Post Traumatic Stress Disorder (PTSD)
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Post Traumatic Stress Disorder (PTSD)

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The diagnosis of Post Traumatic Stress Disorder (PTSD) is a relatively recent addition to the psychiatric list of diagnoses in the Diagnostic and Statistical Manual, or DSM. Historically, associated with soldiers in combat, it had been called a variety of names. World War I gave rise to the term “shell shock” and in World War II the same set of symptoms was called “battle fatigue” or “combat fatigue”.

Although more frequently the disorder had been associated with soldiers, in the nineteenth century the symptoms were described associated with railway accidents. The terms used for PTSD-like symptoms in a non-battle setting was “hysteria” or even “traumatic reminiscences”. After World War II, the symptoms were associated with concentration camp survivors. Rachel Yehuda, a research scientist from Mount Sinai Hospital in New York, studied the offspring of Holocaust survivors and found that Holocaust survivors with PTSD had children who also suffered from PTSD.

Rachel Yehuda, a research scientist from Mount Sinai Hospital in New York, studied the offspring of Holocaust survivors and found that Holocaust survivors with PTSD had children who also suffered from PTSD. What she and a few other
researchers found was unexpected. Cortisol, a hormone linked with stress, is released in high amounts under stressful conditions. The expectation was that people with Post Traumatic Stress Disorder who respond poorly to stress, must have excessive amounts of cortisol. After all, cortisol is called “the stress hormone”. Yehuda and others instead found that they actually appeared to have low levels of cortisol. Her papers on the offspring of Holocaust survivors created a stir in scientific communities. Although some research scientists duplicated her results there were others who found the opposite to be true and yet others who found that there was no difference from the control group. This disparity may have been due to the differences in the populations studied and may also have been a result of variations in research parameters where some of the studies included a stress inducing facet that may have skewed the results. Additionally, the methods of measuring levels of cortisol also varied and might explain the discrepancy. Considering that PTSD is based solely on symptom clusters and behavioral patterns, it is possible that more than one physiologic cause lies at
the root of this psychiatrically defined disorder. Nevertheless, low cortisol levels were found in a number of studies linked with PTSD. For people with symptoms of Post Traumatic Stress Disorder that trigger the Trauma-Drama Effect, the source may be two-fold. A genetic predisposition may create a possible dysregulation of cortisol that is activated by a traumatic event. The trauma often occurs in childhood and may actually start with high levels of cortisol that then can lead to a subsequent cortisol “burn out” resulting in low levels. The triggering event or events vary. They may be due to a direct threat from an accident or injury or even a serious illness in a child. However, a child might also feel threatened by an accident, serious illness or death of a close family member or even a classmate.

Approximately 7%-8% of people in the United States will likely develop PTSD in their lifetime. Somewhat higher rates of this disorder have been found to occur in African Americans, Hispanics, and Native Americans compared to Caucasians in the United States.

Although the disorder must be diagnosed by a mental health professional, symptoms of PTSD are clearly defined. To be diagnosed with PTSD, you must have been in a situation in which you were afraid for your safety or your life, or you must have experienced something that made you feel fear, helplessness, or horror.

Research has shown that PTSD changes the biology of the brain's MRI (magnetic resonance imaging) and PET (positron emission tomography) scans show changes in the way memories are stored in the brain. PTSD is an environmental shock that changes your brain, and scientists do not know if it is reversible.

Anxiety Disorders

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Five major types of anxiety disorders are:

* Generalized Anxiety Disorder
* Obsessive-Compulsive Disorder (OCD)
* Panic Disorder
* Post-Traumatic Stress Disorder (PTSD)
* Social Phobia (or Social Anxiety Disorder)

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things. People with the disorder, which is also referred to as GAD, feel that worrying is beyond their control and they are powerless to stop it. They often expect the worst, even when there is no apparent reason for concern. This anxiety or worry occurs on more days than not for at least six months. Exaggerated and unrelenting worry often centers around issues of health, family, money, or work, and it can interfere with all aspects of a person's life.

The anxiety disorders are the most common, or frequently occurring, mental disorders. They encompass a group of conditions that share extreme or pathological anxiety as the principal disturbance of mood or emotional tone. Anxiety, which may be understood as the pathological counterpart of normal fear, is manifest by disturbances of mood, as well as of thinking, behavior, and physiological activity.



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