Post Traumatic Stress Disorder Case Study
Case study one discusses the current situation that a 27-year old male, Josh is going through. Three months ago, Josh was walking to meet his Fiancée for lunch one day when she was struck and killed by a car, right in front of his eyes. He was with her in the final moments that she was alive, and has recently quit his job. It has become too difficult for him to revisit the area in which his Fiancée was killed and now lives with his parents. Often he finds that he relives the scene of her death in his head. He has nightmares nearly every night regarding the event and various aspects of his life have been affected as a result of the accident. It is due to the evidence presented in this case study that I can conclude, Josh is suffering from a very serious case of Post Traumatic Stress Disorder.
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The evidence for Josh having PTSD is very clear when consulting the criteria for this disorder.
The symptoms for Post Traumatic Stress Disorder are grouped into four different categories: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions (“PTSD Overview,” 2014). The case study says that it has been three months since Josh’s Fiancée was killed, and the symptoms for Post Traumatic Stress Disorder are said to begin anywhere from three months after the event occurs or can remain dormant until years following the traumatic event. In Josh’s situation, he is experiencing a number of symptoms at the three-month mark, as determined by the case study. Broken down into the four categories of symptoms for Post Traumatic Stress Disorder, Josh is experiencing at least one symptom from each of the
categories.
Firstly, Josh is definitely experiencing at least three of the four symptoms associated with intrusive memories. He has recurrent and unwanted distressing memories of the traumatic event. He also has flashbacks where he relives the traumatic event, as if it were happening again. Finally, he has nightmares almost daily that also mirror the traumatic event. It is unclear in the case study whether or not Josh is experiencing the fourth symptom of intrusive memories, which is when someone has “severe emotional distress or physical reactions to something that reminds you of the event” (“PTSD Overview,” 2014). Intrusive memories are perhaps the strongest of the symptoms that Josh is experiencing, which leads to the diagnosis of Post Traumatic Stress Disorder. Secondly, Josh is most certainly exhibiting patterns of avoidance. There are two distinct aspects of avoidance symptoms: 1) Trying to avoid thinking or talking about the traumatic event 2) Avoiding places, activities or people that remind you of the traumatic event (“PTSD Overview,” 2014). It is evident that Josh is experiencing the second of the avoidance symptoms. Considering his work was located directly across from the where his Fiancée was killed, it was nearly impossible for him to return to work the following few times that he attempted to go. It is because of this that he decided to quit his job. His avoidance behavior has also led to him being unable to go to that section of town, due to the event that took place there. These actions surely contribute to the symptom of avoidance that Josh is experiencing. In terms of the third category of symptoms, which is “negative changes in thinking and mood”, Josh is dealing with a difficulty in maintaining close relationships, feels emotionally numb, and has a lack of interest in activities that he once enjoyed. While he only experiences three of the seven symptoms that appear with the negative changes in thinking and mood, these symptoms greatly impact Josh’s quality of life. As the case study says, Josh has become withdrawn and has moved back in with his parents. These two examples absolutely play a large part in Josh’s ability to maintain close relationships. If he is only having contact with his parents and is becoming increasingly withdrawn, it is unlikely that he is speaking to or spending time with many people outside of his family. Another contributing symptom to this category is the fact that Josh has lost interest in activities that he had once enjoyed. He no longer works out, plays guitar or basketball with his friends like he used to. This confirms that he doesn’t spend time with friends or partake in activities that he once enjoyed, leaving him isolated. His parents reported that they are worried about how “detached and emotionally flat he’s become”. This statement gives way to the symptom that Josh is experiencing, relating to feeling emotionally numb (“PTSD Overview,” 2014). Finally, Josh shows one of the symptoms for changes in emotional reactions. It has been noted on the case study that he has been “jumpy” and irritable following his Fiancée’s death. Irritability, angry outbursts or aggressive behavior is one of the symptoms that falls under the category of changes in emotional reactions. It is evident that this is what Josh is experiencing. Another one of the symptoms is “being easily startled or frightened” (“PTSD Overview,” 2014). This could be the explanation for Josh’s jumpy behavior, which could be best described as him being startled or frightened. Now that it is clear that Josh is suffering from Post Traumatic Stress Disorder, what are the treatment options that he has? The preferred method for treating Post Traumatic Stress disorder is a combination of psychotherapy and medication. The three main types of psychotherapy that are used are cognitive therapy, exposure therapy and eye movement desensitization and reprocessing (EMDR). Cognitive therapy allows you to think about and recognize the ways in which you think about the traumatic event that is leading you to be stuck in those moments (“Treatments and Drugs,” 2014). Exposure therapy helps the individual face what has been causing the disorder in a safe manner so that the individual can learn how to cope with it effectively. Eye movement desensitization and reprocessing works to put the individual through a series of guided eye movements that will help them to process the memories and change how they react to such memories (“Treatments and Drugs,” 2014). The medications that are often prescribed in addition to psychotherapy are antidepressants, anti-anxiety medications and prazosin, which is not FDA approved but may reduce or suppress nightmares in people with PTSD (“Treatments and Drugs,” 2014). Post Traumatic Stress Disorder, when experienced over a 12-month period is found in 3.5% of the U.S. adult population (“PTSD Among Adults”). Out of these cases, 36.6% of them are marked as severe (Kessler, p. 617-27). The fact that a little less than 40 percent of cases are marked as severe shows that there is a large need for assistance with this disorder. The website for the National Institute for Mental Health (NIMH) also says that the average age of onset can be placed around 23 years old, although depending on when the trauma was experienced, Post Traumatic Stress Disorder can often come up at different times for each person who experiences it (“PTSD Among Adults”). Even children are susceptible to having this disorder, depending on the trauma that they experience. Only 57.4% of those who are living with PTSD are receiving treatment for it (“PTSD Among Adults”).
The evidence for Josh having PTSD is very clear when consulting the criteria for this disorder.
The symptoms for Post Traumatic Stress Disorder are grouped into four different categories: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions (“PTSD Overview,” 2014). The case study says that it has been three months since Josh’s Fiancée was killed, and the symptoms for Post Traumatic Stress Disorder are said to begin anywhere from three months after the event occurs or can remain dormant until years following the traumatic event. In Josh’s situation, he is experiencing a number of symptoms at the three-month mark, as determined by the case study. Broken down into the four categories of symptoms for Post Traumatic Stress Disorder, Josh is experiencing at least one symptom from each of the
categories.
Firstly, Josh is definitely experiencing at least three of the four symptoms associated with intrusive memories. He has recurrent and unwanted distressing memories of the traumatic event. He also has flashbacks where he relives the traumatic event, as if it were happening again. Finally, he has nightmares almost daily that also mirror the traumatic event. It is unclear in the case study whether or not Josh is experiencing the fourth symptom of intrusive memories, which is when someone has “severe emotional distress or physical reactions to something that reminds you of the event” (“PTSD Overview,” 2014). Intrusive memories are perhaps the strongest of the symptoms that Josh is experiencing, which leads to the diagnosis of Post Traumatic Stress Disorder. Secondly, Josh is most certainly exhibiting patterns of avoidance. There are two distinct aspects of avoidance symptoms: 1) Trying to avoid thinking or talking about the traumatic event 2) Avoiding places, activities or people that remind you of the traumatic event (“PTSD Overview,” 2014). It is evident that Josh is experiencing the second of the avoidance symptoms. Considering his work was located directly across from the where his Fiancée was killed, it was nearly impossible for him to return to work the following few times that he attempted to go. It is because of this that he decided to quit his job. His avoidance behavior has also led to him being unable to go to that section of town, due to the event that took place there. These actions surely contribute to the symptom of avoidance that Josh is experiencing. In terms of the third category of symptoms, which is “negative changes in thinking and mood”, Josh is dealing with a difficulty in maintaining close relationships, feels emotionally numb, and has a lack of interest in activities that he once enjoyed. While he only experiences three of the seven symptoms that appear with the negative changes in thinking and mood, these symptoms greatly impact Josh’s quality of life. As the case study says, Josh has become withdrawn and has moved back in with his parents. These two examples absolutely play a large part in Josh’s ability to maintain close relationships. If he is only having contact with his parents and is becoming increasingly withdrawn, it is unlikely that he is speaking to or spending time with many people outside of his family. Another contributing symptom to this category is the fact that Josh has lost interest in activities that he had once enjoyed. He no longer works out, plays guitar or basketball with his friends like he used to. This confirms that he doesn’t spend time with friends or partake in activities that he once enjoyed, leaving him isolated. His parents reported that they are worried about how “detached and emotionally flat he’s become”. This statement gives way to the symptom that Josh is experiencing, relating to feeling emotionally numb (“PTSD Overview,” 2014). Finally, Josh shows one of the symptoms for changes in emotional reactions. It has been noted on the case study that he has been “jumpy” and irritable following his Fiancée’s death. Irritability, angry outbursts or aggressive behavior is one of the symptoms that falls under the category of changes in emotional reactions. It is evident that this is what Josh is experiencing. Another one of the symptoms is “being easily startled or frightened” (“PTSD Overview,” 2014). This could be the explanation for Josh’s jumpy behavior, which could be best described as him being startled or frightened. Now that it is clear that Josh is suffering from Post Traumatic Stress Disorder, what are the treatment options that he has? The preferred method for treating Post Traumatic Stress disorder is a combination of psychotherapy and medication. The three main types of psychotherapy that are used are cognitive therapy, exposure therapy and eye movement desensitization and reprocessing (EMDR). Cognitive therapy allows you to think about and recognize the ways in which you think about the traumatic event that is leading you to be stuck in those moments (“Treatments and Drugs,” 2014). Exposure therapy helps the individual face what has been causing the disorder in a safe manner so that the individual can learn how to cope with it effectively. Eye movement desensitization and reprocessing works to put the individual through a series of guided eye movements that will help them to process the memories and change how they react to such memories (“Treatments and Drugs,” 2014). The medications that are often prescribed in addition to psychotherapy are antidepressants, anti-anxiety medications and prazosin, which is not FDA approved but may reduce or suppress nightmares in people with PTSD (“Treatments and Drugs,” 2014). Post Traumatic Stress Disorder, when experienced over a 12-month period is found in 3.5% of the U.S. adult population (“PTSD Among Adults”). Out of these cases, 36.6% of them are marked as severe (Kessler, p. 617-27). The fact that a little less than 40 percent of cases are marked as severe shows that there is a large need for assistance with this disorder. The website for the National Institute for Mental Health (NIMH) also says that the average age of onset can be placed around 23 years old, although depending on when the trauma was experienced, Post Traumatic Stress Disorder can often come up at different times for each person who experiences it (“PTSD Among Adults”). Even children are susceptible to having this disorder, depending on the trauma that they experience. Only 57.4% of those who are living with PTSD are receiving treatment for it (“PTSD Among Adults”).