درمان سرطان ریه

اختلال استرس پس از سانحه (PTSD) چيست؟

تلفات سنگين، نااميدي ها و ديگر آزمايشات سرنوشت در زندگي بزرگسالان و كودكان اتفاق مي افتد. افرادي كه سطح بالايي از مقابله (تحمل استرس) دارند، مي‌توانند منابع رواني را براي زنده ماندن در شرايط بدون به خطر انداختن سلامت روان خود بسيج كنند. هنگامي كه مكانيسم هاي مقابله اي به اندازه كافي قدرتمند نيستند، اختلال جدي در عملكرد روان رخ مي دهد كه به عنوان اختلال استرس پس از سانحه (PTSD) تشخيص داده مي شود. اين بيماري با اختلالات رواني مشخص مي شود كه از سازگاري با زندگي عادي پس از تجربه ضربه رواني جلوگيري مي كند. اطلاعات بيشتر در مورد تشخيص، علائم و روش هاي درمان را در مقاله بخوانيد.

علل اختلال استرس پس از سانحه

PTSD بر اساس يك واكنش ذهني غيرقابل كنترل به فشار بيش از حد عاطفي و ارادي ناشي از استرس شديد است. بيمار ممكن است خود در معرض اقدامات رواني باشد يا شاهد يا شركت كننده در رويدادهاي رواني باشد.

مهم ترين شرايطي كه باعث ايجاد اختلال رواني استرس مي شود:

بلاياي طبيعي يا اجتماعي؛

جنگ؛

اپيدمي؛

حمله تروريستي، گروگان بودن؛

خشونت خانگي (شايع در كودكان و زنان)؛

حادثه جنايي (تجاوز جنسي، سرقت يا باطري)؛

بيماري شديد غير قابل برگشت، ناتواني، نقص زيبايي شناختي جبران نشده؛

مرگ ناگهاني اقوام و دوستان نزديك.

در زنان، علل PTSD اغلب خاتمه يك بارداري مورد انتظار (سقط جنين)، ماستكتومي (برداشتن غده پستاني) است.

نوع سوماتوفرم با اضافه شدن اختلالات قلبي، گوارشي و عصبي مشخص مي شود. همراه با تغييرات رواني رفتاري، درد منظم در قفسه سينه، شكم، گردن، كمر و سر ايجاد مي شود. به عنوان يك قاعده، خود بيماران بر كمك پزشكي اصرار دارند، اما براي درمان تظاهرات منحصرا جسمي به يك درمانگر مراجعه مي كنند.

الكليسم، اعتياد به مواد مخدر و ساير اختلالات رواني (هيپوكندريال، افسردگي، پارانوئيد، مضطرب، فوبيك، هراس، اسكيزوئيد) اغلب در پس زمينه PTSD ايجاد مي شوند.

تقريباً همه بيماران مبتلا به اختلال استرس پس از سانحه علائم زير را دارند:

واكنش هاي مبهوت كننده - لرزيدن در پاسخ به محرك هاي خارجي غير منتظره (معمولاً صدا)؛

اختلال در ريتم شبانه روزي؛

واكنش هاي فوبيك؛

اختلال خوردن؛

عدم تعادل؛

تحريف هاي شناختي؛

اختلال در مهارت هاي ارتباطي؛

هوشياري بيش از حد، سوء ظن، هوشياري مداوم.

PTSD بر عملكردهاي ذهني بالاتر - حافظه، تفكر، توجه، ادراك و انتقال اطلاعات تأثير منفي مي گذارد. به همين دليل، عملكرد كودكان در مدرسه كاهش مي يابد و بزرگسالان در حوزه حرفه اي مشكلاتي دارند.

تشخيص و درمان اختلال استرس پس از سانحه

اختلال استرس پس از سانحه توسط روانپزشك و روان درمانگر (در كودكان، توسط متخصصان اطفال) تشخيص و درمان مي شود. پزشك تاريخچه پزشكي را مطالعه مي كند، جزئيات آسيب رواني را روشن مي كند و آزمايشاتي را براي ارزيابي وضعيت رواني (رواني) بيمار انجام مي دهد. براي حذف بيماري هاي جسماني كه منجر به تغييرات ذهني مي شود، آزمايش خون براي هورمون ها، EEG و MRI مغز تجويز مي شود.

درمان PTSD در دو جهت - تثبيت وضعيت رواني و تقويت سلامت جسماني انجام مي شود. تاكتيك هاي درماني و روش هاي اصلاح رواني به صورت جداگانه انتخاب مي شوند.

دارودرماني

دوز و رژيم داروها بسته به علائم اصلي، عوارض در حال توسعه، ميزان انگيزه و پاسخ بيمار به درمان تجويز مي شود. درمان شامل ***‌هاي خواب، ضد افسردگي‌هاي سه حلقه‌اي، آرام‌بخش‌هاي طبيعي - استرسوويت، يك مخلوط گياهي آرام‌بخش، جوشانده خار مريم، قطره‌هاي Zelenin، آماده‌سازي سنبل الطيب (نورونورم Sw، تنتور الكل، گياه در كيسه‌هاي فيلتر) است.

At the first stage, the person denies what happened. On the second, he realizes what happened and experiences strong emotions (fear, horror, anger, sadness). On the third, he accepts what happened and adapts. If after the second stage a person does not move on to the third stage and gets stuck in the trauma, he develops PTSD.

In the acute period (the first month after the traumatic event), a crisis psychologist works with the client. For example, if we are talking about shock due to physical trauma, being in a military conflict zone. And the trauma therapist gets involved later.

The psychologist’s task is to help the client live through the second and third stages. To do this you need:

Inform the client. Tell him that his condition is a normal reaction to a traumatic situation. Recommend books, talk about PTSD. It is important that the client understands what is happening to him and that it can be dealt with.

Work with the individual holistically. It is important not only to remove the symptoms of PTSD and work out the cause, but also to explain to the client the importance of a healthy lifestyle. Help him maximize his personal potential.

Provide social support. Communication with a psychologist already provides a powerful base, but it is important that other people also support the client. This could be friends, family or therapy groups.

Help the client individually reassess the traumatic experience. Direct processing of trauma.

PTSD Treatment Plan

1. Establishing contact. The specialist needs to determine the client’s motivation and mood, his attitude towards therapy, himself and the psychologist himself. Set up for work: talk about PTSD, therapy, talk through the client’s fears and anxieties.

The goal of therapy is to help the client feel in control of life, accept experience, and take responsibility. At the beginning, it seems to him that the future is doomed, and the pain will never go away. The psychologist’s task is to set the client up for work. To do this, at the stage of establishing contact, you can ask questions:

What helped you cope at that moment?

What has kept you going all this time?

What you went through is terrible, but can you say that it made you stronger?

What resources did you see in yourself then, and do you see now?

What would you say to someone who has experienced something similar?

In the work, you can ask questions from three groups: establishing contact, collecting information about the injury, maintaining the client’s confidence. It is important to move at a pace that is comfortable for the client to avoid retraumatization.

2. Working with emotions. The psychologist needs to help the client release repressed feelings and emotions. And also ask the client’s loved ones to support the experience of emotions, and not try to distract him.

3. Processing traumatic memories. The psychologist’s task at this stage is to work through the trauma using psychotherapy methods.

In addition, the psychologist must remember that a person may have several traumas, and they may overlap each other. And the subjective perception of a traumatic situation is different for each client. There cannot be a universal algorithm in PTSD therapy; in this article we have analyzed the basis of the work.

PTSD therapy, also known as post-traumatic stress disorder therapy, encompasses a range of evidence-based treatments designed to help individuals recover from the psychological and emotional impact of traumatic experiences. The primary goal of PTSD therapy is to alleviate symptoms, improve daily functioning, and promote long-term recovery. Various therapeutic approaches, such as cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and medication, can be utilized depending on the individual's needs and preferences.

Cognitive-behavioral therapy (CBT) is one of the most commonly used and effective forms of PTSD therapy. CBT focuses on identifying and changing negative thought patterns and behaviors associated with trauma. The therapy helps individuals develop coping strategies, challenge distorted beliefs related to the traumatic event, and gradually confront situations that trigger distressing memories. CBT may also involve exposure therapy, where individuals are guided through carefully controlled and gradual exposure to traumatic memories or situations.

Eye Movement Desensitization and Reprocessing (EMDR) is another evidence-based therapy often used in the treatment of PTSD. EMDR involves the use of bilateral stimulation, such as eye movements or tapping, while recalling distressing memories. This process aims to facilitate the reprocessing of traumatic memories and reduce the emotional intensity associated with them. EMDR also incorporates elements of cognitive restructuring and relaxation techniques to promote healing and resolution.

Medication can be a valuable component of PTSD therapy, particularly in cases where individuals experience severe symptoms or struggle with co-occurring conditions such as depression or anxiety. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressant medications that can help alleviate symptoms of PTSD. Other medications, such as prazosin, may be used to target specific symptoms like nightmares or sleep disturbances. Medication should be prescribed and monitored by a qualified healthcare professional.

Group therapy and support groups can also play a significant role in PTSD therapy. Connecting with others who have experienced similar traumas can provide a sense of understanding, validation, and support. Group therapy allows individuals to share their experiences, learn from others, and develop coping strategies together. It can foster a sense of community and reduce feelings of isolation that often accompany PTSD.