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Posttraumatic Stress Disorder: Nightmare After The
Ordeal
Michael G. Rayel, MD
Sarah is a 28 y/o accountant who had a traumatic past that
she kept to herself. At age 15, she was grabbed by a masked
man while she was jogging in a park. The man threatened to
kill her with a knife and brutally raped her. She screamed
but nobody seemed to have heard her.
Since that time, Sarah has developed nightmares about being
raped or killed. In most days, she has suffered from
flashbacks of her being attacked. Each time she watches TV
shows that remind her of the incident, she gets scared,
overwhelmed, and becomes agitated. At times, she develops
anxiety attacks, palpitations, sweating, and restlessness.
Since the attack, Sarah can hardly trust people. As a
result, her relationships have profoundly suffered. More
recently, she's been depressed and feeling hopeless. She
hasn't been sleeping and eating well. Her inattention has
negatively impacted her work.
Based on the above symptoms, Sarah is most likely suffering
from Posttraumatic Stress Disorder (PTSD). What exactly is
PTSD?
PTSD is a psychiatric disorder characterized by avoidance,
hypervigilance, emotional difficulties, and recall behavior
such as flashbacks and nightmares after a traumatic event
such as rape, war, vehicular accident, or natural disasters.
Recent researches have shown that after a trauma,
biochemical changes develop in the brain that can result in
psychological signs as shown above.
If untreated, some individuals develop emotional
difficulties such as depression associated with inability to
concentrate, sleep, and eat. Occasionally, they also become
hopeless to the point that they want to die.
What is the treatment for PTSD?
The combination of individual psychotherapy and medications
is known to help. Antidepressants especially SSRIs have been
tried with some success. Other medications have been helpful
to address the associated symptoms. Anxiety and agitation
can be treated with benzodiazepines. The latter should be
restricted to short-term use because of their addiction
potential. Insomnia can be treated by a small dose of
Trazodone.
Psychotherapy or "talk therapy" is an important part of
treatment and recovery. The individual should be able to
express the fear, the frustration, the guilt, and the blame
in a secure and safe setting. Moreover, the therapist should
provide ample support and empathy.
Copyright © 2005. Dr. Michael G. Rayel – author (First Aid
to Mental Illness–Finalist, Reader's Preference Choice
Award 2002) psychiatrist, and inventor of Oikos Game: An
Emotional Intelligence or EQ Game. For more information,
visit www.oikosgame.com and www.soardime.com
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