PTSD
DSM 5 Criteria
Exposure to events
Persistent avoidance of stimuli associated with the trauma
o Accompanied by feelings of detachment, emptiness, and
numbing
Negative alterations in cognition and mood
o Chronic depression, negative appraisals, lack of interest in
previously pleasurable activities
Alterations in arousal and reactivity
o Irritability, difficulty sleeping, difficulty concentrating,
hypervigilance, or exaggerated startle response
Can be triggered by a singular or multiple events of exposure
War
Abuse
Natural disasters
Crime-related
Intrusive thoughts take control of everyday life
Anxiety provoked
Common S/S of PTSD
Recklessness or self-destructive behaviors
inability to recall details of the traumatic event
Nightmares/flashbacks
Isolation
Distant
Disinterested
Depression- feelings of hopelessness/helplessness
Survivors guilt
Interventions
o Assess overall
Anxiety
SI/HI
DON’T RUSH RESPONSES
Calm/safe environment – establish trust
, Identify triggers
Evaluate coping mechanisms that patient uses
Journaling
Visualization
Mindfulness – being present in the moment
Support groups
o Way for patient to feel part of something
bigger. Can see how others cope
Relaxation techniques
o Pet therapy, herbal, meditation
Defense mechanisms
o Minimize anxiety/guilt (Freud)
o Unpleasant emotions, impulses, thoughts from conscious mind
1. Repression: involuntary block (unconscious)
2. Suppression: voluntary (deliberate) - try to forget
Purposely try to forget
Don't think about event
Do everything they can to avoid
Treatment
Medications
o SSRI
Sertraline, Fluoxetine, Escitalopram, Citalopram
Signs of serotonin Syndrome:
S – Seizures
S – Sweating and fever
R – Rigidity of muscles
I – Increased HR
NSG considerations:
Monitor sodium levels
SI
Give in morning with or without food
Monitor weight loss if nausea occurs
Report rash or itching
Do not use within 14 days of taking MAOI
o SNRI
Duloxetine
DSM 5 Criteria
Exposure to events
Persistent avoidance of stimuli associated with the trauma
o Accompanied by feelings of detachment, emptiness, and
numbing
Negative alterations in cognition and mood
o Chronic depression, negative appraisals, lack of interest in
previously pleasurable activities
Alterations in arousal and reactivity
o Irritability, difficulty sleeping, difficulty concentrating,
hypervigilance, or exaggerated startle response
Can be triggered by a singular or multiple events of exposure
War
Abuse
Natural disasters
Crime-related
Intrusive thoughts take control of everyday life
Anxiety provoked
Common S/S of PTSD
Recklessness or self-destructive behaviors
inability to recall details of the traumatic event
Nightmares/flashbacks
Isolation
Distant
Disinterested
Depression- feelings of hopelessness/helplessness
Survivors guilt
Interventions
o Assess overall
Anxiety
SI/HI
DON’T RUSH RESPONSES
Calm/safe environment – establish trust
, Identify triggers
Evaluate coping mechanisms that patient uses
Journaling
Visualization
Mindfulness – being present in the moment
Support groups
o Way for patient to feel part of something
bigger. Can see how others cope
Relaxation techniques
o Pet therapy, herbal, meditation
Defense mechanisms
o Minimize anxiety/guilt (Freud)
o Unpleasant emotions, impulses, thoughts from conscious mind
1. Repression: involuntary block (unconscious)
2. Suppression: voluntary (deliberate) - try to forget
Purposely try to forget
Don't think about event
Do everything they can to avoid
Treatment
Medications
o SSRI
Sertraline, Fluoxetine, Escitalopram, Citalopram
Signs of serotonin Syndrome:
S – Seizures
S – Sweating and fever
R – Rigidity of muscles
I – Increased HR
NSG considerations:
Monitor sodium levels
SI
Give in morning with or without food
Monitor weight loss if nausea occurs
Report rash or itching
Do not use within 14 days of taking MAOI
o SNRI
Duloxetine
