My first encounter with Post traumatic Stress Disorder, or PTSD dates all the way back to the early 80’s in Moscow, USSR. I was a young family physician then. One day, during routine home visits I meet a young man who just recently came back from Afghanistan. At that time the war was between the Soviet Union and Afghan rebels. As we are learning now, the consequences to both parties involved were and remain the same. They were and are disastrous. That young man apparently witnessed a number of atrocities. He was visibly anxious to the point of sheer panic. He also complained of frequent flashbacks and night terrors he experienced almost every night. Unfortunately, at that time I was just beginning to practice homeopathy and could not fully appreciate this and adequately prescribe for the young man. Later in my life I had another opportunity to face PTSD. Lamentably, this opportunity is known worldwide as 9/11. I was in New York working at the Center for Health and Healing of the Beth Israel Medical Center. I was surprised that very few patients came. But slowly, more and more surfaced, frequently coming with seemingly unrelated complaints. I’ve seen a significant number of patients since then and as it turned out, this time I was well prepared. Homeopathy brought about amazing results of the kind that conventional (allopathic) psychiatry has not been able to achieve. The goal of this article is to share my experience with my fellow homeopaths, and anyone willing to learn and apply this miraculous healing practice of homeopathy.
Posttraumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events, such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assault like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping and feel detached or estranged. These symptoms can be severe enough and last long enough to significantly impair the person’s daily life.
Data from a number of studies indicates that up to 30% of individuals of various age groups, including children and adolescents exposed to life-threatening events, present with a clinical picture of PTSD 1-4. Unfortunately, only about a fourth of victims discuss their problems. For example, despite universal health coverage and the benefits of an employee assistance program for all employees, only 28.5% of those with PTSD symptoms have talked to a health professional about the events of Hurricane Katrina or issues encountered since the storm 4.
To memorize all the key signs of PTSD, psychiatrists suggest the following mnemonic:
E – Event/experience (threatening to life or physical integrity of self or others)
R – Re-experiencing (flashbacks, nightmares etc)
A – Arousal (anxiety, startle, hypervigilance, irritability)
A – Avoidance (of things, places, images etc. reminiscent of event)
D – Duration of plus one month
It is important to remember that PTSD can occur at any age, including childhood. Not surprisingly, PTSD is generally more severe or long-lasting when the trauma is of human design (e.g., torture, terrorist attack) vs. a natural disaster (e.g., earthquake)
History of PTSD
As one can easily imagine, even from such a basic fact as having had wars throughout human history, PTSD has always been there. Below are some highlights of historical development for better understanding of PTSD.
1900 B.C. – Egyptian physicians report hysterical reaction.
VIII Century B.C. – Homer in The Odyssey describes flashbacks and survivor’s guilt.
490 B.C. – Herodotus writes of a soldier going blind after witnessing the death of a comrade next to him.
1597 – Shakespeare vividly describes war sequelae in King Henry IV
1600 – Samuel Pepys describes symptoms in survivors of the great fire of London.
1879 – Rigler coins term Compensation Neurosis
1880’s – Pierre Janet studies and treats traumatic stress. He describes “hysterical and dissociative symptoms”, inability to integrate memories, by “phasic nature” of suppression and intrusion.
1899 – Helmut Oppenheim coins term Traumatic Neurosis
WW I: – “Shell Shock”
WW II: -“Battle fatigue”, “Combat exhaustion”, and, again, “Traumatic Neurosis”
1980 – PTSD becomes a diagnostic category in DSM III
Careful research and documentation of PTSD began in earnest after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% and that 30% had experienced the disorder at some point since returning from Vietnam.
Nowadays clinical criteria characteristic to the majority of patients is best described in the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders 5.
â€¢ Exposure to a Trauma – The person has been exposed to a trauma, in which he or she has experienced or witnessed an event involving the threat of death, serious injury, or a threat to the physical well-being of oneself or others. Note that only physical threats count in the definition of a trauma in PTSD. Situations that represent a psychological threat (e.g., a divorce, being criticized by a loved one, being teased) are not considered traumas in the definition of PTSD, even though they may lead to difficulties for the individual.
â€¢ A Response of Fear, Helplessness, or Horror – The immediate response to the trauma is one of fear, helplessness or horror (in children, it may be a response involving disorganized behavior or agitation). If an individual’s response to the trauma is primarily one of sadness or loss, rather than fear (this is often the case following the death of a loved one who was ill), PTSD would likely not be diagnosed.
â€¢ Symptoms of Re-Experiencing the Trauma – The individual persistently re-experiences the event in at least one of the following ways:
1. Recurrent and disturbing memories, images, and thoughts about the trauma.
2. Recurrent and disturbing dreams or nightmares about the trauma
3. Acting or feeling as if the trauma was occurring again (these experiences are often called flashbacks). This may include hallucinations (e.g., seeing things or hearing voices that were present during the trauma, even though they are not really there currently), misinterpreting things that are heard or seen (e.g., being convinced that the sound of fireworks in the distance is actually the sound of gunfire).
4. Becoming emotionally upset upon being exposed to reminders of the trauma, including physical sensations that were present during the trauma or situational reminders (e.g., the street where the trauma occurred, the anniversary of the trauma).
5. Becoming physically aroused (e.g., breathless, heart racing) upon being exposed to reminders of the trauma, including physical sensations that were present during the trauma or situational reminders (e.g., the street where the trauma occurred, the anniversary of the trauma).
â€¢ Symptoms of Avoidance and Emotional Numbing – The individual avoids triggers and reminders of the trauma, or experiences a sense of emotional numbing, as indicated by at least three of the following features:
1. Avoiding thoughts, feelings, or conversations that remind the individual of the trauma.
2. Avoiding activities, places or people that remind the individual of the trauma.
3. An inability to remember important aspects of the trauma.
4. A lack of interest or participation in significant activities, such as socializing, work, and hobbies.
5. Feeling detached or different from others.
6. An inability to enjoy things or to experience positive emotions (e.g., feeling “flat”).
7. A sense that one’s future will be shortened. For example, it may be difficult to imagine having a career, getting married, having children, or having a normal life span.
â€¢ Symptoms of Increased Arousal and Vigilance – The individual has symptoms of arousal and vigilance that were not present before the trauma, as indicated by at least two of the following features:
1. Difficulty falling or staying asleep.
2. Feeling irritable and grumpy, or experiencing outbursts of anger and temper tantrums.
3. Difficulty concentrating.
4. Hypervigilance (e.g., always being on guard, looking over one’s shoulder while walking down the street, etc.)
5. Becoming startled very easily (e.g., jumping when the telephone rings).
â€¢ The problem must last at least one month for a diagnosis of PTSD to be assigned.
â€¢ The individual’s fear, anxiety, avoidance, or other PTSD symptoms cause significant distress (i.e., it bothers the person that he or she has the symptoms) or significant interference in the person’s day-to-day life. For example, the difficulties may make it difficult for the person to perform important tasks at work, meet new friends, attend classes, or interact with others.
Conventional Treatments for PTSD and Acute Stress Disorder.
Most of the treatment guidelines suggest psychotropic medications (psychopharmacology) and /or various types of psychotherapy6-8. While certain types of psychotherapy have been consistently shown to be effective in treatment of PTSD7,9, the evidence of the effectiveness of psychotropic medications has been, at best inconclusive 8,9. Remarkably, one of the most frequently used prophylactic psychological tools, a brief psychological intervention (debriefing), that is conducted immediately after the exposure to a stressful event, has also been reported ineffective in preventing of development of PTSD10. A large proportion of female PTSD victims opt for psychotherapy over medication11. Most frequently cited reasons are the effectiveness (or lack thereof) of a treatment, including potential masking of symptoms with the medication and more logical, long-lasting effects with the psychotherapy.