Identify the dysfunctional symptoms of post-traumatic stress disorder, how to recognize them?

The percentage of diagnoses of mental conditions has increased in recent years due to the pandemic.

Joalex Antongiorgi, psychiatrist and child specialist on the campus of medical sciences at the University of Puerto Rico. Photo: Provided by Dr. Antongiorgi to the Journal of Medicine and Public Health.

The term is often heard post-traumatic stress (PTSD) when talking about war veterans, as well as people who have witnessed or experienced any kind of aggression, incident, catastrophe or other serious event.

All these types of circumstances can trigger a psychiatric condition capable of generating dysfunction in people’s normal behavior, while also affecting the quality of their interpersonal relationships and therefore their quality of life.

In a conversation conducted by the Journal of Medicine and Public Health with Dr. Joalex Antongiorgi, who is a psychiatrist on the Medical Sciences campus of the University of Puerto RicoThe expert explained the main symptoms of post-traumatic stress.

“First of all, these people tend to have obsessive thoughts that are very repetitive. They also deal with avoidance behavior, that is, they avoid the topic and avoid talking about how they feel about it. They become hyperreactive to some stimuli around them and their mood is affected.

And that is that according to the medical literature, these signs usually appear within three months after a traumatic event, although sometimes they may appear later. It is now important to clarify that the presence of some of these symptoms is not synonymous with this disorder, as it is diagnosed in people whose prevalence of the clinical picture reaches or exceeds four weeks and its manifestations interfere with various aspects of their daily lives. life as personal and work relationships.

“As this combination of factors has already been identified, we can analyze what it is post-traumatic stressbut not everyone will develop it, “he said. “If we see, for example, the frequency of the veteran population compared to the general population of Puerto Rico, we will see a higher prevalence among veterans due to the number of high-risk incentives they have been exposed to.

However, this does not mean that all people who have been directly or indirectly affected by traumatic circumstances will develop post-traumatic stressand the presence of one of the above-mentioned symptoms does not mean that the person suffers from it.

“Maybe they can be reactive people who have always been like that in their lives, but that doesn’t mean it’s PTSD. “There must be dysfunction and an effect on the four categories I mentioned in order to make a diagnosis,” he said.

Post-traumatic stress in the pediatric population, how does it manifest itself in children?

Children are very vulnerable to suffering from this type of condition, and even more so if we take into account the events in Puerto Rico, not only because of the pandemic, but also because of climatic and environmental events that somehow interfered with its normal development.

“When we think of normal growth, school is an important factor, not only because of everything they learn academically, but also because of the social relationships they build there, sharing with other people and how they deal with conflict,” he said.

We can take as a reference, for example, the passage of Hurricane Maria through the island in 2017 and the impact it left as a consequence on Puerto Ricans; In fact, studies show that after this natural disaster, between 8% and 10% of babies experience symptoms associated with the disorder. post-traumatic stress.

“They are not yet mature enough to handle things, although we have seen that they are more resilient,” he added.

In addition, it is common for a person, including children and adolescents, with PTSD to develop symptoms associated with depression, such as low self-esteem, frustration and predisposition, to resort to high-risk actions that need to be treated by a mental health professional.

“Symptoms of depression are seen in many conditions, but being sad is not necessarily a psychiatric condition. By this I do not mean that we should not deal with sadness or that we do not care about sad children; We need to acknowledge these emotions and provide support to the patient, but by acknowledging that their mood is not part of the picture of major depression.

Unlike adults, depressive symptoms in children and adolescents are manifested through irritability, very noticeable changes in behavior, changes in assessments, social isolation, patterns of dysfunction and others.

Return to normalcy: the challenge for patients with PTSD

Regarding the recent shooting at an elementary school in Uwalde, Texas, the expert said it was important to emphasize that there is a high level of social stigma against people diagnosed with mental health, as they would blame and involve acts of violence and aggression similar to the aforementioned event that took place in the United States.

“This behavior is not secondary to pathology, and in fact most of our patients are not aggressive or dangerous to society. “On the contrary, everything that is happening is a problem that we need to see,” he said. “Hate is not a psychiatric condition.”

Taking this as a reference, the specialist pointed out how the process of reintegration of minors present during the event in their daily lives should be, as he assures that many of them can develop post-traumatic stress disorder.

“The first thing we need to do is try to get them back to normalcy as soon as possible; “The more time they spend out of school outside their routine, the more they will be affected because they will spend more time remembering what happened,” he said. “The other thing is that we should avoid asking him or making him remember what happened, because we will make him relive the moment.”

Of course, in situations like this, educational strategies should be sought not only for minors or parents, but also for teachers and staff who can participate.

“We need to teach them what the symptoms of dysfunction are so that they are aware, and once we identify them, we need to start working on them early,” he concluded.

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