All Posts Tagged: ptsd

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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Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation: High Tech Help For Treatment Resistant Mood Disorders

Despite therapy and the use of medications, we occasionally find that the effects of a mental health disorder persist in some people. For these individuals, brain stimulation therapies like transcranial magnetic stimulation (TMS) may provide relief from their symptoms. TMS may also be an alternative for those who cannot tolerate mood stabilizing medications.

The National Institute of Mental Health (NIMH) reports that TMS and other brain stimulation therapies “involve activating or inhibiting the brain directly with electricity.” TMS is the most noninvasive of these treatments and is given via energy pulses that are generated by an electromagnetic coil held near or against the person’s head.

Because these magnetic pulses are given over and over in a repetitive rhythm, the most technically correct term for TMS is repetitive transcranial magnetic stimulation (rTMS).

What Is Transcranial Magnetic Stimulation Used For?

In 2008, the Food and Drug Administration (FDA) approved repetitive transcranial magnetic stimulation to treat major depressive disorders and their associated cases of severe depression and anxiety. It has also been studied as a therapy for psychosis and researchers are looking into how it may help conditions like post traumatic stress disorder (PTSD). Additionally, another form of rTMS, called deep transcranial magnetic stimulation (dTMS), has been FDA-approved for the treatment of obsessive compulsive disorder (OCD).

In 2010, the NIMH funded a clinical trial on the effectiveness of transcranial magnetic stimulation. Initial results showed that the effectiveness of rTMS was around 14 percent compared with a placebo-type procedure, which was only 5 percent effective. However, when participants were put into a second-phase trial, the remission rate of rTMS increased to 30 percent.

How Does A TMS Work?

When you go through a session of rTMS, you will be fully awake. Each session lasts between 40 and 60 minutes and no anesthesia is required. It is an outpatient procedure so you can drive yourself to the appointment and back home again. Typically, a person is treated four to five times per week for between four and six weeks.

During the rTMS session, an electromagnetic coil, which is about the size of your hand, will be passed over your forehead and scalp along the region of the brain thought to regulate mood. This coil produces short electromagnetic pulses similar in strength to the ones generated by a magnetic resonance imaging (MRI) machine. According to the Anxiety and Depression Association of America (ADAA), “The magnetic pulses cause small electrical currents that stimulate nerve cells in the targeted region of the brain.”

As scientists gain more knowledge about how rTMS can help people, they are developing new treatment methods. In fact, the FDA has sanctioned the use of theta burst stimulation, which is a variation of rTMS. In the theta burst procedure, the person only receives transcranial stimulation for about 10 minutes per session, however they still need to have daily sessions for several weeks.

In addition, another form of rTBS, called iTBS or intermittent theta burst stimulation, is now being given in 3 minute treatments. iTBS (also FDA-approved) gives intensive bursts of high frequency stimulation and has shown results comparable to the customary rTMS therapy.

Does TMS Therapy Hurt?

While rTMS therapy doesn’t hurt, the person may feel some mild sensations as the electromagnetic pulses are administered. These sensations might include:

  • A light knocking or a mild tapping feeling on their skull.
  • The muscles in their face, jaw, or scalp tingling when the magnet is applied.
  • These same muscles contracting while the magnet is in use.

Is Transcranial Magnetic Stimulation Safe?

Although most people do very well with it, rTMS does have some temporary, mild side effects for a small number of people. They can include:

  • Mild headaches
  • Lightheadedness
  • Scalp discomfort

Rare, but possible, is the chance of a seizure, however no seizures were reported during the two large studies that have been done on the safety of rTMS, according to the NIMH.

Additionally, Johns Hopkins reports that people who have non-removable metal objects in their head (for example: stents or aneurysm clips) should not receive rTMS. This is because the magnets can cause these objects to move or heat up, which could produce a serious injury or even death.

It’s worth noting that because transcranial magnetic stimulation is relatively new, we haven’t been able to study its long term effects. That said, treatment data has been compiled and studied since the mid-1990s and there have been no long term complications from its use, to date.

We Can Help

If you are struggling with anxiety, depression, or other mental health concerns, consider speaking with the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information on how we can help, contact us or call us today at 561-496-1094.

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What Problems Do Adopted Adults Have?

When we think about adopted children, most of us picture a happy family of cooing parents bonding with an adorable infant. For the adult who was adopted as a child, however, this blissful image is often tarnished by issues that carry over from childhood.

What problems do adopted adults have? Among other things, they often suffer from:

  • Feelings of loss and grief
  • Problems with developing an identity
  • Reduced self-esteem and self-confidence
  • Increased risk of substance abuse
  • Higher rates of mental health disorders, such as depression and PTSD.

In fact, Childwelfare.gov reports that, “…most of the literature points to adopted adolescents and adults being more likely to receive counseling than their nonadopted peers (Borders et al., 2000; Miller et al., 2000).”

What Are The Psychological Effects Of Adoption?

Way back in 1982, Silverstein and Kaplan did a study that identified seven core issues in adoption that still hold true today. They are:

  • Loss
  • Rejection
  • Guilt/Shame
  • Grief
  • Identity
  • Intimacy
  • and Mastery/Control

The study reports that, “Many of the issues inherent in the adoption experience converge when the adoptee reaches adolescence. At this time three factors intersect: an acute awareness of the significance of being adopted; a drive toward emancipation; and a biopsychosocial striving toward the development of an integrated identity.”

Loss first comes into the adoptee’s life when they are given up by their birth parents. Although the child is taken into a new family, there is still a sense of loss, even if the child is an infant. We know that it is very beneficial for newborns to bond with their mother – imagine how it can affect a baby who does not make this crucial connection.

Later, as the child matures and finds out they were adopted, that sense of loss becomes a theme running through the person’s subconscious. As such, adopted children typically feel succeeding losses much more deeply than their non-adopted counterparts.

Rejection is part of the initial loss the adoptee experiences. In order to be adopted, they had to be rejected by their birth parents. Later in life, if a birth parent blocks the adoptee’s search for them, the person experiences yet another rejection.

Guilt/shame comes from the adoptee’s feelings of rejection. As we know, children tend to blame themselves when something bad happens, therefore an adopted child naturally questions what they must have done wrong (or what was wrong or “bad” about them) that made their birth parent give them away. Even if the adoptee knows the reason they were placed for adoption, they often still secretly harbor the idea that they were somehow “broken” or could have been a “better” baby, which is why their birth parents rejected them.

Grief is part of adoption because the child lost their birth parents. We see adoption as a joyous occasion for the parents who are adopting the child, therefore the thought is that adopted kids should feel thankful to have a new family. Grieving for what they lost doesn’t usually have a place in the child’s life – it is considered a rejection of the adoptive parents if the child grieves.

Additionally, children sometimes don’t feel the effects of their deep-seated loss until they reach adolescence or adulthood and have developed a high enough cognitive level to understand what the loss means to their life. In many cases, this leads to substance abuse, depression, or aggression.

Identity is another loss the adopted adult must face. While they have been given a new name and identity by their adoptive parents, is it who they truly are? Or are they really the person they were before the adoption?

Even if they fully embrace their new family, the adoptee still suffers a loss of identity because they often know nothing about their birth family. What medical concerns do they need to watch out for (i.e.” does heart disease run in their birth family)? Who are their ancestors? What do they know about inherited genetic ties or family backgrounds?

Intimacy is frequently difficult for the adopted adult because they have such deeply rooted feelings of rejection, guilt or shame, and don’t truly have an identity. Often people who have gone through these negative emotions subconsciously push others away to avoid experiencing another loss.

The Silverstein and Kaplan study notes that, “Many adoptees as teen[s] state that they truly have never felt close to anyone. Some youngsters declare a lifetime emptiness related to a longing for the birth mother they may have never seen.”

Lastly, adoptees often feel little sense of mastery/control over their lives because they had no say in the matter of their adoption. Whether placed with their adoptive family at birth or as an older child, they were not given an option. As they mature, this can result in power struggles with authority figures and a reduced sense of responsibility.

How To Cope With Being Adopted

The first step to coping with being adopted is to recognize that the experience itself leaves residual problems. When the adoptee learns about and acknowledges the core issues inherent to adoption, they can begin to talk about them with someone, such as their adoptive parents, support groups, or a professional.

Accepting and exploring these core issues helps the adoptee work through them. The open adoptions that are the norm nowadays may reduce their sense of loss and guilt, while interacting with other adopted adults can allow the person to feel less alone.

It should be said that, while finding the birth parents can give the adoptee answers and closure, this is a deeply emotional process. Before contacting their birth family, the individual should prepare themselves to experience possible further rejection if a reunion is not what they dreamed it would be (or if the birth parents refuse to meet them once they have been found).

In addition, if an adoptee seeks out a therapist, they should make sure they talk to a professional who has special training in adoption issues.  

We Can Help

If you are an adopted adult and are struggling with your feelings, 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.

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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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Is Suicide Contagion Behind The Recent Parkland Deaths?

We are only one month past the first anniversary of the shootings at Marjorie Stoneman Douglas High School and this past week we have all been saddened to learn of the suicides of two students who survived the attack. Additionally, the father of a child who was killed in the 2012 Sandy Hook school shootings also died this week – apparently due to suicide. Is it possible that these deaths are the result of suicide contagion?

What Is Suicide Contagion?

When the media reports that someone notable has died by suicide, it often seems that other suicides quickly follow – as if taking one’s life somehow becomes “contagious.” As an example, we saw this phenomenon last summer when Anthony Bourdain took his own life within days of Kate Spade’s death. Now there are concerns that this most recent suicide cluster involving the Parkland students and the Sandy Hook father may have happened partly because of suicide contagion.

Suicide contagion is also known as the Werther Effect – a phrase coined by suicide researcher, David Phillips, in the 1970s. Werther was a character in a 1774 novel by Johann Wolfgang von Goethe. In the book, Werther kills himself after the woman he loves marries another man.

The book was blamed for numerous copycat suicides across Europe after its release. In this early example of suicide contagion, many of the victims died in a similar manner to the Werther character’s death in the novel. Some were even found with copies of the book on or near their bodies.

There is strong evidence to suggest that suicides can occur in groups. Moreover, Phillips’ research into clusters of suicides led him to conclude that copycat suicides rise when there is excessive media coverage of the suicide of notable figures.

The Media’s Connection To Suicide Clusters

Besides Phillips’ research, several other studies agree that suicide rates go up when there is an increase in media coverage about a suicide. And the rates fall when the media coverage stops. Dr. Madelyn Gould, a suicide researcher from Columbia University has said, “The way suicide is reported is a significant factor in media-related suicide contagion, with more dramatic headlines and more prominently placed (i.e., front page) stories associated with greater increases in subsequent suicide rates.”

And, as with Goethe’s book, suicide clusters also tend to happen when a fictional television or movie character dies by their own hand. Dr. Gould says, “Research into the impact of media stories about suicide has demonstrated an increase in suicide rates after both nonfictional and fictional stories about suicide.”

Experts have long debated why suicide contagion occurs. Does the news coverage of a suicide cause other people to take their own lives or do they do so because they were already in a vulnerable state?

Either way, media guidelines for reporting these deaths have been in place in many parts of the world since the end of the twentieth century. The Centers for Disease Controls and Prevention (CDC) and the World Health Organization (WHO) have both issued policies for how news reports should cover notable and celebrity suicides.

Nowadays, however, we have a new concern. In the twenty-first century, we rely less on standard media reporting (like radio, newspapers, or television reports) and depend more on online sources to find out what is happening around us.

In particular, young people get their news from the internet and social media, which can spread a topic far faster than news broadcasts and – unfortunately – can do so with no filtering.

Suicide Risk Factors

In the case of the Parkland tragedy, we know that the first student to take her life was struggling with post-traumatic stress disorder (PTSD). She also suffered with survivor’s guilt, as do many of the teens who were there that day. It can be devastating to know that you’re still alive, but your friends will not reach the milestones that you will. Instead of being happy occasions, events like graduation or the first day of college are often very distressing for a survivor.

For young people between the ages of 10 and 24, suicide is already the second leading cause of death and this is without factoring in the trauma of a massacre like the one in Parkland. Clearly, we need to talk more openly about suicide prevention.

Adults and peers can help prevent a death by watching for youth suicide signs and risk factors and asking direct questions.

Although a risk factor can’t predict if someone will take their own life, having one or more of them makes it more likely the person will consider or attempt suicide. These risk factors are:

  • Mood or mental disorders (particularly anxiety disorders, schizophrenia, and some personality disorders)
  • A personal history of trauma or abuse
  • Feeling hopeless
  • A family history of suicide
  • A previous suicide attempt
  • Isolating themselves or having a lack of social support
  • Stigma against asking for or needing help
  • Alcohol abuse or abuse of other substances
  • Absence of mental health and substance abuse treatment
  • Knowledge of recent suicides of peers or learning about others who have taken their lives via news stories, the internet, or social media
  • Suicide ideation

The chances of suicide can also increase in someone who has recently had a financial loss, been diagnosed with a major physical illness, lost their job, or lost a close relationship.

Preventing Suicide

The first step in suicide prevention is awareness that someone is considering suicide. The next step is determining whether intervention is needed immediately.

If you know someone is at risk, you can help them by using the Columbia Protocol suicide risk assessment. The Columbia Protocol was developed jointly by researchers from Columbia University, the University of Pittsburgh, and the University of Pennsylvania, in conjunction with the National Institute of Mental Health (NIMH). In 2011, it was adopted by the CDC and today it is used worldwide to assess at-risk individuals.

The Columbia Protocol is a series of three to six simple, direct questions that you ask the person you are concerned about. The answers they give will provide enough information to know whether they need help and whether urgent action is needed (download the free Columbia Protocol toolkit now).

If your child or someone else you know tells you they are considering suicide, don’t judge them. Instead, show compassion for their feelings. Next, get help from a mental health professional or a suicide crisis hotline. The crisis hotline is especially critical if the person is in immediate danger of attempting suicide.

Never leave someone alone if they are threatening suicide. If you believe they are in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) in the United States. The line is open 24/7.

Let Us Help

If you are worried about yourself or a loved one who may be at risk for suicide, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Contact us or call us today at 561-496-1094.

References

Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine; National Research Council. Contagion of Violence: Workshop Summary. Washington (DC): National Academies Press (US); 2013 Feb 6. II.4, THE CONTAGION OF SUICIDAL BEHAVIOR. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207262/

 

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PTSD After The Sudden Death Of A Loved One

PTSD After The Sudden Death Of A Loved One

People form countless relationships throughout their lives – with family members, friends, coworkers, and neighbors. We have the deepest connections with the people we love – these relationships help make us who we are. They contribute to our sense of identity and have the power to transform us, for good or bad. Because of this, the death of a loved one can create numerous psychological issues, including PTSD, particularly if the loss was tragic and unexpected.

Posttraumatic Stress Disorder (PTSD) Symptoms

We know that survivors often experience depression or anxiety after the death of someone close. We don’t usually think about them having posttraumatic stress disorder (PTSD), but it can also happen, especially after a catastrophic death.

By definition, PTSD can occur when someone has “experienced, witnessed, or been confronted with a terrible event.” News of an unexpected death already brings up especially strong emotions because it catches us off guard. A tragic death magnifies those feelings.

In fact, a 2014 study¹ by Keyes, et al, noted that, “unexpected death was associated consistently with elevated odds of new onsets of PTSD, panic disorder, and depressive episodes at all stages of the life course.”

The symptoms of PTSD include:

  • Being frequently angry, tense, or jumpy.
  • Physical symptoms like heart palpitations, sweating, or hyperventilating.
  • Flashbacks of the trauma or dwelling on what the person might have gone through in their final moments.
  • Persistent avoidance of things or events that remind us of the person or place where the tragedy occurred.
  • Avoiding the emotions surrounding the death or event.
  • Problems sleeping or nightmares.
  • Changing their personal routine to avoid reminders of the event.
  • Distorted feelings of guilt; blaming themselves for the event.
  • Negative thoughts

Most of the time, people will slowly begin to recover from the initial shock and grief of a death. For those with PTSD, though, the symptoms dramatically affect their day-to-day life and they experience them for at least a month.

Treating PTSD After A Sudden Death

There are several effective treatment therapies for PTSD after the sudden or traumatic death of a loved one, including Cognitive Behavior Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Sometimes medications are used in conjunction with these modalities.

Cognitive Behavioral Therapy (CBT)

A tragedy and the resulting trauma can alter your thinking as you try to process what happened. For example, you might feel overwhelming guilt as if you were somehow responsible for the event. Or you may feel detached from the world or from those you love.

These negative thoughts can cause you to avoid the things you normally enjoy or make you worry obsessively that you’ll lose someone else in a similar manner.

Cognitive behavioral therapy (CBT) teaches you to become aware of your beliefs and thoughts about the situation. Once you identify them, it gives you the skills to see whether there are facts to support those thoughts and how to let them go if there aren’t. In short, CBT helps you manage your destructive beliefs so you can replace them with accurate views.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps people process trauma on an emotional level. It has been shown to help PTSD sufferers heal faster than through traditional therapy. In fact, a study funded by the Kaiser Permanente HMO found that 100% of single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after just six 50-minute sessions.

In PTSD, traumatic thoughts and memories work against the brain’s healing process. Flashbacks, nightmares, and disturbing emotions cycle through the brain, keeping the ordeal in the forefront of the person’s mind. Eye Movement Desensitization and Reprocessing therapy can break that cycle.

EMDR uses bilateral (both sides of the body) stimuli to tap into the biological mechanisms the brain uses during Rapid Eye Movement (REM) sleep. The theory is that using REM while recalling the disturbing thoughts or memories of the trauma helps the brain process it naturally, allowing the mind to heal.

The bilateral stimulation a therapist might use can include:

  • Hand tapping or toe tapping
  • Eye movements (following a pattern of lights)
  • Musical tones

Let Us Help

If you or someone you love has been suffering from PTSD following the traumatic death of someone close to you, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida help. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

References

  1. Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. The American journal of psychiatry171(8), 864-71.
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How Stress Affects Child Development

How Stress Affects Child Development

Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.

Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in, raising blood pressure and heart rate, and sometimes causing you to lose sleep or feel like you can’t breathe. While this response usually subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under constant stress. It’s called toxic stress, and children can be affected by it just the same as adults.

What are the Effects of Stress on Kids?

The incidence of obesity, diabetes and heart problems, cancer and other diseases goes up when a child lives with toxic stress. Additionally, their chances of depression, substance abuse and dependence, smoking, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence greatly increase. So does their tendency to be more violent or to become a victim of violence.

Studies done by the Centers for Disease Control and Prevention (CDC) have shown that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse, and they lack adequate support from adults, their brain architecture is actually altered and their organ systems become weakened. As a result, these kids risk lifelong health and social problems.

Of the 17,000 people who took part in the CDC study, two thirds had an Adverse Childhood Experiences (ACE) score of 1 or higher. 87% of those people had more than one ACE. By measuring and scoring ten types of trauma ranging from childhood sexual abuse to neglect or bullying and even divorce, researchers were able to assess the chronic disease risk for the study’s mostly white, middle class participants. Their results show that the problem of toxic stress isn’t limited to children who face poverty or to those who come from certain ethnic groups – children from all walks of life can have high ACE scores.

If you are interested in finding out your ACE score and what it might mean for you, go here.

Signs of stress

Children who are exposed to toxic stress exhibit:

  • Poorly developed executive functioning skills
  • Lack of self-regulation and self-reflection
  • Reduced impulse control
  • Maladaptive coping skills
  • Poor stress management

Research on children who face continued toxic stress shows they have:

  • More trouble learning in school
  • More difficulty trusting adults and forming healthy relationships and an increased chance of divorce as an adult
  • Higher incidence of unhealthy behaviors such as substance abuse, sexual experimentation and unsafe sexual practices, engaging in high-risk sports, smoking and alcohol abuse
  • Higher incidence of depressive disorder, post-traumatic stress disorders (PTSD), behavioral disorders, and even psychosis
  • Poor health outcomes such as obesity, heart disease, diabetes, cancer, and a higher suicide risk

Help for Toxic Stress

Awareness is key to preventing and reducing toxic stress in kids. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities have set up task forces and others are working with schools, pediatricians, daycare centers and the justice system to set up screening programs that can turn lives around.

Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that decrease stressors and strengthen the individual’s response to stress.

As more programs are enacted, researchers are finding that children benefit even when the solutions are solely focused on their caregiver and not on the child. This is likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, telephone support and peer support are beneficial, as are cognitive behavioral therapy and relaxation methods like yoga and mindfulness. Additionally, community-based programs like Head Start have been shown to be effective.

Do you have Questions?

For more information about toxic stress and its effects on child development, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Contact us or call us today at 561-496-1094.

 

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