What's bothering them?

(debateitout.com)

    In this post, I would like to explain more about post-traumatic trauma disorder (PTSD). If stress is present in acute state and is not recurrent, it may have low probability of developing PTSD. PTSD is common in many unresolved case. The incidence of PTSD is higher when mass disaster happened such as Jogjakarta Earthquake in 2006. There are many clinical manifestation of PTSD including associated symptoms of detachment and loss of emotional responsivity, avoidance behaviours toward stimuli, recurrence thought, dreams and flashback of the events as well as feeling of depersonalized and unable to recall the specific aspect of trauma.

Moreover, there are three stages of disaster’s victim psychological reaction: Shocked stage, Honeymoon stage, Disillusionized  stage. The first stage usually occurs just after the event hit until several days of disaster. There are many criteria of victim who are still living in this stage such acquiring basic needs to survive, finding a place that is secure – that can provide adequate food, and place for sleep, having unclear recognition of reality such as still go to the office to work despite of having serious disaster, concern about their family members excessively and many other symptoms. In the second stage, the duration may vary from each individual. It can take several weeks or several months to proceed to the third stage. People reactions in this honeymoon stage may react differently. Some people tried to escape from the disaster area and migrate to the other area that is more secure. For some people who have skills or other abilities to survive in the new place, this action may allow them to recover faster than other people in term of economy. Other than that, some response by staying at their home instead of dangerous condition that threats them. The action taken may be due to their concern about home or attachment to their home. In this stage, many people are expected to have sleepiness. The third stage is the disillusionized stage. In this stage, people stage to feel hopelessness when mass media stop the reporting the disaster and people that are not affected by disaster (who are living outside the area) start to forget about them. This stage may occur after several months of honeymoon stage and may last for more than a year. 

  The etiology and pathophysiology of PTSD are related to the excessive norepinephrine discharge in locus coeruleus as well as increase in noradrenergic discharge at projection sites in hippocampus and amygdala. This theory correlate PTSD and fear-based memories.

  The treatments of choice for PTSD are SSRIs, TCAs such as imipramine and amitriptyline, MAOI phenelzine, trazadone (for insomnia treatment), propranolol (used in acute phase for PTSD prevention), and many other medications. The first three groups of drugs mentioned above help in reducing anxiety, symptoms of intrusions and avoidance behaviour. Psychotherapeutic therapy can help in the treatment of avoidance therapy and demoralization. 

References:1. Fauci. Et al. Stress Disorder. Harrison’s Principles of Internal Medicine. 2008.
2. Sakurai, S. Miyata, S. Nakagawa, I. PTSD and Natural Disaster.
. [online accessed on November 29th 2010]
URL: http://www.soi.asia/seminar/tsunami/material/PTSD_miyata.pdf