How to diagnose and treat PTSD?

Parsing "features"

Briefly

I often hear about PTSR. Is this a really serious illness?

Doctors disagree whether PTSR is considered a disease, but explain that this is a severe mental disorder that may appear after a serious traumatic event and lead to very serious consequences.

The author of Psychotherapy PTSRA at combatants, the psychotherapist Evgeny Alexandrov believes that a stressful disorder is a normal body reaction to very severe stress. “Normally, the information falls from the right hemisphere to the left frontal share, where we have an analytical zone, is processed by consciousness - and that’s all, it ceases to be relevant. Like the beasts: the dog was scared, bounced, saw that there was no danger and calmed down. A person is not like this: each time, recalling a traumatic event, the brain will produce a certain number of neuropeptides that again start a stressful reaction. PTSR is not a disease. This is a painful, but normal state, ”explains Alexandrov.

Psychologist and psychiatrist Anastasia Afanasyeva does not agree with such an assessment. “In our body, reactions are laid down that help to adapt even to very strong traumatic events. But these reactions depend on the predisposition of the person himself and all work in different ways. If a person suddenly stopped leaving the house, closed, wakes up every night in nightmares and cannot work - it is difficult to call this the norm, ”says Afanasyeva,“ there is still a line in psychiatry, even if it is not very clear, where the norm ends, the disorder begins there. This line is usually outlined where the psychological state begins to influence our social functions. ”

How to diagnose PTSR?

For the diagnosis of PTSD, a set of criteria formulated in the DSM-5 (diagnostic and statistical manual for mental disorders of the 5th edition) is used. The first criterion-a person had to survive the situation that threatening life, become a witness to something terrible or find out that his relatives were faced with an injuring event. After that, he should manifest certain symptoms: obsessive memories, flashbacks, sleep disorder, deterioration of cognitive functions, complexity with the management of aggression.

An important symptom is physiological reactions in situations that remind of traumatic experience. For example, a person who has passed through hostilities can frighten a salute or even simple cotton.

Can I understand that a person has a post -traumatic disorder?

The diagnosis of PTSD can only be made by a specialist. Therefore, when one or more of the above symptoms appear, you must consult a doctor of symptoms.

But it must be borne in mind that in our society, fear of psychiatrists is still greatly developed, and mental illness is stigmatized. Therefore, persistent tips to consult a doctor can be perceived as aggression and only aggravate problems.

Is it possible immediately after traumatic experience to diagnose PTSR?

Anastasia Afanasyeva explains that if a person reacts excessively to an injuring event in the first couple of months after what happened, this may not always be associated with PTSD. For example, in those who were in war, in the first weeks after returning, similar symptoms can be caused by an adaptation disorder (or a disorder of adaptive reactions). But if after a few months a person’s condition does not stabilize, if he suffers from flashbacks or nightmares, his character continues to change (irritability, tearfulness, pronounced anxiety appears) - then, most likely, it is already in post -traumatic stress disorder.

How often does PTSR meet among participants in hostilities?

The rector of the Eastern European Institute of Psychoanalysis Professor Mikhail Reshetnikov in a speech at a meeting in the State Duma on the rehabilitation of the Russian military estimated the number of PTSD subjects at 1.2% of all participants in hostilities.

However, this assessment is very diverge from the opinion of not only Western, but also Russian experts. Experts from the Center for Psychiatry and Neurology named after Bekhterev claim that PTSR is developing in 14% - 17% of combatants. And if a person was wounded, this indicator increases to 30%.

How is PTSR treated?

Treatment methods are based on psychotherapy courses . Traditionally, patients undergo cognitive-behavioral therapy, but recently, desensitization has given very good results.

It is based on the connection of the mental and physiological reactions of a person. During such therapy, the psychotherapist asks the patient to concentrate simultaneously on his traumatic experience and on alternative physiological stimulation: cotton on the arms and legs, eye movement or third -party sounds.

Typically, psychotherapy is combined with treatment with drugs - antidepressants and antipsychotics are mainly used.

Are patients of PTSD a threat?

People with PTSD can really be aggressive, but not all. Many, on the contrary, are closed in themselves and move away as much as possible from others. But in this case, they become dangerous for themselves: 20% of PTSR patients attempted to commit suicide.

However, traumatic experience can cause increased aggression without PTSR. Especially when it comes to participation in hostilities. The war often arouses the worst qualities in people, and a change in their behavior may not be associated with the disease, but with the rollback to “basic settings”. And such a change in character can be even more dangerous for loved ones than PTSR.

How to distinguish PTSD from abusive behavior?

The psychologist and psychiatrist Anastasia Afanasyeva explains how to separate the pathology at the household level from the situation where your loved one simply abuses with its position: “If [participation in hostilities] reinforced the abusive features of a person, then most likely he will not have other symptoms associated with PTSD. But if he cannot sleep, suddenly problems with alcohol appeared, if an external triggers are worried about a person, these can be changes due to PTSR. ”