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Q: Is This PTSD & What to Do
Dear Doctor Phelps,
I have a question about PTSD. I was diagnosed as being Bipolar in 1990, and just
three years ago my mother (who given 3 to 6 months to live) died in my arms at
her home. I have constant flashbacks and get very upset and anxious when these
flash backs occurr. Is this considered PTSD behavior? And what can I do to rid
myself of
this terrible monster?
Thank YOu for your time,
Cheryl
Dear Cheryl --
You have at least one component of PTSD, namely intrusive recall. If you
also have avoidance, i.e. try to manage your life so as not to have these
recollections; and hypervigilance/arousal (this one's pretty vague, but you can
think of it as "anxiety", especially anxiety that revolves around the theme of
the trauma itself -- like getting anxious driving past a hospital or something),
then you would have full PTSD, most likely. You could of course have other
things also.
What to do about PTSD? In general, psychotherapy
is a "must try". It doesn't always work, but it should be tried.
Then there are a lot of medications that have helped some people:
antidepressants are usually tried first, and Prozac has one of the best records
in that respect, Zoloft is also in there.
Mood stabilizers are often useful; among them
topiramate has one "open study" (no control group) with some really stunning
rates of response, although that's not been replicated so far and the drug has
some side effects to watch out for. Low doses of antipsychotics are
frequently used, especially the newer ones (Risperidone, Seroquel, Zyprexa;
maybe Geodon but it's pretty new). And finally there's the anxiolytics
(basically the Valium family although some would include Buspar; we usually use
and tend to favor one called Klonopin (clonazepam is the generic).
In other words, there are a lot of things to
try. I hope you find one that helps. As you might gather, I'd be
inclined to steer you toward psychotherapy first if you can
find
a good therapist in your area.
Dr. Phelps
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