Integrative Psychiatry and TMS

The person has been exposed to a traumatic event in which both of the following were present:

1. the person experienced, witnessed, or was confronted with an event that involved actual or threatened death or serious injury, or a threat of the physical integrity of the self or others.

2. the person’s response involved intense fear, helplessness, or horror.

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Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociate symptoms:

1. Subjective sense of numbing, detachment, or absence of emotional responsiveness.

2. A reduction in awareness of his or her surroundings (e.g., “being in a daze”).

3. Sensation of changed reality or that one’s surroundings have altered.

4. Sensation of unreality concerning oneself or parts of oneself.

5. Inability to recall an important aspect of the trauma.

6. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.

7. Recurrent distressing dreams of the event.

8. Acting or feeling as if the traumatic event were recurring (including a sense of reliving the experience, illusions, hallucinations, and flashback episodes). These can occur on awakening or when intoxicated with drugs or alcohol.

9. Intense psychological distress and reactivity at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

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Persistent symptoms of increased arousal:

1. Difficulty falling asleep or staying asleep.

2. Irritability or outbursts of anger.

3. Difficulty concentrating.

4. Hyper-vigilance.

5. Exaggerated startle response.

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The disturbance usually occurs within 4 weeks of the traumatic event.

Treatment of Acute Stress Disorder can be a challenge, since the stressors that initially led to the disorder continue to affect the individual, and are beyond his/her control.

Supportive psychotherapy and counseling are usually the most effective in treating acute stress disorder. When medications are needed, their use would depend on the symptoms present. In most cases, a short term use of tranquilizers and (or) sleeping aids is sufficient to get the person back to normal functioning.