After a traumatic event, most people feel shock, anger, nervousness, fear, and even guilt. Although these feelings may be intense for a while, they usually lessen with time and eventually go away. With PTSD, however, these feelings persist and can even worsen, often making it difficult or impossible for the person to function in daily life.
Hallmark characteristics of chronic PTSD are more understood than they were decades ago. Symptom categories are: Intrusive thoughts of the trauma that lead to trouble sleeping, irritability and anger, and hypervigilance. Avoidance behaviors, including staying away from people or activities that remind the person of the trauma, are very common. Often patients will report changes in mood and thinking, such as poor recall of the traumatic events, extreme negativity, detachment, or withdrawing from family and friends. Other common problems that accompany PTSD are efforts at “self-medication” as a means to “forget,” such as alcohol or drug abuse.
Table 1 provides a quick assessment tool that can be readily used in any healthcare setting or by other members of the community such as clergy who might be in a position to know the patient and have his or her trust. Patients who score as indicative of having PTSD should be urged to seek help. Successful treatment is usually multidisciplinary, involving mental health professionals as well as primary care providers. Care should also be offered to the family of the patient, as the family members are often hurt and confused by their loved one’s behavior. Anyone with concerns for the safety of someone with PTSD can call the Suicide Prevention Lifeline at 1-800-273-8255.
The Primary Care PTSD Screen
The Primary Care PTSD Screen (PC-PTSD) should be considered “positive” if a patient answers “yes” to any three items.
In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past month, you:
- Have had nightmares about it or thought about it when you did not want to?
- Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?
- Were constantly on guard, watchful, or easily startled?
- Felt numb or detached from others, activities, or your surroundings?
Source: PTSD: National Center for PTSD. US Department of Veterans Affairs Web site. Available at www.ptsd.va.gov/professional/assessment/screens/pc-ptsd.asp