From our story try to know our subject ? Maria was only 15 when she was attacked by 6 men on the way home from school. They took her, remove all her clothes off let scream and then each one of them raped her while videoing . Finally, they tried to stab her to death and would almost certainly have succeeded but the police arrived after one of them was a fried of killing the victim . For months after this horrifying event, Maria was not herself. She was unable to keep the memories of the attack out of her mind. At night she would have terrible dreams of rape, and would wake up screaming. She had difficulty walking back from school because the route took her past the site of the attack, so she would have to go the long way home. She felt as though her emotions were numbed, and as though she had no real future. At home she was anxious, tense, and easily startled. She felt “dirty” and somehow shamed by the event, and she resolved not to tell close friends about the event, in case they too rejected her.

What is post traumatic disorder ? Its an anxiety disorder characterized by the persistent re- experience of a trauma , efforts to avoid recollecting the trauma, and hyperarousal .

Can you think with me about the cause !!!

Etiology : A lot of researches says develop post-traumatic stress disorder can be through, see or learn about an event involving actual or threatened death, serious injury or sexual violation. They aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of: Stressful experiences, including the amount and severity of trauma they've gone through in their lives Inherited mental health risks, such as a family history of anxiety and depression Inherited features of personality The way the brain regulates the chemicals and hormones in the body releases in response to stress

Etiology : So there is no specific reason or cause .. That’s why some people have the same experience but the do not develop PTSD

Symptoms : Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They divided into 4 types : 1- Intrusive memories: Recurrent, unwanted distressing memories of the traumatic event Flashback Nightmares Severe emotional distress or physical reactions to something that related to the trauma .

Symptoms : 2- Avoidance : trying to avoid thinking or talking about the trauma Trying to avoid any place , activity and people related or can remind them with trauma . 3- Negative changes in thinking and mood: Negative thoughts about them self also people around Hopeless Difficulty experience positive emotions Lack of interest in activity that was enjoyable for them

Symptoms : 4- Changes in physical and emotional reactions: trouble sleeping Trouble concentrating Irritabilty and anger Over guilt feelings

What is the risk factors ? Having other mental health problems, such as anxiety or depression Having problems with substance misuse, such as excess drinking or drug use Lacking a good support system of family and friends Having blood relatives with mental health problems, including anxiety or depression Having a job that increases your risk of being exposed to trauma

Think fast !!! Can the PTSD develop other mental disorders : Depression , anxiety , substance abuse , eating disorder and suicidal thoughts .

Differential diagnosis 1- acute stress disorder : similar features to PTSD but the on set within 1 month after exposure to the stress ( if the symptoms appear after 1 month so its PTSD and the minimum duration of ASD 2-4 days but id continued its PTSD 2-anxiety disorder

Differential diagnosis 3- adjustment disorder : stressor is not life threatening no dissociative features or flashbacks 4- head injury 5- substance abuse ( withdrawal , intoxication )

Treatment : Post-traumatic stress disorder treatment can help regain a sense of control over their lives . The primary treatment is psychotherapy, but can also include medication. Combining these treatments can help improve :

Treatment : Psychotherapy: 1-Cognitive behavioral therapy 2- eye movement desensitization and reprocessing (EMDR).

Treatment : Medications : Symptomatic treatment anti-anxiety : alprazolm Antidepressants : SSRI : sertraline

So … When you have some one you love and he/she develop PTSD how can you differentiate if its PTSD od ASD ?! how can you help ?!

Summary : (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. It starts after one month . And the TTT is symptomatic .

Reference : Basic psychiatry of Mohammed Abdullah Al-Sughayir http://www.mayoclinic.org/diseases-conditions/post- traumatic-stress-disorder/home/ovc-20308548 Psychiatry book by Micheal J.Murphy and Ronald L.cowan