Post Traumatic Stress Disorder (PTSD)

Nick

What is Post Traumatic Stress Disorder (PTSD)? PTSD is the primary psychiatric disorder that follows from traumatic life experiences. PTSD is central to many discussions in relation to stress and trauma. According to a July 2017 article by Michael S. Scheeringa M.D. PTSD has 20 diagnostic symptoms which are outlined below.

PTSD first appeared in the formal Diagnostic and Statistical Manual (DSM) classification system (USA) in 1980. It has been adopted and somewhat popularised in the common vernacular in recent years and has, for better or worse, been accepted into the lexicon of our culture. Books and films have centralised the issue of PTSD affecting central characters as part of the (e.g., American Sniper). It should be understood that stress should not be mistaken for PTSD trauma.

The diagnostic criteria for PTSD in the fifth and latest edition of the DSM (DSM-5) consist of 20 possible symptoms that are divided amongst 4 clusters.

20 diagnostic symptoms of PTSD

1. 5 symptoms in the re-experiencing cluster:
Nightmares
Intrusive recollections
Flashbacks
Psychological distress at reminders
Physiological distress at reminders

2. 2 symptoms in the avoidance cluster:
Avoidance of internal reminders
Avoidance of external reminders

3. 7 symptoms in the altered cognitions and moods cluster:
Dissociative amnesia
Negative beliefs about oneself and the world
Distorted blaming of oneself
Negative persistent emotional states
Loss of interests
Detachment from loved ones
Restricted range of affect

4. 6 symptoms in the increased arousal cluster:
Hypervigilance
Exaggerated startle response
Concentration difficulty
Sleep difficulty
Irritability or outbursts of anger
Self-destructive or reckless behavior

A possible diagnosis of PTSD will be based on a requirement that requires symptoms from all four clusters.

To be diagnosed with PTSD, a person must have at minimum the following:

  • 1 of the five re-experiencing symptoms
  • 1 of the two avoidance symptoms
  • 2 of the seven altered cognition symptoms
  • 2 of the six increased arousal symptoms

There are a variety of different types of symptoms are represented that can be interpreted and the algorithm is such that people with minimal symptoms are not over-diagnosed. Someone with the diagnosis can have as few as 6 or as many as 20 of the possible symptoms.

Many professionals feel that the bar has been raised too high in recent versions of the DSM where minor changes have served to provide a, perhaps unrealistic, statistical decrease in the rates of PTSD. This may mean that some suffers are not being diagnosed now as before. There is a significant gray area containing people who cannot be formally diagnosed but may still be a sufferer.

Generally the disorder is characterised by failure to recover after experiencing or witnessing a terrifying event. PTSD is treatable through various means and there is mounting evidence that one of the most effective treatments may be the use of Cannabidiol (CBD Oil).

Normally if treated correctly the issue can be resolved within months, however this requires the right diagnosis of severity.
The condition of PTSD may last months and can last for years being triggered by memories of the trauma accompanied by intense emotional and physical reactions. Conventional treatment includes different types of psychotherapy as well as medications to manage symptoms. A health professional should be consulted if you think you or someone you know is suffering from PTSD.

New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyse psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. Methods: The Clinician Administered Post traumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Results: Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Conclusions: Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

(Taken from: http://www.tandfonline.com/doi/abs/10.1080/02791072.2013.873843?journalCode=ujpd20)

A recent survey asked 300 PTSD sufferers in the United States about their use of CBD and other medications.

  1. 80% of survey respondents reported that they consume less alcohol when using cannabis. This suggests that, when used medically, marijuana is not a “gateway” drug.
  2. Veterans reported being prescribed more medications than civilians. They were also more likely to be prescribed medications that generally worsened symptoms, including anti-psychotics, narcotic pain medication, and mood stabilizers.
  3. Survey respondents reported that cannabis was the most likely to improve PTSD symptoms—albeit to an unknown degree—and the least likely to make symptoms of irritability, depression and sleep problems worse.
It’s estimated that over a million veterans are living with PTSD. The anxiety disorder is believed to be a major contributor to the staggering number of veteran deaths each year from prescription drug overdoses and suicides. Veterans are often underserved by the healthcare system and conventional PTSD therapies are of limited efficacy for many. A groundbreaking 2014 survey by the American Legion found that 59% of veterans reported feeling no improvement or worse after undergoing treatment for PTSD. Half were interested in exploring complementary and/or alternative treatments.