Post-traumatic stress disorder (PTSD) is a challenging condition with a collection of possible symptoms: nightmares, relentless harmful emotions (anger, fear, guilt), hypervigilance, flashbacks, and an amplified startle response. PTSD patients are at greater risk of suicide. About 80-percent of the afflicted also suffer from other psychiatric problems (depression, alcoholism, drug abuse). Some causes of PTSD are rape, combat exposure, child abuse, accidents, and fire. Psychiatrist Jain (the daughter of immigrants from India with a family history of trauma) incorporates anecdotes of her patients to help explain the etiologies, diagnoses, and treatments of PTSD. A sampling includes a woman who is sexually assaulted as a teenager and later endures her baby's SIDS death, a marine who served in Iraq and witnessed a street bombing that maimed or killed many civilians, and an individual badly injured in a car accident. The best treatment remains talk therapy (cognitive behavioral therapy), and medication (chiefly SSRI antidepressants) can be beneficial. Jain asserts that the importance of accessible treatment and early intervention for PTSD cannot be overstated, while also emphasizing the genuine healing value of empathy and simply listening.
Part 1. Discovering traumatic stress. The road trip with my father ; A pressing public health concern ; A brief history of trauma ; Old wine in a new bottle? From shell shock to battered women to PTSD ; Rocky roads: overdiagnosis and underrecognition -- Part 2. The Brain. A disorder of memory ; Nightmares ; Flashbacks ; An unlived life: the hidden cost of avoidance ; Denial land: when trauma memories are deeply buried ; Carrying sorrows in the blood: cortisol, epigenetics, and generational trauma ; A wildness in the bones: acute awareness and shady moods ; Dissociation: the two-thousand-yard stare -- Part 3. The Body. Bodily wounds ; A soldier's heart: PTSD and cardiac disease ; Russian roulette: the perilous bond between traumatic stress and addiction ; Broken smiles: the toxicity of childhood adversity ; Senescence: traumatic stress in late life -- Part 4. Quality of life. Complex trauma ; Intimate violence: a secret pandemic ; A danger to others: hurt people hurt other people ; Angry loving: the stubborn imprint of inner-city poverty ; The fairer sex? Rape, secondary injuries, and postpartum PTSD ; Shame: the Cinderella emotion ; The science of suicide prevention -- Part 5. Treating traumatic stress. Talking cures and beyond ; Psych meds ; Medication management ; The allure of magic bullets -- Part 6. Our world on trauma. Trauma of the masses: a wicked problem ; The 1947 partition ; War, disaster, and terror: hard-earned knowledge and lessons for the future ; An Americanization of human suffering? -- Part 7. New era: an ounce of prevention. Prevention with precision ; The golden hours ; Reaching the hard to reach: making PTSD treatment more accessible ; The power of social networks ; The science of resilience ; Afterword: a precious inheritance
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