All Posts in Category: Post-Traumatic Stress Disorder

How Coronavirus News Coverage Can Activate PTSD

As the world struggles with the global coronavirus pandemic, we are learning how to deal with the “new normal.” Health care workers are going without breaks or days off. Families are coping with layoffs and have been thrown into homeschooling their children. The majority of us are under stay-at-home orders. The outcome of such undue psychological stress creates anxiety and can trigger symptoms of post traumatic stress disorder (PTSD). Watching the constant news coverage of the outbreak doesn’t help.

The therapists at the Center for Treatment of Anxiety and Mood Disorders have long been concerned about the repetitive exposure to traumatic life events that people get through the internet and television newscasts. Not only are we captive audiences to the trauma, we are often mesmerized by it and can have trouble disconnecting ourselves from the TV set or internet.

Trauma Symptoms In The Wake Of COVID19

Right now, we all are experiencing this pandemic in our own unique way. Our daily lives have changed, seemingly overnight. Watching the news coverage of the infections and deaths around the globe, combined with our own worries for our loved ones and ourselves, has created a psychological trauma for many.

This trauma leaves people shaken, especially because we have little to no control over the virus. Numerous times in the last few weeks, I’ve heard people say, “I had no idea this could happen.” Thus, we feel helpless in the face of the virus’ persistent march.

This unrelenting distress can bring up the emotions surrounding other traumatic life events. For those who suffer from PTSD, it can also intensify the inescapable fear that something bad will happen to them again.

Even though these emotional responses are part of a normal reaction to a stressful situation, trauma actually changes patterns in your brain. It causes you to carry the emotional distress long after the events have passed. And, watching untold hours of news coverage keeps that distress actively whirling through our minds.

Self Care For Stress During The Coronavirus Outbreak

If you know someone who has had the virus, you are likely experiencing a heightened fear that you could also get it. Additionally, since most of us know the virus’ symptoms by now, getting the runny nose that defines allergy season or the cough that may come with the pollen from budding trees can send us into a panic.

Couple this with the fact that we don’t have a timeframe for when our lives can get back to normal and it seems that a trauma response and some form of PTSD is almost inevitable for many people.

To support yourself emotionally during the outbreak, it will help if you can normalize your environment as much as possible. By that I mean:

  • Try to create a routine. Get out of your pajamas and dress for a regular day. Keep to an exercise schedule and a meal schedule. Block off time for certain activities, such as helping your children with school work or reading through emails. Structure helps you feel more stable and in control.
  • Back off on the news coverage about the pandemic. Limit yourself to watching the news for an hour or less and do so several hours before bedtime so you don’t carry your distress into your sleep.
  • Don’t beat yourself up for how you feel. It is perfectly normal to flounder a little while you adjust to this uncertain period in our lives.
  • At the same time, be kind to yourself and those around you. Understand that they are going through similar fears, so try to take a step back before getting angry with someone (or yourself). Remember that fear is often expressed as anger.
  • Get plenty of rest and eat as healthy a diet as possible.
  • Engage in exercise to help relieve your stress. If you are worried about going outside, try jumping jacks or climbing the stairs in your home. I just saw a news report of a man who completed a marathon in his own back yard by running back and forth across the yard more than 7,000 times. While I am not advising that you suddenly attempt a back yard marathon, the point is to do what you can to get some exercise.
  • Create a sense of safety by playing calming music, meditating, or “walking through” our national parks virtually.
  • Keep in touch with friends and loved ones virtually. Many people are creating virtual dinner parties via a video platform, like Zoom or Skype, for example, or playing online games virtually with friends.
  • Avoid destructive diversions, such as drinking alcohol, binge eating, or using illicit drugs.

For some people – especially the healthcare workers who are dealing with the virus on the front lines or those who have lost loved ones – the trauma response could morph into full blown PTSD. If you find your trauma symptoms are becoming overwhelming, don’t try to go it alone.

Many practitioners, including those at our trauma clinic, are able to see patients virtually during the pandemic. Reach out and get the help you need, particularly if your stress if interfering with your daily life and has persisted for longer than two to three weeks.

Learn To Feel Safe Again

By working with a mental health professional who specializes in trauma, you can experience recovery from your PTSD relating to the coronavirus.

For more information, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 today.  

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breast cancer awareness ribbon

PTSD In Breast Cancer Survivors

October is Breast Cancer Awareness month and pink ribbons abound. Everywhere you look, people are wearing pink and various organizations are engaging in fundraising for cancer research. For survivors of the disease, this outpouring of hope is welcome, but at the same time, these visual reminders of their fight can bring up symptoms of post traumatic stress disorder (PTSD).

Even though it is best known for affecting war veterans or people who have been through violent events like mass shootings, PTSD is also found in cancer survivors. “It’s common for cancer patients, even if they don’t have full-blown PTSD, to have some of the symptoms of it,” says Fremonta Meyer, MD, of Dana-Farber’s department of Psychosocial Oncology and Palliative Care.

The color pink isn’t the only thing that can trigger PTSD in breast cancer survivors. Simple actions such as driving past their treatment centers or seeing cancer care commercials on the television can do it, as can hearing about someone else’s diagnosis (or breast cancer scare).

Cancer And PTSD Symptoms

A contract employee of ours went through treatment for stage 1 breast cancer last year. She recently told me how her niece’s routine exam triggered her own PTSD earlier this month.

During an annual exam, the doctor found a lump in her niece’s breast, which led to a mammogram and ultrasound. The results were negative, but our employee found herself crying for no reason, depressed, and sleepless for about two weeks following her niece’s “all clear,” despite the fact that she was obviously very happy that her niece was fine. When she mentioned her symptoms to me, it was clear that she was experiencing some post traumatic stress.

Symptoms of PTSD can include any of the following:

  • Insomnia
  • Startling easily
  • Inability to think clearly or concentrate
  • Re-experiencing the traumatic event – this can happen through nightmares, flashbacks, or memories.
  • Avoidance of situations or places that remind the person of the event
  • Feeling defensive, fearful, or angry
  • Negative self-perceptions

These symptoms could be triggered when the person encounters certain sights, smells, or sounds that remind them of their diagnosis, going through chemotherapy, or other cancer treatments. Additionally, post treatment screening, testing, and waiting for test results can bring the original trauma back to the forefront.

In general, PTSD symptoms begin soon after the initial traumatic event, but sometimes they do not appear for months or even years after the trauma occurred. This happens because, for cancer survivors, the traumatic event continues from the time of diagnosis to the end of treatment, which can take a year or longer. Thereafter, survivors often spend years worrying about recurrence, which may keep their PTSD active.

It also should be noted that the parents of children who go through cancer treatment can also suffer from PTSD, with similar triggers and symptoms.

Factors Contributing To The Development Of PTSD After A Cancer Diagnosis

The National Cancer Institute (NCI) at cancer.gov reports that “certain physical and mental factors that are linked to PTS [post traumatic stress] or PTSD have been reported in some studies:

Physical factors

  • Cancer that recurs (comes back) was shown to increase stress symptoms in patients.
  • Breast cancer survivors who had more advanced cancer or lengthy surgeries, or a history of trauma or anxiety disorders were more likely to be diagnosed with PTSD.
  • In survivors of childhood cancers, symptoms of post-traumatic stress occurred more often when there was a longer treatment time.

Psychological, mental and social factors

  • Previous trauma.
  • High level of general stress.
  • Genetic factors and biological factors (such as a hormone disorder) that affect memory and learning.
  • The amount of social support available.
  • Threat to life and body.
  • Having PTSD or other psychological problems before being diagnosed with cancer.
  • The use of avoidance to cope with stress.

Cancer patients may have a lower risk of post-traumatic stress if they have the following:

  • Good social support.
  • Clear information about the stage of their cancer.
  • An open relationship with their healthcare providers.”

Treatment for Cancer PTSD

Therapy for cancer-related PTSD is similar to treatment for other forms of the disorder and usually involves a combination of therapies:

  • Relaxation techniques, such as deep breathing, mindfulness training, and meditation can help survivors release muscle tension, lower blood pressure, and reduce anger and anxiety levels.
  • Cognitive Behavioral Therapy (CBT) helps survivors challenge and change the negative thoughts and thinking patterns that are causing them stress. CBT helps people cope with their situation in a healthy way.
  • Support groups for survivors in which coping skills and emotional support can come from others who have gone through similar experiences.
  • Sometimes medications are used in the short term to help survivors who have severe trauma symptoms or flashbacks.

Above all, therapy helps the person understand that a disorder like this one develops because of extraordinary stress, not because of weakness.

The key is to get treatment early. Symptoms and mental distress are often long-lasting and can affect your relationships, your job, and your overall health. Please seek help before these symptoms have a chance to further disturb your life.

We Can Help

If you or someone you love have gone through cancer treatment and find that you have some PTSD after your treatment, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, can help. For more information, contact us or call us today at 561-496-1094.

Resources

PDQ® Supportive and Palliative Care Editorial Board. PDQ Cancer-Related Post-traumatic Stress. Bethesda, MD: National Cancer Institute. Available at: https://www.cancer.gov/about-cancer/coping/survivorship/new-normal/ptsd-pdq. Accessed 10/12/2019. [PMID: 26389374]

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Dissociative Identity Disorder

When a person goes through an overwhelmingly traumatic experience, it is common to dissociate from it if it is too distressing to remember. For example, physical or sexual abuse might trigger detachment, the same way that going through an event such as the recent mass shooting at the Las Vegas concert may cause a survivor to “blank out” the memory that is causing emotional pain. For some individuals, however, their distress is so severe they may not be able to connect with their memories, feelings or even to their own sense of identity. These people likely have Dissociative Identity Disorder.

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Post-Traumatic Growth

Post-Traumatic Growth

Emotional trauma or psychological trauma is a reaction to an experience or event that is deeply distressing or disturbing to the individual. Trauma can be the result of things such as going through a natural disaster, being involved in a car accident, living through a major event, such as war or abuse, or having been the victim of a crime. A trauma response will be similar no matter what caused it.

When people experience a psychological trauma, it often shakes them to their core, especially if they felt they had little to no control over the event. They are left feeling helpless and they may experience flashbacks or have a persistent fear that something bad will happen to them again.

Even though these emotional responses are part of a normal reaction, trauma changes patterns in your brain, causing you to carry the burden of distress long after the events have passed. However, by working with a mental health professional who specializes in trauma, you can experience trauma recovery and learn to feel safe again.

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What is Trauma?

What is Trauma

In general, trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. When loosely applied, this trauma definition can refer to something upsetting, such as being involved in an accident, having an illness or injury, losing a loved one, or going through a divorce. However, it can also encompass the far extreme and include experiences that are severely damaging, such as rape or torture.

Because events are viewed subjectively, this broad trauma definition is more of a guideline. Everyone processes a traumatic event differently because we all face them through the lens of prior experiences in our lives. For example: one person might be upset and fearful after going through a hurricane, but someone else might have lost family and barely escaped from a flooded home during Hurricane Katrina. In this case, a minor Category One hurricane may bring up traumatic flashbacks of their terrifying experience.

Because trauma reactions fall across a wide spectrum, psychologists have developed categories as a way to differentiate between types of trauma. Among them are complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder.

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Complex Trauma Disorder

Trauma can come in many forms. The soldier returning from active duty in a war zone, the child who lives with physical, sexual, or emotional abuse or neglect, the first responder who must deal with human suffering on a daily basis, and the adult who endures domestic abuse all are experiencing trauma. Complex trauma occurs repeatedly and often involves direct harm to the victim. Its effects are cumulative and generally transpire in a specific setting and, frequently, within a particular time frame or within a specific relationship.

Going through trauma can make an individual experience intense feelings of guilt, as if they are somehow responsible for the event(s) that are so terrifying to them. This altered sense of shame and painful self-perception is crippling. It can make the person feel isolated and hopeless, and as if they are no longer in charge of themselves.

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Announcing Trauma Institute at the Center for the Treatment of Anxiety and Mood Disorders

The Center for Treatment of Anxiety and Mood Disorders is proud to announce the opening of our Trauma Center and Resiliency Program. We provide trauma-informed and specialized outpatient mental health and consultation services to survivors or victims of recent, current or past trauma.

A traumatic or adverse experience is one that can be described as something that happens to us that shakes us up deeply and from which we have a hard time healing, or being able to “get through.” These may be referred to as emotional trauma, mental trauma, psychological trauma, or by other terms.

Examples of traumatic experiences include, but are not limited to surviving a natural disaster, major accidents, facing chronic or terminal illness, domestic violence, sudden death of a loved one, racism and homophobia, childhood abuse, and interpersonal partner abuse.

Our team of psychologists and psychiatrists will collaborate fully in order to understand your needs, recommend an individually tailored treatment plan, coordinate your care, and provide you with state-of-the-art, high-quality services. We offer services in English as well as in Spanish.

Find out more about the Trauma Center and Resiliency Program here.

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Using Virtual Reality Therapy for Phobias

 

What would you think if you had a phobia about something (example: a fear of flying) and you could overcome your fear just by sitting in your therapist’s office and watching a movie? We think you’d sign up for that! Okay, it’s not entirely that simple (although it almost is), but virtual reality therapy for phobias is now giving patients a high-tech, cutting-edge solution for helping them get past their fears so they can live a better life.

How Does Virtual Reality Exposure Therapy Work?

Many types of phobias can be overcome or greatly reduced when the sufferer goes through cognitive behavioral therapy. In this type of therapy, a patient learns to recognize the thoughts causing the negative feelings surrounding their fears. Once these thoughts are identified, the patient learns how to replace those undesirable beliefs with more positive ones.

In-vivo exposure therapy goes hand in hand with cognitive behavioral therapy. With in-vivo exposure, the patient experiences what they fear in a controlled way and in small doses. By taking small steps, they can confront and gradually conquer their phobia.

Virtual reality exposure therapy combines the best of cognitive behavior therapy and in-vivo exposure. It allows people to work through their fears in a realistic environment without actually leaving the comfort and safety of their therapist’s office.

Virtual Reality Therapy

In the case of the fear of flying phobia mentioned above, a patient comes to our office, sits in a comfortable chair, and puts on a pair of virtual reality therapy goggles. In conjunction with coaching from their therapist, they view a simulation of the inside of an airplane’s passenger compartment and can look around to see all aspects of the interior.

The patient not only sees the plane, they also hear the same sounds they would experience if they were really on a flight, such as the flight attendant’s announcement or the rumble of airplane engines. Additionally, our virtual reality therapy chair vibrates with the motion of the plane “taking off” or “flying” to provide an even more convincing simulation.

Even if a person knows the virtual reality program isn’t completely realistic, there is enough realism in it to trigger their emotional responses to their phobia. And, by working through these reactions, in some types of phobias or traumas, nearly 83 percent of people who have tried virtual reality therapy have managed to put their fears behind them.

Virtual Reality Therapy Benefits

Some of the benefits of virtual reality therapy include:

  • Allowing the patient to try the therapy without as much anxiety. For example: in the case of a phobia about flying, it is much easier for someone to agree to try working through their fears in an office than to have to force themselves to physically go to the place they know will bring an emotional reaction.
  • Experiencing the phobia and/or its triggers without taking the time to travel to an actual location. For the fear of flying phobia, you simply sit in a chair, rather than going to the airport numerous times for several small exposures to your triggers.
  • Confidentiality for the patient: you don’t have to face potential embarrassment by running into someone you know or possibly becoming upset in a public area.
  • The therapist can carefully control the situation, meaning if you are afraid of elevators or airplanes, you don’t have to get in one. Virtual reality exposure therapy allows you to feel as if you are in a location, but the therapist can stop the program if you become truly upset.
  • The therapy is more realistic, in that you can go places or experience things you wouldn’t ordinarily be able to (you can’t get on and off an airplane as part of your flying phobia therapy, for instance). That being said, it is much safer than the real-life setting and minimizes any risk involved.
  • Virtual reality exposure therapy sessions are shorter than those that require you to visit an actual site for therapy (so, there is no travel time from the therapist’s office to the airport for our fear of flying scenario.)
  • Sessions can be repeated several times until the patient has conquered that portion of their phobia and is ready to move on to another phase.

Studies show this treatment has a powerful real-life impact and a great track record, over time. Virtual reality therapy has been successful in treating both children and adults for PTSD (post-traumatic stress disorder), social anxiety, panic disorder, anxiety disorder, OCD (obsessive compulsive disorder), and phobias. It is also a very effective tool for treating children who suffer from phobias such as school phobia or sleep fears.

Do You Have Questions About Virtual Reality Therapy?

Virtual Reality Therapy is coming to our practice very soon. For more information or to find out when it becomes available, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

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Media-Related Post Traumatic Stress Disorder

Veterans of the Vietnam war have sadly raised our awareness of the existence of Post Traumatic Stress Disorder (PTSD). PTSD is a chronic, sometimes lifelong condition resulting in pathological changes in mood, thinking and behavior. It can be incapacitating and lead to job loss, family turmoil and dissolution, poor quality of life and often suicide.

We now understand that the development of Post Traumatic Stress Disorder has its basis in enduring alterations of brain function, which helps to explain the chronic, persistent nature of this disorder. Treatment can be helpful but frustratingly inadequate. Unfortunately, there is no “magic bullet” medication. Research has supported the use of specific psychotherapeutic protocols but community availability can be a problem.

While PTSD’s origins stemmed from war related trauma, we now understand that a wide spectrum of life stressors can result in this disorder. The twenty-first century has brought terror attacks to the world stage. “Lone wolf” attacks, Islamic terrorism, and most recently, violence against the police have become a national preoccupation. In previous decades, our awareness of Post Traumatic Stress Disorder was based on either our familiarity with individuals suffering from this disorder or the occasional print news article. However, the media technology revolution of our current century has brought us both the blessing and curse of 24/7 connectivity to world and national events.

Post Traumatic Stress Disorder  and Media Coverage of Traumatic Events

For several years, the therapists at the Center for Treatment of Anxiety and Mood Disorders have been very concerned about the repetitive exposure to traumatic life events that people experience via internet and television broadcasts. Recent terror attacks around the world are cases in point, for one cannot avoid the media’s persistent replaying of the visual imagery and dramatic accounts of these human tragedies.

Before the media revolution we learned of traumatic events through the newspaper, the 6:00 pm news, or the news hour on the radio. One only has to recall the steady calm recitation of bad news by the likes of Walter Cronkite and compare it to the present day dramatic and horrifying presentation of similar news stories. Clearly, horror sells and is profitable. We have become captive audiences for this traumatic exposure. To make matters worse, we are transfixed by it and have difficulty “unplugging” ourselves from the TV set or internet.

This brings our therapists to their greatest clinical concern. Repetitive exposure to graphic trauma has an impact on our central nervous systems. Even though we may not be the victim of the terror, we are passively being terrorized. Adults have a greater capacity to process such horror, but imagine the difficulties this creates for our children. Their immature nervous systems and reasoning ability pose significant obstacles for coping with this type of daily non-stop life stress. We fear that we are all becoming victims, in our own way, of the “madness” we are being exposed to.

We have a responsibility to control our children’s exposure to traumatic media and to prevent the damage that can result. As adults, we should heed this advice, as well. Ultimately, we must change the way that public media communicates traumatic events, however, this is easier said than done.

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Complex PTSD

 

The majority of us have heard about PTSD (Post-Traumatic Stress Disorder), the condition that can occur when someone is exposed to a situation over which they had little or no control and from which there was little or no hope of escape. It is often associated with members of the military who have witnessed the horrors of battle, or with people who have endured an extreme physical or emotional trauma. PTSD can occur after experiencing even just one threatening situation, such as being involved in a car accident. But, what about those who have gone through long-term exposure to a continuing, intense level of stress?

Recently, mental health experts have begun to realize there are more layers to the emotional suffering experienced by people who have been through long-lasting stressors like childhood sexual abuse, for example, or years of domestic violence. In cases like these, a PTSD diagnosis partly addresses their condition, but doesn’t adequately define the severe psychological harm that has resulted from the trauma. Therefore, some mental health professionals now believe there should be a new category added to the PTSD diagnosis – one that will encompass this emotional scarring from long-term, chronic trauma: Complex PTSD (C-PTSD).

Even with this new classification, it is important to note that the victims of chronic trauma can have both PTSD and Complex PTSD simultaneously. Here is an easy way to see the differences between the two conditions:

  • A child witnessing the death of a friend in an accident may show some symptoms of PTSD
  • A child who has lived with years of sexual or physical abuse may have symptoms of C-PTSD in addition to PTSD.

CPTSD Symptoms

People who have gone through a long-standing, extremely traumatic situation may exhibit both physical and emotional symptoms related to their ordeal.

Emotional symptoms may include:

  • Rage displayed through violence, destruction of property, or theft
  • Depression, denial, fear of abandonment, thoughts of suicide, anger issues
  • Low self-esteem, panic attacks, self-loathing
  • Perfectionism, blaming others instead of dealing with a situation, selective memory
  • Loss of faith in humanity, distrust, isolation, inability to form close personal relationships
  • Shame, guilt, focusing on wanting revenge
  • Flashbacks, memory repression, dissociation

Victims of C-PTSD may also have physical symptoms, such as:

  • Eating disorders, substance abuse, alcoholism, promiscuity
  • Chronic pain
  • Cardiovascular problems
  • Gastrointestinal problems.
  • Migraines

Help for Complex PTSD

With Complex PTSD, healing cannot happen on its own because the survivor keeps reliving the trauma through flashbacks and dreams. People who suffer from C-PTSD may go for years before making the connection between their symptoms and the chronic stress and trauma they have been trying to cope with. Once they do, healing can begin and many people have been able to overcome their past to find a more meaningful and healthy present.

Cognitive Behavioral Therapy (CBT) has been shown to be highly effective in treating both PTSD and Complex PTSD. This therapy works to change unhelpful thinking and behaviors. It challenges deep-seated patterns and beliefs. CBT therapy helps replace “errors in thinking” (for example: magnifying negatives, minimizing positives, and overthinking) with more realistic and effective thoughts. This serves to decrease both emotional distress and self-defeating behaviors.

EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder/CPTSD. It has been shown to help trauma survivors heal faster than through traditional therapy. In fact, EMDR can be successful in as few as 3-12 treatment sessions. This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time.

We Can Help

Complex PTSD can be debilitating. Those who suffer from CPTSD may be at greater risk of substance abuse or of deliberate self-harm in order to cope with their emotional pain. We can help! To learn more, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.

 

 

 

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