All Posts Tagged: post traumatic stress disorder

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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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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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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EMDR Therapy Helps Trauma Recovery

EMDR Therapy Helps Trauma Recovery

Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder (PTSD). PTSD is a disorder that often develops after exposure to a terrifying event or ordeal – one in which intense physical harm occurred or was threatened. PTSD can also result after someone has witnessed an event that is disturbing, distressing, or dangerous. Sufferers of this disorder have persistent, frightening thoughts and memories of their ordeal.

PTSD can be triggered by events such as:

  • Military combat
  • Violent personal assaults
  • Natural or human-caused disasters
  • Car accidents, plane crashes

To understand EMDR therapy, it’s important to first understand how PTSD can impact people. People who have developed this type of disorder often have ‘re-experiencing symptoms’ or exhibit avoidance symptoms, which can include:

  • Flashbacks of the event
  • Nightmares and bad dreams
  • Uncontrollable and frightening thoughts about the event
  • Avoidance of people, activities, or places that remind them of the traumatic experience
  • Severe emotional distress or physical reactions to something that makes them think of the event
  • Irritability, aggressive behavior, angry outbursts
  • Feeling guilt, shame, or worry about the event

What is EMDR?

A great way to understand EMDR is to think through the body’s normal healing process. When you cut yourself, your body works on its own to heal the injury. If the wound is irritated by a foreign object, the abrasion festers and the body is unable to close the wound until the object is removed.

There is evidence to support the theory that the mind works in much the same way. With post traumatic stress disorder, healing cannot happen because the survivor keeps reliving the trauma through their flashbacks and dreams. Those memories are the “foreign objects” that fight the healing process.

Effective EMDR therapy includes some important elements:

  • Processing of the traumatic memory and disturbing feelings
  • Transformation of the painful events on an emotional level
  • Empowerment of the person dealing with PTSD

EMDR therapy also involves using bilateral (both sides of the body) stimulation, such as:

  • Eye movements
  • Physical hand tapping or toe tapping
  • Musical tones

These bilateral stimuli and the guidance of the therapist allow the survivor to tap into the biological mechanisms that come into play during Rapid Eye Movement (REM) sleep. It is believed that this allows the individual to naturally process their memories – effectively removing those “foreign objects” so their mind can heal.

What Does EMDR Therapy Include?

Eye movement desensitization and reprocessing therapy consists of eight therapy phases that are focused around three specific time periods:

  • The past – the event(s) that created or intensified the trauma is identified
  • The present – attention is given to the current situations that are causing distress
  • The future – action is taken to develop the skills and attitudes needed for positive progress

Phase 1: The therapist works with the individual to uncover the incident or trigger event from the survivor’s past that might be relevant for the therapy. This may include not only the traumatic event, but also other incidents from the person’s past. The treatment plan is developed during this stage.

Phase 2: The therapist teaches the individual a variety of stress reduction and imagery techniques that can be used during and between sessions to help them handle their emotional distress.

Phases 3-6: A target memory is chosen and processed using EMDR therapy techniques. In order to start this procedure, the individual must identify the following:

  1. Emotions and physical sensations related to the memory
  2. Visual imagery related to the memory
  3. A negative belief about themselves that is related to their distress
  4. A positive belief they’d like to have

The therapist asks the individual to rate the strength of the negative and positive beliefs they choose. Then, the person is instructed to focus on the imagery, negative thoughts, and body sensations they relate to the target memory while the therapist directs them in performing the bilateral stimulation that is the hallmark of EMDR therapy. These steps are done repetitively in ‘sets’, with the survivor rating the strength of the negative beliefs after each set. Once the person no longer reports distress related to the memory, the therapist will repeat the process while focusing on the positive belief previously identified.

Phase 7: This is the closure phase, where the trauma survivor keeps a log of any lingering negative thoughts or emotions that come up throughout the week. By reviewing the person’s journal of their negative emotions or thoughts, the therapist gains information to help the individual continue to work through their pain while reminding them of self-calming techniques learned during therapy.

Phase 8: In this final phase, the therapist and patient examine the progress made during previous sessions.

How to Get Help

One of the benefits of EMDR is that it has been shown to help trauma survivors with post traumatic stress disorder heal faster than through traditional therapy. Look at these amazing results:

  • One study revealed 84%-90% of single-trauma victims no longer had PTSD after only three 90-minute sessions
  • Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after six 50-minute sessions
  • A third study showed that 77% of combat veterans were free of PTSD in 12 sessions

This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time. If you or someone you know is suffering from PTSD, seeking professional help can be the most direct path to reclaiming your life.

Learn More

For more information about EMDR and how EMDR therapy can help you or a loved one overcome trauma and PTSD, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us at 561-496-1094.

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