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Co-Occurring Disorders with PTSD

Many people may think they have anxiety because they suffer from social anxiety, or they have difficulty making quick decisions or any decision at all. Or some may feel as though they seem to be functioning in “survival mode” in order to just get through the day. While it may be determined that they do have anxiety, in some instances, they may actually be suffering from PTSD, or Post Traumatic Stress Disorder as well as one or more co-occurring disorders.

PTSD Statistics

It has been estimated that almost 8% of Americans will suffer from PTSD symptoms at some point during their life. Women are twice as likely as men to develop PTSD, with the numbers 10.4% and 5% respectively. Approximately 3.6%, or 5.2 million adults in the U.S. have PTSD during the course of a given year.

PTSD Symptoms

Three different kinds of symptoms are experienced with PTSD:

  • First set of symptoms involve reliving the trauma in some way
  • Second set of symptoms occur when you purposefully stay away from places or people that remind you of the trauma; you become isolated from other people or feel numb
  • The third set of symptoms include feeling irritable, startling easily, or feeling on guard

Examples of PTSD Symptoms

While there are numerous symptoms reported with PTSD, following are some of the more commonly reported issues:

  • Loss of confidence in trusting your own instincts
  • Social anxiety
  • Difficulty at times separating reality from imagination
  • Waking up frequently at night; having a “fitful” sleep
  • Finding yourself flip-flopping on making a decision
  • Difficulty with short term memory retention
  • Finding it difficult to focus on a task, conversation, idea; difficulty with following through to the end of a thought process
  • Physical or mental lethargy
  • Feeling hopelessness, despair, or depression
  • Becoming exhausted after even small tasks; simple things become “just too hard to do”
  • Making poor life choices where you feel shame instead of making choices to change the situation to the positive
  • Confusion as to why you feel in a “fog” or feel “shell-shocked” by life in general
  • Exhibiting addictive behaviors as a means of escape

Co-Occurring Conditions with PTSD

Those that suffer from PTSD are also commonly diagnosed with other disorders such as depression, substance abuse, anxiety, difficulties with memory or cognition, as well as other problems with mental health or physiological changes.  The disorder itself is associated with impairment of the ability to function in social or family life – it is common to see problems with relationships, family discord, difficulties in parenting, and job instability.

For men, more than half with PTSD also have problems with alcohol; the most common co-occurring issues for men in order are depression, conduct disorder, and substance abuse.

For women, just under half of those with PTSD experience depression; the next most common co-occurring mental health issues are specific fears, anxiety, problems related to alcohol.

PTSD Psychiatric Care

PTSD is not just a “veteran’s ailment.” PTSD can occur across every socio-economic status and life stage. Call Dr. Hege for a confidential appointment at one of his convenient weekend and weeknight office hours for a comprehensive evaluation that addresses your primary and co-occurring issues.

Mental Health: Do You Have a Common Disorder?

There are many different mental health disorders and conditions that can be diagnosed and successfully treated by qualified mental health professionals. It may be found during a comprehensive evaluation that a person may have a primary disorder or illness with other psychiatric disorders present that require treatment as well.

Qualified Mental Health Evaluation Critical

Diagnosis of multiple mental illness in a person is not uncommon. In addition some mental illness disorders have components of others in them. Some examples: someone with PTSD who also presents with a depression component or a person who may be diagnosed with depression but who also has suicidal tendencies. Working with an experienced psychiatrist provides you with the skills needed to determine your individual issues and needs.

Common Mental Illness Diagnoses

The more common types of mental illness or mental disorders follow.

  • Anxiety Disorders: An anxiety disorder is typically diagnosed when a person’s response is not appropriate to the event or situation — if a person cannot control the response, or if the anxiety is interfering with normal daily life. Anxiety disorders usually come with feelings of fear and dread, physical signs of panic such as sweating and rapid heartbeat. Anxiety disorders do include panic disorder, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder and other specific phobias.
  • Mood Disorders: These disorders involve chronic long lasting feelings of sadness, periods of feeling overly happy, or feelings that fluctuate from extreme happiness to extreme sadness. This category includes the most common mood disorders of bipolar disorder, depression and cyclothymic disorder (low and high mood swings not as severe as those seen in bipolar disorder). 
  • Impulse Control and Addiction Disorders: With a diagnosis or diagnoses of this type of mental illness comes the inability to resist urges or impulses as well as performing acts that may to harmful to themselves or others. Some examples of impulse control and addiction disorders are compulsive gambling, alcohol and drug addiction, pyromania or kleptomania. It is not uncommon for the person to become so involved with their addiction that they start to ignore their work, home and social responsibilities and relationships.
  • Personality Disorders: Those people with personality disorders generally have extreme and inflexible personality traits that cause distress and problems not only to the person with this mental health illness, but also cause disruption at work, school or in social relationships. With personality disorders the pattern of thinking and behavior are often so rigid that they interfere with normal daily living skills. Some examples of this disorder are antisocial personality disorder, obsessive compulsive disorder, and paranoid personality disorder.
  • Post-Traumatic Stress Disorder (PTSD): This mental illness usually develops after a traumatic or terrifying event. People who are diagnosed with PTSD typically have lasting and frightening thoughts and memories of the event and often find themselves emotionally numb.

Expert Mental Illness Help Available

If you see yourself in one or more of the multiple descriptions above and are having difficulty with daily life functioning it may be time to take a proactive step; call for an appointment with a qualified mental health psychiatrist for evaluation.

Do I Have Post Traumatic Stress Disorder

In today’s stressful and high anxiety environment it is not uncommon for many people to suffer from panic attacks, emotional distress, or develop feelings of fear or helplessness after a traumatic event. How can you know if you are suffering from PTSD or some other mental health issue? Below we mention some of the most common signs and symptoms of PTSD; however, it takes a qualified professional to make an accurate diagnosis and develop a treatment plan to meet your individual needs.

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Myths Surrounding PTSD Leave Stigma

There are numerous myths that surround PTSD – Post Traumatic Stress Disorder – myths that bring increased turmoil to the lives of those diagnosed with PTSD through misunderstanding, prejudice, maltreatment and negative attitudes presented by society as a whole. Those diagnosed with PTSD often feel they are “marked with a stigma” often based in myths.

How common is PTSD?

In the U.S. there are approximately 5.2 million adults who develop PTSD during the course of any given year.  Women are twice as likely to develop PTSD as men, yet over 60% of men compared to 51% of women report experiencing one traumatic event – living through a traumatic event does not automatically facilitate the development of PTSD.

Traumatic Events Associated with PTSD

For men, the traumatic events most often associated with PTSD are rape, combat exposure, childhood neglect and/or physical abuse. For women, the events that may lead to PTSD, are rape, sexual molestation, physical attack, being threatened with a weapon, or memories of childhood physical abuse.

Common Myths about PTSD 

Finding or seeking treatment for the mental health diagnosis of PTSD is a big step that can lead to a fuller life. An experienced and qualified therapist can help you dispel the myths from your mind and develop a successful treatment plan designed around your special needs and lifestyle.

Common myths include:

  • Myth: PTSD is a sign of mental weakness, and only people who are weak get PTSD. It is not weakness but rather a human response to uncommon experiences. The trauma experienced may be in the form of a personal trauma, a natural disaster, multiple traumatic events, or trauma that continues over a long term period. Usually those with PTSD have a poor interpersonal support system in place.
  • Myth: Anything can be traumatic. While almost any situation or event could be deemed traumatic in some way, there is criteria in place that needs to be met in order to be classified as “traumatic” which includes a) exposure to actual or threatened death, serious injury or sexual violence, b) directly experiencing the event, witnessing it in person, or being indirectly exposed to the event such as repeatedly hearing and/or seeing the details of a traumatic event.
  • Myth: You can get PTSD immediately after experiencing a traumatic event. Initial emotional reactions are expected; however, stress reactions need to last at least a month for a diagnosis of PTSD to be considered. Acute Stress, while similar to PTSD, may be diagnosed within the first month of the trauma.
  • Myth: People with PTSD are crazy and/or dangerous. PTSD is not demonstrated with psychosis or violence. “Crazy” is not a diagnosis but is a stigmatizing label.
  • Myth: Those with PTSD should “just get over it.” While PTSD can be successfully treated, the symptoms do not just “go away” even with time, and these bothersome symptoms may require continued professional treatment and guidance to cope and adapt.

Treatment for PTSD

Whether you have experienced a trauma recently or decades ago, there is treatment for PTSD. Seeking out help does not mean you failed in coping with your emotions. Getting treatment is a sign of strength and desire to live life to the fullest. Call the office today for a confidential psychiatric evaluation and begin the healing process.

College Transitions with Mental Health Disorders

College students with psychiatric disabilities are entitled to reasonable academic accommodations as provided by the American Disabilities Act of 1990 and 2008 amendments. The University of Washington through a grant from the U.S. Department of Education reports that tens of thousands of adult students report having a mental illness. Students with mental illness may experience symptoms that interfere with their educational goals and create a “psychiatric disability.”

Mental Health Intervention for College Transitions

Without mental health intervention, proper medication if prescribed as part of the treatment plan, or adjunct services, college students with mental health issues may experience severe disturbances in thinking, emotions or functional life skills. These disturbances may bring a diminished capacity to cope with the demands and stress of college life, which include a time of significant transition, a new lifestyle, friends, an alternate way of thinking, and exposure to new cultures along with the pressure of academic rigor and expectations.

College Transitions and Substance Abuse

Academic demands, new peer pressures, and poor ability to adapt and cope to the new environment of a college campus may result in students struggling with mental health or psychiatric disorders. The National Center on Addiction and Substance Abuse report 45% of college students binge drink and almost 21% abuse prescription or illegal drugs, often due to the students’ struggle to feel adequate and cope with their new life situations. Partnering with a qualified college transition psychiatrist can help steer the college student toward positive management of both their psychological issues and academic success.

Symptoms of College Psychiatric Disability

Some of the most common symptoms exhibited by adult students with developing psychiatric disabilities include:

  • Difficulty concentrating, making decisions and remembering things
  • Exhibiting increased anxiety, fear, suspicion, or blaming of others
  • Confused or disorganized thinking
  • Denial of obvious problems and resistive to offers of help
  • Displays of extreme highs or lows in mood
  • Marked personality changes over time
  • Talking about or thinking about suicide

College Transition Psychiatrist

Developing a strategy and treatment plan, as well as stabilizing any psychiatric issues, can help to minimize psychological and mental health issues that would otherwise prevent a successful first college experience. Call the office for a confidential appointment.

PTSD and Heart Disease in Women

CNN recently reported on the results of a 20 year study that show women with post-traumatic stress face a 60% higher risk of developing cardiovascular disease. In addition, the study discovered that women who experienced a trauma without reporting any PTSD symptoms still faced a 45% higher risk of heart attack and stroke than women who did not report any trauma in their lives.

PTSD Occurrence

Post Traumatic Stress Disorder is twice as common in women as in men occurring in some people following a traumatic event in their lives. Those with PTSD may experience flashbacks of the traumatic event, insomnia, fatigue, trouble with memory or focus and a feeling of emotional numbness. Other symptoms of PTSD include nightmares, irritability, or of being easily startled or upset. A knowledgeable psychiatrist will be able to successfully direct the treatment plan to manage both mental health and physical health concerns.

Cardiovascular Disease vs PTSD Symptoms

Data from the 20 year study indicated that almost half of the association between elevated PTSD symptoms and cardiovascular disease was accounted for by unhealthy behaviors like smoking, obesity, lack of exercise and medical factors such as high blood pressure. While PTSD is typically looked at as a psychological disorder, findings from the study point to the profound impact PTSD has on physical health, specifically cardiovascular risk, making PTSD a potentially serious health impacting mental health disorder.

PTSD Symptoms

PTSD symptoms are generally grouped into one of four types: 1) intrusive memories, 2) avoidance, 3) negative changes in thinking and mood, or 4) changes in emotional reactions. The symptoms most commonly seen in each type follow:

Intrusive Memories – symptoms may include:

  • Reliving the traumatic event over and over again
  • Unwanted distressing memories recur frequently
  • Upsetting dreams related to the traumatic event
  • Severe emotional distress
  • Emotional or physical reactions to reminders of event

Avoidance – symptoms seen include:

  • Avoiding places, people or activities that reminds one of the traumatic event
  • Making an effort to avoid thinking or talking about the traumatic event

Negative Changes in Thinking and Mood – symptoms include:

  • Having negative feelings about oneself or others
  • Being unable to experience positive feelings or emotions
  • Feeling emotionally numb
  • Loss of interest in activities once enjoyed
  • Feelings of hopelessness or impending doom
  • Memory loss related to important details about traumatic event
  • Trouble maintaining close relationships

Changes in Emotional Reactions – symptoms for this include:

  • Self-destructive behaviors
  • Overwhelming guilt or shame
  • Feeling constantly on guard for danger
  • Expressions of irritability, aggressive behavior, outbursts of anger
  • Difficulty concentrating or focusing
  • Experiencing sleep disturbances
  • Finding yourself easily startled or frightened

Treatment for Women with PTSD

There has been great success in treating PTSD with a combination of medication and cognitive behavioral therapy. An experienced psychiatrist understands the connection between PTSD and increased risk of cardiovascular disease; both the mental and physical aspects of PTSD will be covered in a treatment plan geared to individual needs.

Call the office to set up an initial visit at a time convenient to your schedule.

Mental Health Self-Assessment

Thousands of people every day wonder if their behavior or emotional state is normal or not. Unfortunately, someone can needlessly suffer for years before their actions or symptoms become out of control and psychiatric help is finally sought.

Mental Health Diagnoses

With more than 200 classified forms of mental health illness, the organization Mental Health Awareness reports that mental health disorders often share similar symptoms. When multiple diagnoses are present, it takes a skilled professional to make an accurate assessment to design an individual treatment plan for recovery.

Following are some of the numerous symptoms and problematic behaviors that indicate further mental health appraisal is in order.

  • Exhibiting frequent and dangerous sexual acting out: The issue may be psychological, emotional or trauma based and include sexting, acting as a prostitute, having sex with multiple partners or wanting an open relationship without boundaries.
  • Displaying frequent physical and/or verbal aggression: Having a “quick temper” or a “difficult personality” does not automatically point to a mental health disorder. Behaviors alerting you to a possible mental health disorder include frequently lashing out in anger at others, being abusive to others (verbal, physical, or sexual abuse), or acting in a manner that jeopardizes your job or living conditions.
  • Planning to harm yourself or commit suicide: All suicidal threats need to be addressed. Threats with a plan need immediate attention.
  • Finding yourself extremely fatigued or depressed: Many have experienced being “worn out” from a hectic work or family week, or feeling sad and depressed about their job, financial situation or relationship. A mental health evaluation may be in order if you suffer for example from chronic sleep disturbance, feel hopeless or helpless, do not care about previously enjoyed activities, have weight gain or weight loss, find yourself irritable with others for no real reason, or finding it more and more difficult just making it through the day.
  • Preoccupation with physical appearance, money or crime: Many in our society may display narcissism yet still be within “normal” ranges. Clinical narcissism on the other hand, interferes with one’s daily life routine. Examples include acting impulsively, gambling beyond your means, displaying risky sexual behaviors including infidelity, substance abuse / addiction, or being extremely vain.  It is time to make an appointment with a psychiatrist for therapeutic intervention.
  • Flashbacks or night terrors: After experiencing or witnessing a traumatic event, it is not uncommon to experience flashbacks or night terrors. Flashbacks about such a traumatic event is known as Secondary Trauma which can often be just as upsetting as or more so than the original event.
  • Frequent mood changes: Those that suffer from emotional lability, changing moods, engaging in risky behaviors without restriction, and having intense emotional reactions to normal everyday situations would find receiving the correct mental health diagnosis or the more common dual or combination mental health diagnoses and treatment life changing.

With the multitude of disorders and mental health illness where symptoms may be identical or overlap, a mental health evaluation by a specialist in the field will find the correct diagnosis so that proper treatment can be started.  Call the office for an appointment today.

PTSD: Gender Differences

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder brought on by a traumatic event and which continues with symptoms of re-experiencing the trauma, avoidance, numbing of the senses and hyper arousal. While most may readily associate PTSD with war veterans, the disorder can affect anyone with research studies showing that women are twice as likely as men to develop PTSD.

Research Results on PTSD

The American Psychological Association reported on a review of 25 years worth of PTSD research in their Psychological Bulletin.  Results of the research showed that while men had a higher risk for being involved in a traumatic event, the numbers of those diagnosed with PTSD were significantly higher for women. PTSD may be diagnosed in women more often than men due to the differences between the sexes in their cognitive and emotional responses to a traumatic event – these differences in emotional responses are part of the diagnostic criteria for PTSD.

PTSD Presents Differently Between Sexes

Those men and women diagnosed with PTSD do not only show a difference in emotional responses; they also display a difference in the symptoms they report. A qualified mental health professional needs to be well informed and practiced with PTSD sufferers of both sexes for a proper and correct diagnosis. The National Center for PTSD reports some of these differences between the sexes are noted as:

  • Women are more likely to have symptoms of numbing and avoidance
  • Men more likely to have co-morbid substance abuse disorders
  • Women are more likely to have co-morbid mood and anxiety disorders
  • Men more likely to feel angry and have trouble controlling their anger
  • Women more likely to feel depressed and anxious
  • Men more commonly have problems with alcohol or drugs
  • Women have more trouble feeling emotions and they tend to avoid anything that reminds them of the trauma
  • Women with PTSD have less memory loss and a lesser degree of cognitive function than men
  • Both men and women may develop problems with their physical health

PTSD Risk Factors for Women

One in ten women may develop PTSD after a traumatic event. Women are at a higher risk for being diagnosed with the disorder if they:

  • Have a past mental health problem such as depression or anxiety
  • Experienced a very severe or life-threatening traumatic event
  • Were physically injured during the traumatic event
  • They were sexually assaulted
  • Experienced other stressful situations after the traumatic event
  • Has limited to poor social support

Atlanta PTSD Support

Finding the correct treatment for PTSD begins with the correct diagnosis. Call the office of Dr. Hege for a confidential appointment.

Sleep Problems and Psych Disorders: The Relationship

Research has found that sleep problems which used to be viewed as a symptom of mental health disruption may actually be a contributing factor for psychiatric disorders. Studies at Harvard Medical School confirm that sleep problems affect between 10% to 18% of adults in the general U.S. population; the percentage of adult patients seen in psychiatric practices with chronic sleep issues jumps to 80%.

Sleep Problems Point to Increased Risk for Psychiatric Disorders

Patients with a diagnosis of anxiety, depression, bipolar disorder and ADHD commonly report being plagued with sleep problems. While sleep dysfunction was once viewed as a symptom, clinical data supports the hypothesis that adult sleep problems raise the risk for developing a psychiatric disorder. In long term studies it was found that adults who reported a history of insomnia were four times as likely to develop major depression on re-evaluation three years later, indicating the sleep disruptions developed before the mental health disorder.

Sleep Problems versus use of Antipsychotics

Sleep issues and insomnia began to be more closely looked at in the 1970’s. The sleep problems were thought to be directly tied to use of antipsychotics at the time; however, data indicates a long history of sleep disturbance complaints long before use of antipsychotics began. Today it is more widely believed that chronic sleep problems puts one more at risk for the development of psychiatric issues and that treating the sleep disorder can actually assist in alleviating symptoms of a co-occurring mental health problem.

Sleep Disorders in Psychiatric Patients

Of the more than 70 types of sleep disorders the most common problems are insomnia, obstructive sleep apnea, unpleasant sleep movement syndromes and narcolepsy. The University of Brazil Medical School reports the type and impact of the sleep problems vary by the psychiatric diagnosis with examples noted below:

  • Up to 90% of adults with major depression experience a sleep problem
  • One-in-five adults with depression suffer from obstructive sleep apnea
  • Depressed adults with insomnia less likely to respond to treatment, at a higher risk for relapse and are more likely to die by suicide
  • Up to 99% of adults with bipolar disorder experience insomnia or restless sleep
  • In adults with bipolar depression up to 78% sleep in excessive amounts
  • More than 50% of adults with anxiety disorders have dysfunctional sleep patterns
  • Sleep problems precede anxiety disorders 27% of the time
  • Sleep dysfunction precedes depression 69% of the time
  • 68% of adults with PTSD report sleeping problems
  • Long term studies indicate that insomnia or other sleep disruptions worsen before a manic episode or bipolar depression

Sleep and mental health are interconnected though not yet completely understood. Neurochemistry studies do indicate that having a good night’s sleep promotes a healthier outlook, while chronic sleep problems can set up an arena for negative thought processes and emotional vulnerability. Call the office for a comprehensive evaluation with Dr. Hege who will work with you to get your sleep patterns and mental health issues back into functional ranges.

PTSD: Women 2X the Rate of Men

While most people associate the term PTSD more closely with those seeing military action, Post Traumatic Stress Disorder has affected over 30 million adults in the U.S. who have not experienced military service. Both men and women develop PTSD; however, women are twice as likely as men to be diagnosed with PTSD. Approximately 1 out of every 10 adult women will face PTSD.

What’s Normal and what’s PTSD

After living through a traumatic event, it is normal to display some of the symptoms of PTSD. It is not uncommon to feel numb, crazy, disconnected, fearful and distrustful. Bad dreams and inability to stop dwelling on the event is also normal. Depending on the impact of the traumatic situation, “PTSD symptoms” may last for a few days, weeks or even months however they slowly decrease over time – with PTSD you do not start to feel better – you start to feel worse.

PTSD Symptoms

PTSD can affect the victim, police officers, emergency medical personnel, neighbors, or family and friends of the victim. PTSD is experienced differently by everyone, however there are three main types of symptoms that are reported for PTSD:

Re-experiencing the traumatic event over and over in your mind

  1. Flashbacks about event
  2. Nightmares
  3. Upsetting memories that impact your function and relationships
  4. Intense distress or fear
  5. Physical reactions such as pounding heart, sweating, nausea, shortness of breath

Avoiding reminders of the event and feeling numb

  1. Loss of interest in normal routine, activities and life
  2. Avoiding thoughts, feelings and places that remind you of the traumatic event
  3. Poor to no ability to remember details of the situation
  4. Feeling numb and detached from the world around you
  5. Sense of impending doom or that something bad will happen

Increased anxiety and emotional turmoil

  1. Sleep problems
  2. Feeling irritable or having outbursts of anger
  3. Problems concentrating or focusing
  4. Feeling on edge, jumpy, and tense
  5. Feeling like you are constantly on “red alert” for doom and gloom

PTSD Psychiatric Treatment

Other common PTSD symptoms may also include depression, guilt, feeling all alone in the world, having physical aches and pains, having suicidal thoughts, developing a substance abuse habit, or feeling betrayed. PTSD may have common symptoms but each case is unique, requiring an experienced psychiatrist to develop a treatment plan for your own individual experiences and symptoms.

Atlanta PTSD Help

If you think you have PTSD seek help as soon as you can. There is help for overcoming PTSD and getting your life back to normal. Call the office for an appointment today.