their feelings about the event and their responses to it; you learn the skills to actively change your thoughts and feelings in response to the traumatic event.  Essentially you work through your feelings and change your response, and no longer keep your feelings bottled up about the event, prior, and after. There is also Prolonged Exposure therapy, where you talk about the event and your feelings so extensively, that it no longer causes you such pain and anxiety, you then expose yourself to   things you have been staying away from to decrease your anxieties.

There are treatments out there, and they are not quick or easy, but they work.  All victims need to know that they should not keep their feelings inside, and they need to talk to a therapist that will help them work through their feelings. I was encouraged to talk about the event with people at the hospital that experienced the same event, and talk to everyone who asked; it was very, very hard, but also made me feel better.  I also used the outlet of writing about the event as a form of therapy, and I felt SO much better having people hear my story. It can be horrible to relive experiences, but it will be worth it to work through the feelings and anxiety, and be able to live your life without the fear or stress of that traumatic experience, and truly begin to live your life again.  If you know anyone with symptoms, or you think you might have symptoms, talk to a family member, your HCP, a therapist, anyone to get help.  If you are in crisis, call 911, go to the nearest emergency room, or call a suicide prevention line (800-273-8255) * if you are a veteran, you can press 1 after dialing the same suicide prevention number and speak with someone trained to specifically work with veterans.

**The FBI set up a victim assistance line specifically for the victims of Monday’s bombing.  Please ask for help, and talk to someone….anyone. It WILL make you feel better.

Take control of your life back.

Yours in Good Health


Animal Assisted Therapy: Pro or Con?

At my hospital we offer Animal Assisted Therapy animal visits a couple of days a week, patients and their families are asked when they are admitted if they like animals and if they are interested in getting a visit.  The handlers of the therapy animals (which are all certified and up to date on all vaccinations), then will go to various floors where patients have requested a visit, make sure it is still acceptable with their current state of health and with various procedures, etc. and then will pop in for a 15-30 minute visit, depending on what is allowed by the patient and their Healthcare Practitioners (HCPs). There are differences of opinion about Therapy Animals in the hospital, however, and some feel that these visits can be detrimental to patients health.

The two cutest therapy dogs on planet earth....if I do say so myself!

The two cutest therapy dogs on planet earth….if I do say so myself!










What are the two sides to the debate?

Obviously I’m biased on this one, I love animals, and have two therapy dogs of my own, and there is another side to the story; I’d like to pretend there isn’t one, but I will give you both sides of the debate so you can make your own judgement!


The overall goal of Animal Assisted therapy is to improve the cognitive, social, and emotional functioning of any given patient. It was first used in the 18th Century with patients that had mental/psychiatric disorders, and though it was based on no real science at that time, it was found that the patients were better able to socialize with one another when caring for and being with animals. Sigmund Freud found that children and adolescents were much more comfortable and open in therapy when animals were present, they helped to decrease stress.  In modern-day life, the therapy is based on a biophyllia hypothesis, which basically states that because humans depended upon animals for survival long ago, when we see an animal at rest, is signals to humans that they can be calm and restful as well. Animal assisted therapy is currently brought to prisons, hospitals, nursing homes/extended care facilities, and with home therapy; patients who use animal assisted therapy see great results and report feeling better, they have seen elderly with significant dementia who can be aggressive or mean, change their behavior when there is an animal around. Children with autism that had extreme inability to interact with humans, are able to show emotion and interact with animals. There was a study performed in 1998 that found patients with various mental disorders, including anxiety, had observed and reported decreased in anxiety after animal assisted therapies. Another study on 2007 looked at patients with heart failure and found that after three months with animal therapy, their blood pressure and heart rates were decreased at rest, showing less strains of stress on the heart, and they had and improved quality of life. There have been numerous other studies published, but these are a couple with tangible results.


There are numerous HCPs that either don’t believe in the benefits of Animal Assisted Therapy or are just really against it.  One reason that some HCPs don’t buy into it is that the research studies that have been published aren’t the strongest scientifically speaking, they aren’t studying the neuron effects of patients as they get therapy with a dog, for example, instead they report based upon the patients actions and reported feelings after therapies. Mostly, just like anything else, poking holes in the research is the way to show negativity or “prove” it doesn’t work. The biophyllia hypothesis (mentioned above) is also highly questioned as a theory in general, as the basis for it is pretty weak.  One reason why one, very outspoken, Medical Doctor, is very anti Animal Assisted Therapy is because he thinks of the animals as vectors to transmit disease and bacteria; not that the animals themselves are dirty, but that so many people pet the animals without washing their hands, and even if I do clean my hands, I could (theoretically) obtain others bacteria from my hands.  There are very few bacteria/viruses that dogs and humans can share in common, so the concern is strictly with bacteria that might travel from patient to patient. Of course, there is also the risk that some patients have low immune systems from their disease process or are allergic.

Just to reiterate: we do not bring therapy dogs to rooms of people who do not request them (due to allergies, they don’t like dogs, etc.) OR if it is medically inappropriate. The dogs are washed and clean when coming into the place of therapy, and every place is different, but it is normally requested that people either wash their hands or use an alcohol based antibacterial cleaner on their hands before touching the therapy animals. I never really thought about the fact that my cute little pooches could be vectors for bacteria BUT I don’t normally like tons of random people touching them, so when they are used for therapy, I do keep an alcohol based cleaner on me to strongly encourage use before petting my dogs!  And just from personal experience, patients and the hospital staff light up when they get visited by the therapy animals, and the atmosphere that can be highly charged with stress, feels lighter, happier, and everyone has a smile on their face. I think that says it all!

So, what do you think?  Would you be willing to allow it for you or your family member? Do the benefits outweigh the risks?

Yours in Good Health