Shadowing-Übung: PTSD. Psychiatrist Explains What It Is And How To Get Help - Englisch Sprechen Lernen mit Video

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Post-traumatic stress disorder, aka PTSD,

we have a psychiatrist here to help us understand this incredibly challenging phenomenon.

Welcome to Talking with Docs of Dr. Bradwyn.

I'm Dr. Paul Zalzel.

And I'm Dr. Sammy Barakat.

Okay, so if you've had a traumatic experience

or a series of traumatic events and the aftermath of this

and how you live your life and how you're dealing with it or affected by it, that's kind of where this falls.

So let's start at the beginning Sammy.

How does someone know that they've gone from having something traumatic

Versus having a little bit anxiety about it versus having full-on

post-traumatic stress disorder good question I think the biggest distinction is functioning after the event.

I think it's normal after a traumatic event

Or event that causes distress to have anxiety perhaps some sleeplessness Preoccupation with the event, but you're still able to function.

You still feel like yourself your relationships are intact You're able to go to work.

You're able to, you know, do other things that are part of your normal functioning And when

that starts to go in addition to a myriad of other

symptoms We start to think of some more intense impacts of the trauma

And is this trauma something that just happened or could it be some trauma that happened like a while ago?

It can be something that happened a while ago.

Okay.

There can be delayed onset of symptoms sometimes It's not always

immediately after the trauma Although for the most part you can pretty much tie it back to what the trauma was.

Okay, and is it always an isolated incident

or could it be a series of incidents or in the setting of maybe your job like a first responder?

Is that a unique type of post-traumatic stress?

Yeah, I think that's a that's a good question

because there are different there are different types in in the pure form of PTSD it was it's a single event trauma,

but for certain occupations like first responders, police officers, military personnel.

It can be repeated exposures over time.

So again, but the idea of a post-traumatic stress disorder is the exposure has to be somewhat specific, right?

So it's, you know, real or threatened death.

It's a violence or sexual violence or a significant accident that are often the triggers

and then you re-experience it in a certain way, right?

So either you have to have been the victim of the event

or you have to have witnessed it directly

or it can be recounted to you by a loved one or a very close friend.

But again, often that's for something violent or significant.

Or again, there is a category for those first responders, military personnel, where you get repeated exposure,

right, to distressing images, aspects of your work that result in post-traumatic symptoms.

And I think that's kind of the first distinction.

So say you have a very negative experience giving a speech when you're in grade four, and then you go on to be afraid of giving speeches.

That's more on the anxiety spectrum.

That is not post-traumatic stress.

Yes, that is not post-traumatic stress disorder.

It is not kind of purely a subjective definition.

That has to be something significant fitting into one of those categories.

Okay.

Unless the teacher yelled at you and told you you were useless.

But even then I don't...

Yeah, even then that's not kind of, you know, threatened death or...

But again, repeated, you know, if you're if you grew up in childhood and you're repeatedly verbally abused in that way, that can lead to a myriad of mental health difficulties.

Not necessarily PTSD.

We need some nasty teachers.

Sure.

Okay, so can we talk a little bit about the the diagnostic criteria, and I think the timeline is a significant thing about PTSD, like how long you felt these symptoms.

Can we talk about how that defines an acute stress response versus the disorder?

So if you have immediate kind of consequences fitting all the criteria for PTSD and they're forming kind of categories, there are intrusive recollections of the event.

There's avoidance of stimuli related to the event.

There's a category related to changes in cognition or mood related to the event.

And then there's a change in arousal state.

And within each of those broad categories, there are different examples that we could get into.

But if you have all of that almost immediately, but it resolves within the first month, That fits into the category of an acute stress disorder.

If it kind of persists beyond that and becomes a bit more longstanding, then you start getting into post-traumatic stress disorder.

Right.

Tell me a bit about that delayed onset.

So you get over it in a month.

Okay, it's just an acute stress disorder.

You recover, let's say, and then 10 years later, all of a sudden it can show up again as a delayed onset of PTSD?

It can, but often there's a new trigger.

Often there's something else that happens, And it can sometimes be something that happens

that others wouldn't you would might not have suspected would trigger a Reawakening of the prior trauma, but it has okay and and the timeframe of it And again,

you have to kind of fit all the constellation of symptoms Okay, and categories in order to but what are some of those symptoms?

If you just give us like so if we're talking about the kind of intrusive recollections for instance, right?

It can be any one of a number of things it can be just Really intense Reflections, right or memories of it.

It can be ruminating on those memories.

It can be Nightmares, okay of the recurrent nightmares.

It can be almost Flashbacks, you know, people will lose track of the here now and almost feel like it happened yesterday or five minutes ago

in terms of the the Avoidance type of behaviors people start to avoid places,

sights, sounds, smells, media, anything that reminds them of the event, or any kind of thoughts or recollections of it, they start pushing away.

The changes in mood and affect can be kind of a change in the worldview, like people will close ranks, they will feel like the world is kind of unsafe, that their world is bad,

that they are bad, they can have a lot of shame or guilt about the event, somehow almost personalize that they're somewhat responsible for it.

Do they typically become more isolated?

Is that part of it?

People tend to withdraw from any people.

They can tend to withdraw completely and not really share what they're experiencing because they don't really trust as much as well.

You can lose experience and pleasure about things.

And then in terms of that hyper, those changes in arousal, those are kind of classic.

People can have exaggerated startle response.

So those people that even

when you talk quietly behind will jump right out of their seat

or you touch on the shoulder or hyper vigilant to their surroundings.

There's no environment that's they're really at ease.

They're always on guard for who's around.

Angry outbursts, impulsive or reckless behavior, difficulty concentrating, difficulty falling asleep.

Those are kind of the changes in arousal.

So if you, those are just in some examples of kind of constellation of things you can get it.

You get a sense of how much this would impact someone's

functioning to have all those things going on at once in a prolonged fashion.

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The other thing I'll say about the progression.

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Acute stress disorder can resolve with minimal support on its own.

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Once you have full-blown PTSD, it's hard to kind of just have it.

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It can get better over time.

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Some of the nightmares may stop over time, but the idea of the diagnosis is made, really, you need some sort of treatment.

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It's a fascinating disorder, and that's probably why we see it in Hollywood and movies so much, or in books.

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It's something that's portrayed in storytelling a lot.

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I wonder why that is, is that just because it's so interesting and so multifaceted?

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I think it's because it's fairly common, especially in first responders, military personnel.

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Like if you're in the military, you know, and you're in combat up to 10, 20% of people.

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Sure, isn't that high?

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Yeah, I mean, and again, there's a lure to it, right?

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That started in after World War I, the idea of shell shock, what is that?

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People coming back from war, completely different than they were, acting differently, struggling to function.

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So there's kind of a lure to it that's developed over time, and it's a serious condition.

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and it's very heterogeneous obviously in Hollywood

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or another depending on the genre it's portrayed fairly dramatically yes for effect

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but it's a what there's a wide range of behaviors

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that people can see it's not always dramatic

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so you're more subtle than we're seeing it absolutely can be quiet suffering for people right okay

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so so really what people hear now is probably like okay

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so if you think you may be on the path to this maybe you're not at the one month yet

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but if you've had something significantly traumatic and you're in that early phase, A, when should people seek care or help their family members seek care?

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And once they do get care, what does care look like?

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How do we treat this?

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So first of all, when should you go see somebody?

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I think the earlier you can see somebody, this is where the idea of debriefing comes from when it comes to traumatic events, right?

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Getting in early to engage with people that have experienced

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or witnessed a traumatic event and trying to have them explore their feelings and thoughts, check in with them.

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So that's an immediate impact that people need to do.

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And then if you begin suffering from these symptoms, then you need to seek help, right?

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There are obviously self-help mechanisms, but really it's a combination of medication and therapy that often helps people get better.

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There are a number of kind of evidence-based therapies that can be helpful for people.

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Yeah, let's talk about that.

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We've talked about what it is, how to diagnose it, what the symptoms are.

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And from what I've gathered, you're saying it is treatable.

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So there is hope with this.

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Yes, it is treatable.

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It's a complex condition, but it can be treated.

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The earlier the better.

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But yeah, there are a number of evidence-based treatments.

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Can you run through just sort of an overview of what this treatment looks like?

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So sometimes people will take medication to help kind of treat some of the core symptoms, especially the mood and anxiety symptoms related to the condition.

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And then there are different types of therapies that can be helpful.

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There's one that focuses kind of on a prolonged exposure therapy, where you methodically kind of go through in more detail and process the emotions and cognitions related to it.

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Cognitive behavioral therapy is a core.

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There's cognitive processing therapy, which is another type of therapy evidence-based.

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There's another type of therapy called eye movement.

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EDMR.

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Yeah.

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EMDR.

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Eye movement desensitization and reprocessing.

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And is that you're essentially focusing on whatever the problem is

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and your eyes are moving back and forth is

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that kind of the nature of it

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that in a nutshell yes that's what it is right in a nutshell it's the idea is

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that by by triggering eye movements uh as you're kind of exploring the affects

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and emotions of the events that you can um impact the brain

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and your neurons in certain way

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that help you process things better it's not necessarily eye movements it's evolved sometimes it's tapping sometimes it's tones

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but there's this idea that

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that in combination with some of the exposure to the emotions

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can help people get better faster without necessarily having to be so detailed in terms of the recollections.

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So a number of different therapies that are evidence-based

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that can help people get better as well as of course general self-care

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which is common to all mental health conditions right and not isolating yourself right which is very important too.

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With the exposure part is it is it talking about the event

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and like kind of thinking about it and reliving it

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that way or like

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if you were in a car accident you literally it's part

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of your exposure going into a car driving on a busy or both.

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If you're talking about the prolonged exposure in a very desensitized way, it usually starts with exploring your emotions.

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It starts in an office with imaginal exposure.

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Getting comfortable with thinking about it.

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Comfortable with the ideas of thinking about it.

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Right.

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And then ideally progressing to those things that you're avoiding.

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And kind of that.

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So it can take you into kind of what we say in vivo.

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Yeah.

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But you can't do that sometimes if it's a war that did it.

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No, of course not.

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Send you back into combat here, buddy.

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No.

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And that's kind of the base a little bit of CBT too right you're thinking about kind of what are you feeling?

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And you're kind of sitting with that saying okay, well is this a real threat?

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You know what do I do about it that kind of thing?

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Absolutely.

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Yeah, and of course with a trained therapist.

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Yes, okay And so how successful is treatment for this okay?

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You know we have some things that we treat

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and get like a 90% success rate some things we treat really like a 20% success rate Where does this fall?

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But someone has PTSD Looking at all, I think it's a tough question, but looking at all the different treatment options, what's the success?

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It's a tough question in terms of percentage, but if you have evidence-based treatment in an ongoing fashion,

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as well as medication management if necessary, I think the response is very good.

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Yeah.

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Very good for patients, but it can be a long journey.

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It is not a quick fix.

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What are we talking about?

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Months?

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Years?

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Certainly months.

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Okay.

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And sometimes in terms of the ongoing maintenance works, it can be years.

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I'm sure depending on the like the trauma too like I mean

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if you've had trauma for five well this is an interesting point I think it's important to make this point.

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Yeah, there is a kind of What we call complex post-traumatic stress disorder.

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It's not really within the lexicon of the diagnostic and statistical manual

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that we use in North America But certainly in the inter International classification of disease what the world uses.

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Yeah complex PTSD is not about single event or a few events.

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It's about people who are subject to trauma, either physical violence, sexual violence, emotional violence, all through their upbringing.

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So essentially it impacts their personality, their character, who they are, and becomes part of that character makeup, which is much more challenging.

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Also that chronic childhood abuse situation.

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Yes.

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And so complex post-traumatic stress disorder.

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So it's a form of post-traumatic stress disorder, but it adds a layer of complexity and a different layer of work that needs to happen.

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Yeah, and the symptoms can be somewhat and understandably be harder for a kid

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or now an adult to trust people

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When they've had years of say adults betraying them

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or whatever rather than being in a car accident or having Absolutely I mean, you're you know the ideally if you've had a healthy upbringing and you have this type of event happen Right.

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The goal is to try and get you back to where you were right, but if you've grown up with that You've never really experienced the safety right so you're really starting from scratch.

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Yeah And that's just sort of in the family of post-traumatic stress disorder but more subset of it within the complex.

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I guess within our world it's kind of a subset of it.

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But others would suggest yes it fits within comorbid other conditions

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and post-traumatic stress disorder so we start getting into crossover with other conditions where the symptoms start to overlap a bit.

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Okay.

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Wow there you go.

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Tough topic.

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Thank you.

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That's a complicated topic but you really nailed it for us into a way we could try

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and wrap our heads around it.

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And I would say like so many other mental health conditions, kind of the take-home message today is A, what you're experiencing is very real.

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B, it is very common.

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And C, there is help that is available to you.

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So do what you can to either help your family or yourself to reach out to get the process started.

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And if you like this video, please like it.

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Subscribe to our channel.

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Share a comment if you feel comfortable about your experience with this problem.

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And you're not alone if you're feeling this as we've talked about.

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It's a very common condition.

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Remember, you are in charge of your own health.

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Thanks, Dr. Pericott, for joining us.

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Thank you.

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Appreciate it.

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Thanks.

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We'll see you next time.

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"aka" (also bekannt als): Ein informeller Ausdruck, der oft in Gesprächen verwendet wird, um Begriffe zu erklären. Beispiel: "Post-traumatic stress disorder, aka PTSD". Übe, es nahtlos in Sätze einzubauen, um deine Sprache lebendiger zu machen.
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Beim shadow speech stößt du vielleicht auf Wörter, die schwieriger zu sagen sind. Hier sind die wichtigsten:

Post-traumatic: Achte auf die Betonung auf "trau" – nicht "post". Sage es langsam: "post-TRAUM-at-ic".
Psychiatrist: Die "ch" wird wie "k" gesprochen, nicht wie in Deutsch. Übe: "sai-KAI-uh-trist".
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Struktur	Im Video
Present Perfect have/has + Partizip Perfekt – eine vergangene Handlung, die jetzt noch wichtig ist	you've had · they've gone · have exaggerated
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