American Medical Association Family Medical Guide - American Medical Association [460]
Symptoms
During the traumatic event, you may have felt profound fear, helplessness, and horror. Flashbacks cause you to feel that you are reliving the incident, recalling the sounds, odors, and feelings related to the event to the exclusion of physical reality. Even when you are not reliving the event, you may feel numb and detached from your surroundings and be easily startled. You may also have difficulty returning affection and engaging in activities you previously enjoyed. Irritability, aggression or violence, and sleep problems are common. People with posttraumatic stress disorder are highly susceptible to depression (see page 709) and substance abuse (see page 732).
Diagnosis
Your doctor can diagnose posttraumatic stress disorder after listening to a description of your experiences and symptoms. The diagnosis is confirmed if you have had symptoms for more than a month.
Treatment
Antidepressant and antianxiety medications (see page 709) can reduce the symptoms of depression and help with sleep problems in people with posttraumatic stress disorder. Psychotherapy (see page 710), especially cognitive-behavioral therapy, which helps to change negative patterns of thought and behavior into more positive ones, can also be helpful. Many people with the disorder find group therapy beneficial because they can share their feelings with others who have had similar experiences.
Phobias
For people with phobias, certain objects or situations provoke irrational fear so overwhelming that it interferes with normal life. The two main types of phobias are specific phobias and social anxiety disorder. When fear is connected to a particular object, such as bridges, snakes, or water, a person is said to have a specific phobia. Specific phobias can arise at any age. In children, specific phobias are learned, either by experiencing a traumatic event, such as being bitten by a vicious dog, or by observing a parent who is afraid of some object. Adults typically develop specific phobias as a learned response after experiencing intense anxiety in a particular situation, such as being confined in a stalled elevator.
Social anxiety disorder can involve fear of being humiliated in front of other people. A person may experience a social phobia in most social situations or only at certain times, such as when speaking in public or performing onstage. Social anxiety disorder usually first appears between ages 15 and 20 and occurs equally in men and women. Doctors believe that people who have social anxiety disorder have an inborn tendency to have exaggerated physical responses, such as blushing or increased heart rate, in social situations.
Both types of phobias run in families. People with phobias may be genetically programmed to easily learn to be fearful, or they may acquire their fear from watching the fearful behavior of others.
Symptoms
In both specific phobias and social anxiety disorder, the anxiety produced by the feared object or situation is so great that it produces physical symptoms, including a pounding heart, sweating, and rapid breathing. Anticipation of a situation in which the person might have to face the object of fear can cause loss of sleep and loss of appetite. People with social anxiety disorder have difficulty talking to other people in everyday social situations, both in person and on the telephone. They may blush or shake in front of other people, believing that others are watching them closely and waiting for them to make a mistake. Their anxiety may become so extreme that they begin to have panic attacks (see page 719) and may take extreme