Post-traumatic stress disorder (PTSD) develops after exposure to an event that carries a life threatening or bodily harm. Its development is not systematic and results from the interaction of multiple factors. PTSD can set in for a long time, varying in intensity from mild to severe.

Post-traumatic stress disorder (PTSD) appears after exposure to an event that carries a life threatening or bodily injury. It is one of the consequences among many possible. Its development is not systematic.

“In its most serious forms, it can cause intense moral suffering, disabling difficulties on a daily basis and profoundly deteriorate the quality of life of the person who suffers from it and those around him,” explains Dr Molenda. In one in two individuals, it is complicated by depression ”.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) identifies four groups of symptoms.

Intrusive symptoms

The first refers to intrusive symptoms. These can occur day or night. During the day, they impose themselves on you and appear in the form of thoughts or flashes of specific moments of the event. “They can also take the form of deep distress in the presence of signs suggestive of the trauma (such as the sound of a siren in a person in a traffic accident). At night, they express themselves in nightmares of revival or even in nightmares of violence ”.

Symptoms of avoidance

The second refers to avoidance symptoms. These symptoms result in conscious, voluntary efforts to hold off anything that may recall the event and trigger bad memories. “Avoidances can be behavioral: we avoid going to the location of the event, we avoid meeting people present at the time of the event, we avoid broaching the subject, etc. They can also be cognitive: we avoid thinking about what happened to us and we try to think of something else, we block access to the consciousness of bad memories ”.

Negative alterations in cognitions and emotions

The third group refers to negative alterations in cognitions and emotions. The person with PTSD is overcome with negative emotions such as anger, guilt, shame or fear. “She can also make very pejorative judgments with regard to herself, such as” my life is destroyed by this event “,” I was something good, but today I can’t stand myself “. All of these difficulties are often accompanied by a withdrawal into oneself ”.

Symptoms associated with changes in wakefulness and responsiveness

The last group refers to symptoms associated with changes in arousal and responsiveness. “These symptoms lead to difficulty concentrating, short-term memorization, irritability and even outbursts of anger. They keep the individual in a state of alert, especially when they are outside of their home. They disturb the quality of sleep either because they prevent you from falling asleep or because they cause awakenings several times a night ”.

Finally, in some people, all of these symptoms can be associated with a feeling of emotional detachment and a feeling of being foreign to oneself, to others or to one’s environment. This is called a dissociative subtype of PTSD.

Anyone, regardless of their age, can encounter difficult, painful and stressful situations to varying degrees during their lifetime. Other situations can be potentially traumatic or traumatic, which is a qualitatively different experience.

DSM 5 defines as traumatic any situation that involves “actual death, threat of death, serious injury or sexual violence”. “The events meeting this definition are many and varied. They relate to both accidentology (domestic accidents, transport, work, etc.), disasters (natural disasters, technological disasters, wars, etc.) as well as interpersonal violence (physical, sexual assault, seizures). hostages, psychological violence, child abuse, etc.) ”.

Finally, the traumatic experience can be experienced by being directly exposed to the event or by witnessing it.

The diagnosis of PTSD can only be made one month after the onset of the triggering event.

Below this, manifestations resembling the symptoms of PTSD may appear without being pathological. Often, they bear witness to the adaptation efforts that the survivor of the event must make to “emotionally digest” what he has experienced.

“However, when these manifestations are severe from the outset or worsen very quickly and they deeply interfere with all spheres of life – professional, school, social, personal, intimate – they can constitute an acute stress disorder (ASD) which is neither more nor less than an acute form of PTSD. In this case, it is important to confirm the diagnosis ”.

Disorders associated with PTSD

Finally, PTSD is often associated with other mental health disorders such as depression, addictions, certain anxiety disorders, traumatic bereavement or suicidal behavior. “For these reasons, the initial clinical assessment of the repercussions of the trauma suffered must be as broad as possible”.

Psychotherapy

International recommendations for good therapeutic practice recommend psychotherapy as the first-line treatment for PTSD. These psychotherapeutic measures are however likely to be supplemented by the prescription of drugs.

“Among the various psychotherapies, behavioral and cognitive therapies (CBT) called trauma-focused and EMDR (Eye Movement Desensitization and Reprocessing) are those which benefit from the highest level of evidence in favor of their effectiveness. Clinical studies show that these two types of treatment induce a significant reduction in PTSD but also in anxiety and depression. They also act on negative emotions like anger, guilt or shame. Other approaches (hypnosis, sophrology) also seem to have a beneficial effect. However, for the moment, the number of clinical studies examining their effectiveness is insufficient to be able to recommend them ”.

Antidepressants

Some antidepressant drugs also have a beneficial effect, shown in clinical studies, even if the person is not depressed. “Paroxetine (Déroxat, Divarius and generics) and sertraline (Zoloft and generics) are the only molecules with an official indication in the treatment of post-traumatic stress disorder. If the sleep problems are important, hypnotic treatment can be offered ”.

The practice of a physical activity

Recent scientific work also highlights the value of adapted physical activity (APA) in post-traumatic recovery. “Regular physical activity helps improve mood and self-esteem, reduce stress and help rebuild self-image.”