Individuals Can Become Temporarily Overwhelmed

The harm, such as it is, may arise in several areas. First, accuracy in the terminology that all clinicians use is important for communication. Second, it is important for research. It is doubtful that the biological stress reactions and neural circuit patterns that occur when teenagers struggle with a romantic breakup are identical to those that occur with the overwhelming fear of death when others are trying to kill you. Third, it matters for evaluations. For that reason, the definition of what constitutes a traumatic event is extremely important because this determines who is eligible for the diagnosis. The diagnosis is the starting point for much of what psychiatrists, psychologists, social workers, and other types of mental health clinicians do for patients. It is the same reason that it is wise to have one type of money for everybody within a country. If your grocery store does business in dollars, but the drug store uses drachmas, and the gas station uses yen, it would be quite inefficient. Sounds simple and basic, but this is the kind of confusion parents currently face with many mental health providers. Fourth, and perhaps most important, in order to determine the best treatment options, clarity is needed about stress versus trauma matters. The wrong diagnosis could mean a patient receives the wrong treatment.

What Happens Tomorrow?

Part of my job at Tulane involves supervising doctors who are in training to become child and adolescent psychiatrists. When police entered the home, they also decided to charge the mother with neglect because this boy and his siblings were in the home unsupervised and without food. The trainee had assumed that the experiences of both neglect and being separated from his mother were traumatic. Instead, we backed up and reviewed the case. Furthermore, the child did not exhibit distress or avoidance of reminders of possible abuse or violence that might be clues for traumatic events we did not know about. The wrong treatment can be delivered on a much larger scale, too. In the usual money grabs that occur after disasters in the United States, these discussions happened at many other universities as well. There is harm from lumping stressful events in with traumatic events. A person does not need all twenty symptoms for the diagnosis. Instead, a person needs one or more symptoms from each of the four clusters, so there is a wide variety of ways one can qualify for the diagnosis. Patient #1 may have two cluster B symptoms, one cluster C symptom, three cluster D symptoms, and two cluster E symptoms. Patient #2 may have the same two cluster B symptoms, one cluster C symptom, and three cluster D symptoms just like the first person, but then have three instead of two cluster E symptoms.

Hard To Believe

That which we call a rose by any other name would smell as sweet. As written by William Shakespeare, these are the immortal lines Juliet spoke to argue that it did not matter to her that her Romeo came from the wrong family and had the wrong family name. In contrast, in psychiatry, the name is of great consequence. The name in psychiatry is the diagnosis, and it determines nearly everything that needs to happen in the treatment. The right diagnosis determines whether treatment is needed at all. The right diagnosis determines whether the wrong type or the right type of treatment is given. In addition, patients must have both symptoms and impairment to formally qualify for a diagnosis. Unwanted memories of the traumatic events burst into their minds. These memories are always distressing, and patients find it difficult to control them and make them go away. Nightmares and highly distressing dreams. Young children usually call out for their parents when they have nightmares. Adolescents may handle them on their own and not tell their parents.

Any Other Way

Sometimes the dreams do not cause the youths to wake up, but they are highly distressing, and the youths can be seen thrashing around or calling out in their sleep. Dreams often are by nature symbolic in the sense that the events and characters in dreams are not the real events and characters that the sleeping mind is thinking about. Individuals can become temporarily so overwhelmed by their own thoughts and feelings that they break from reality in what are called dissociative reactions. There are two types of dissociative reactions. In the classic reaction, called a flashback, persons feel like they are back in the traumatic events and they act accordingly. He was also receiving weekly psychotherapy with a female therapist in our clinic. During one of his psychotherapy sessions, he suddenly stood up and started backing into a corner of the room and started screaming, Stay away from me! Get away! He put his arms up to defend himself from blows, but his therapist had been seated and calmly talking with him. Something, however, had triggered him and he felt like he was back in the moment when he had been beaten by his father and then thought the therapist was his father. After a few minutes, he calmed down and recognized where he was again. In the second and far more common type of dissociative reaction, persons freeze and stare straight ahead into space for a few moments. These reactions usually last less than a minute. Most of these episodes probably go completely unnoticed because the children do not cause any disturbance. Psychological distress when triggered by reminders. The triggers are specific to the traumatic events that the individual experiences. The triggers can be places, people, objects, sounds, music, smells, or thoughts. The boy would become distressed every time he had to be strapped into his car seat because it instantly reminded him of the accident. Physiological distress when triggered by reminders. Typical reactions include heart racing, hands shaking, butterflies in the stomach, dry mouth, lump in the throat, sweating, and stuttering. More severe reactions may involve dizziness, nausea, and vomiting. This symptom can be difficult to tell apart from psychological distress when triggered by reminders.