PTSD first defined in soldiers returning from the Vietnam War and officially recognised since 1980.


The distilled essence which you won't find anywhere else is as follows:

Similar to phobias there is a processing block causing an emotion logic gap: I know I should not feel like this but I can't help it. This is because we are hard wired to avoid or reduce anxiety so the brain actively suppresses anything causing anxiety so you can't think about it long enough to bring the emotion down to the logic. No amount of sense or education helps here which is in contrast to a real danger where you need tools and education without which just thinking about it will not help at all.

There can be minor and major processing blocks. There can also be a processing block from a misperception of an event so here the processing needs to overcome the discomfort of having got it wrong and the consequences of that. It's easy to see how we all have various degrees of emotion logic gap. For instance have you found that no matter how well you explain something to someone they won't change their minds? Even if you know they have understood the logic? It is because it is too painful to do so and they have no reason to go through that pain. Or how many times have you done something knowing it is wrong just because you want to for various reasons? Here again there is a type of processing I teach bit it needs self awareness and motivation.

Yet the harm from chronically raised cortisol from even mild processing gaps can be measured by improvement in all aspects of mental and physical health when it is dealt with.

It is why I say you only have clarity of mind at two points in your life: 1 when you are borne, 2 after you have had good therapy by a true expert which you pay for. (The payment indicates your motivation versus just turning up).


Life time prevalence of PTSD 8% of the population, about 90% are exposed to trauma including unexpected death of a loved one, equating to a lifetime occurrence of 5 separate traumas in men and 4 in females.

Women are less likely to be exposed to traumas than men but the traumas they are exposed to are more likely to cause PTSD such as rape and sexual molestation where as males are more likely to be exposed to combat and witnessing trauma to others.

About 30% of women view their child birth as traumatic with 30% of those developing PTSD hence about 10% of all mothers have PTSD.

About 25% of acute medical problems including ITU have PTSD.


Psycholgical sequalae of PTSD: Clinical depression , alchol and drug abuse.

Predisoping factor: Clinical depression.


Self report questionnaire: PCL-5 Post traumatic stress disorder Check List for DSM 5 20 questions scored 0-4 relating to the previous month.


DSM 5:  SIACAD

Stressor

Intrusion

Avoidance

Cognition

Arousal

Distress

More than 1 month


Can specify whether dissociation or delayed onset.

Routine debriefing re living trauma may make it worse


CBT 4-5 sessions, EMDR, Reprocessing


Live Exposure


SSRI SNRI


Psychedelics FDA approval pending


Transcranial Magnetic Stimulation


Atypical Antipsychotic , ECT




Important nuances:

Chronic loss of control eg bullying or lock-down = Prolonged Duress Stress Disorder

Minor trauma still causes processing blocks or impaired processing which needs to be properly processed either with self journaling or with reprocessing therapy. In fact Professor Pennebaker showed that in Yale University students self journaling difficult events reduced cortisol and improved mental and physical health and exam results.



Naomi Breslau

The Epidemiology of Postraumatic Stress Disorder

Jounral of clinical psychology 2001