DR. HOOK- Post-trauma tip: Take advantage of help

One of my favorite movies of all time is When Harry Met Sally. No, it isn't because of Meg Ryan's "faking it" scene in the restaurant. I love the movie because of the way Billy Crystal's and Meg's characters deal with their losses in love. Harry mopes a lot. Sally becomes a cold, distant person who thinks everything is fine. Billy eventually yells at her, "How can everything be fine? Don't you feel anything?"

When something awful happens in your life, how do you deal with it?

Post-traumatic stress disorder (PTSD) is described in the medical literature as "the complex somatic, cognitive, affective and behavioral effects of psychological trauma." (Don't you love science?) What that means in English is, "Something bad happened to you, and now you're a mess. You don't sleep well, and you probably have nightmares and flashbacks about the bad event. You avoid things that remind you of the trauma. You're on edge and snap like a wound-up rubber band. "

Rape, personal assault, incest, kidnapping, military combat, natural or human-made disasters, severe motor vehicle accidents, diagnosis of a life-threatening illness– all these traumatic events can easily lead to PTSD. (So can listening to Marilyn Manson.) People are all individuals and deal with events in different ways. Overall, the lifetime chance of a person having PTSD is thought to be 7.8-12.3 percent.

Interestingly, one study showed by MRI that people with a small hippocampus (the part of the brain that deals with emotions and memory) have more PTSD. There might also be a brain chemical component that makes a person more at risk for developing PTSD.

After a terrible event such as rape, a person has an "acute phase" (immediate response to the event) that lasts for hours to days. The person might totally freak out (think Omarosa), cry a lot but be controlled (Suzy in The Biggest Loser), or be totally calm and devoid of emotions (Meg Ryan as Sally, "I'm totally fine. The more I think about it, the more I'm at peace about it.").

One might experience physical feelings like headaches, body pains, itching, change in appetite, and sleeping problems. Emotional issues are common such as depression, anxiety, and mood swings.

The next phase is "delayed or organizational." I think about war movies like The 4th of July and Coming Home in which the characters experience flashbacks, nightmares, and phobias. There's a lot of grief as well– sadness over what happened, a feeling that a part of them died in the experience, and anger for what has occurred.

PTSD can last from months to years, and it often presents as depression and/or anxiety, which unfortunately can lead to alcohol and drug abuse. Friendships and relationships can go downhill because the person emotionally shuts down. Others around a person with PTSD often feel like they have to walk on eggshells because the PTSD person can lash out very quickly due to a type of hyperarousal– a defensive feeling.

What to do? I encourage my patients to undergo psychotherapy. Most patients say to me, "Doc, I'm not crazy. I don't need to see a shrink." I respond, "A therapist is a great mentor. Learn some tools to put under your belt and deal with your issues differently. A therapist is going to be able to help you see things in a different way."

Medications can help, too, despite what Tom You-Know-Who says. SSRI medications, like Lexapro, reduce flashbacks, depression, anxiety, moodiness, and avoidant behaviors. For those with severe anxiety, a short course of anxiolytics, like clonazepam, might be helpful– but there is a risk of addiction.

Life can be very tough. Olympia Dukakis in Steel Magnolias says something like, "The difference between humans and animals is that we can accessorize." Well, we have medications and therapists to help people with PTSD adjust– so why not use them?