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    Post-Traumatic Stress Disorder (PTSD)

    Children and PTSD continued...

    Preadolescents and adolescents (12-18 years)

    • Self-consciousness
    • Life-threatening re-enactment
    • Rebellion at home or school
    • Abrupt shift in relationships
    • Depression, social withdrawal
    • Decline in school performance
    • Trauma-driven acting out, such as sexual activity or other reckless risk-taking
    • Effort to distance self from feelings of shame, guilt, humiliation
    • Excessive activity/involvement with others, or retreat from others in order to manage inner turmoil
    • Accident proneness
    • Wish for revenge, action-oriented responses to trauma
    • Increased self-focusing, withdrawal
    • Sleep/eating disturbances, including nightmares

    Treatment: Treatment of children with PTSD should include the involvement of parents and other important people such as teachers and school counselors in the child’s life. Treatment of traumatic stress in adults is generally focused on individual treatment or group therapy with other individual adults who have experienced a similar type of trauma.

    Medical Care for PTSD

    Talk about it: Early on, grief counseling can be helpful. Cognitive psychotherapy in which a trained mental health professional helps the traumatized person talk through the distressing event is also supportive. Dealing with the thoughts and emotions with a counselor is important.

    Exposure therapy is a form of cognitive behavioral therapy used to treat post-traumatic stress disorder. In this therapy, you are gradually helped to process your memories or cues associated with your traumatic experience. In other words, the therapist helps you "get back on the horse" and helps you deal with the memories -- a process you may not be able to do yourself, even though you relive the memories yourself.

    Medication: Two drugs, sertraline (Zoloft) and paroxetine (Paxil), have been approved for the treatment of post-traumatic stress. They work much like Prozac and similar antidepressants in helping to overcome the symptoms of depression and anxiety.

    With medication or counseling and usually both, the movie inside a person's head stops playing and fades with time. Symptoms may get better without treatment, too.

    Prevention of PTSD

    Those most at risk for developing PTSD are the survivors of trauma, of course. The next most vulnerable are the rescue workers and volunteers at disasters, untrained in psychological techniques. They are seeing and smelling and feeling vivid, unimaginable horrors and fearing for their lives working in unstable structures. Firefighters and police officers, doctors, nurses, and EMTs may have more coping skills. However, all need mental health counseling during the recovery phase.

    No prevention for PTSD exists, because traumatic events are often unpredictable and random. In some experimental studies, though, certain blood pressure drugs, if given immediately and taken over time, have shown promise in lowering the intensity of the symptoms, if symptoms are going to develop at all. The problem is that health care providers cannot predict who will develop symptoms and who will not.

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