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Michael G. Rayel
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Books
• Passing Strategies

• Successful Preparation for the Psychiatry Oral Exam

• First Aid to Mental Illness: A Practical Guide for Patients and Caregivers


Articles
• Major Depression and Its Serious Complications

• Emotional Intelligence: The Basics

• Panic Attacks: Effective Ways to Cope

• How to Deal with Your Child’s Inappropriate Behaviour

• Announcing Expectations

• What is the Treatment for Bipolar Disorder?

• Make Role Modeling a Hobby

• How Do You Know if You Have Manic-Depression

• Is Dysthymic Disorder a Second-Rate Depression?

• How Distressing is Social Phobia?


News
• Forensic Psychiatrist Creates Kid's Game To Help With Life Issues

• Maker of Oikos Game Announces Annual Contest for Kids

• Oikos Game: An Invention for Emotional Success

• Raising Possibility Kids through Oikos Game

• FDA Suicide Warning for Antidepressants: Is it the right decision?

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Psychology

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Posttraumatic Stress Disorder: Nightmare After The Ordeal
By Michael G. Rayel
Last edited: Sunday, March 20, 2005
Posted: Sunday, March 20, 2005

Each time she watches TV shows that remind her of the incident, she gets scared, overwhelmed, and becomes agitated.
Sarah is a 28 y/o accountant who had a traumatic past that she kept to herself. At age 15, she was grabbed by a masked man while she was jogging in a park. The man threatened to kill her with a knife and brutally raped her. She screamed but nobody seemed to have heard her.

Since that time, Sarah has developed nightmares about being raped or killed. In most days, she has suffered from flashbacks of her being attacked. Each time she watches TV shows that remind her of the incident, she gets scared, overwhelmed, and becomes agitated. At times, she develops anxiety attacks, palpitations, sweating, and restlessness.

Since the attack, Sarah can hardly trust people. As a result, her relationships have profoundly suffered. More recently, she’s been depressed and feeling hopeless. She hasn’t been sleeping and eating well. Her inattention has negatively impacted her work.

Based on the above symptoms, Sarah is most likely suffering from Posttraumatic Stress Disorder (PTSD). What exactly is PTSD?

PTSD is a psychiatric disorder characterized by avoidance, hypervigilance, emotional difficulties, and recall behavior such as flashbacks and nightmares after a traumatic event such as rape, war, vehicular accident, or natural disasters. Recent researches have shown that after a trauma, biochemical changes develop in the brain that can result in psychological signs as shown above.

If untreated, some individuals develop emotional difficulties such as depression associated with inability to concentrate, sleep, and eat. Occasionally, they also become hopeless to the point that they want to die.

What is the treatment for PTSD?

The combination of individual psychotherapy and medications is known to help. Antidepressants especially SSRIs have been tried with some success. Other medications have been helpful to address the associated symptoms. Anxiety and agitation can be treated with benzodiazepines. The latter should be restricted to short-term use because of their addiction potential. Insomnia can be treated by a small dose of Trazodone.

Psychotherapy or “talk therapy” is an important part of treatment and recovery. The individual should be able to express the fear, the frustration, the guilt, and the blame in a secure and safe setting. Moreover, the therapist should provide ample support and empathy.

About the Author:

Copyright © 2005. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: An Emotional Intelligence or EQ Game. For more information, please visit www.oikosgame.com and www.soardime.com






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Reviewed by Savage Grace 11/19/2007
If the "nightmare" goes untreated for years after the event it can cause enough damage that returning to "Normal" becomes questionable.
Reviewed by m j hollingshead 3/22/2005
well done
Reviewed by Karen Lynn Vidra, The Texas Tornado 3/21/2005
excellent and informative write, michael; i suffer somewhat from ptsd myself; when i was little, a kid tried to set my hair on fire, and ever since, i have had a bad fear whenever i am around fire.

(((HUGS))) and love, your tx. friend, karen lynn. :(


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