Traumatic Stress and Post-traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows a terrifying event. In many instances, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, often towards people they were once close to.
Each day man-made and natural disasters occur. Each year millions of people are affected by traumata. In more than hundred states, violence against members of groups of a certain culture, religion or political orientation is initiated or encouraged by organized groups. Torture and other kinds of violations of human rights, aim at frightening the population and suppressing opposition. Mass expulsions and genocide are no rarity. Humans in great numbers are forced to flee their home countries under the direst circumstances. Men, women and children suffer from public as well as hidden sexual and physical abuse during war and peacetimes. Disastrous events may only last a short period, however their effects on individuals can continue for years, or even centuries for communities.

After such shattering, horrifying, life-threatening events, many survivors, witnesses and relief workers begin to suffer from acute stress or post-traumatic stress disorder, once referred to as shell shock or battle fatigue. These events include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as mugging, rape, or torture, or being held captive. The event that triggers it may be something that threatened the person's life or the life of someone close to him or her. Or it could simply be witnessing acts of violence, such as a mass destruction or massacre.

Whatever the source of the problem, the victims post-trauma repeatedly relive the traumatic experience in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feelings of detachment or numbness, or being easily aroused or startled. They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent. Seeing things that remind them of the incident may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often difficult.

Post-trauma suffering can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety. Symptoms may be mild or severe - people may become easily irritated or have violent outbursts. In severe cases victims may have trouble working or socializing. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person, a human perpetrator - such as a rape, as opposed to a flood.
Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and re-enact the event for a period of seconds or hours or, very rarely, days. A person having a flashback in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again in that instant.

Not every traumatized person gets full-blown PTSD, or experiences PTSD. PTSD is diagnosed only if the symptoms last more than a month. In those who do have PTSD, symptoms usually begin within 3 months of the trauma, and the course of the illness varies. Some people recover within 6 months, others have symptoms that last much longer; the condition may be chronic. Occasionally, the illness does not show up until years after the traumatic event.

Disorders of extreme Stress
People who experience sever traumata early in life or repeatedly over a longer period of time, i.e., who encountered a whole series of severe distress may show agonizing changes in their whole personality. They suffer from a yet to be detailed disorder of extreme stress that persists or develops sometimes years or even decades after a continuing persecution, persecutions by man that may include torture, hostage taking, captivity in war and concentration camps.
Currently it is under debate if the consequences should be viewed as symptoms of a cluster of otherwise specified disorders or diagnosed as a disorder in itself:

• problems in affect regulation, for instance persistent depressive symptoms, explosion of suppressed anger and aggression alternating with blockade and loss of sexual potency;
• disturbance of conscious experience, such as amnesia, dissociation of experience, emotions, and feelings;
• depersonalization, (feeling strange about oneself);
• rumination;
• distorted self-perception, for instance, feeling of helplessness, shame, guilt, blaming one-self, self-punishment, stigmatization, and loneliness;
• alterations in perception of the perpetrator, for instance, adopting distorted beliefs, paradoxical thankfulness, idealization of perpetrator and adoption his system of values and beliefs;
• relationship to others, for instance, isolation, retreat, inability to trust, destruction of relations to family members, inability to protect oneself to become a victim again;
• alterations in systems of meaning, for instance, loss of hope, trust and previously sustaining beliefs, feeling of hopelessness;
• despair, suicidal thoughts and preoccupation;
• somatization, for instance persistent problems in the digestive system, chronic pain, cardiopulmonary symptoms (shortness of breath, chest pain, dizziness, palpitations);