Post-Traumatic Stress Disorder
Case Study:Post-Traumatic Stress Disorder
You are working the afternoon shift in an inpatient psychiatric unit. The patients are in the day room watching a movie when suddenly someone starts yelling. You and other staff rush to the day room to find J.J., a 55-year-old male patient, crouched in the corner behind a chair, yelling at the other patients, “Get down. Get down quick. “You and the other staff are able to calm J.J. and the other patients and take J.J. to his room. He apologizes for his outburst and explains to you that the movie brought back memories of the Gulf War. He had forgotten where he was and thought he was in combat again. He describes to you in detail the memory he had of being ambushed by the enemy and watching several of his comrades be killed. You remember hearing in report that J.J. is a Gulf War veteran.
1. You read in his medical record that J.J. has post-traumatic stress disorder (PTSD). What are common causes of PTSD, and what is the most likely cause of J.J.’s condition?
2. According to the DSM-V, name three criteria that must be present to diagnose posttraumatic stress disorder (PTSD).
3. What is the difference between PTSD and acute stress disorder, according to the DSM-V?
4. Which symptom(s) of PTSD did J.J. most likely experience?
5. What therapeutic measures can be done to help J.J. during your shift this evening?
6. While you are in J.J.’s room, he states that he would like to rest for a while, and he requests something to “calm his nerves. “You check his medical record see these PRN medications listed. You review the Chart and the following medications are ordered PRN: Tylenol, Xanax, and Ambien.
a. Which medication is most appropriate to administer at this time? Explain.
7. What are the adverse effects of long-term use of benzodiazepine anxiolytics?
8. You decide to notify J.J.’s physician about his reaction to the movie. The physician writes an order to start paroxetine (Paxil). How does this medication differ from the alprazolam?
9. J.J. asks you whether there are other things he can do, in addition to medications, to help his anxiety.
a. List some relaxation and therapeutic techniques that could be implemented or taught to J.J. to help relieve his anxiety.
10. J.J. is for discharge from the hospital. To what level of care will J.J. be discharged, and name some of the treatment modalities that could help him with his PTSD and related problems?
Post-Traumatic Stress Disorder (PTSD)
The symptoms of PTSD can include re-experiencing the traumatic event through flashbacks, nightmares, or intrusive thoughts, avoiding triggers that remind the person of the trauma, experiencing negative changes in thoughts and mood such as feeling hopeless, having trouble sleeping or concentrating, feeling irritable or angry, and being easily startled or hyper-vigilant. These symptoms can be severe and long-lasting, affecting a person’s ability to function in their daily life.
PTSD is a treatable condition, and there are various evidence-based therapies that can help people manage their symptoms and improve their quality of life. These therapies may include cognitive-behavioral therapy (CBT), exposure therapy, eye movement desensitization and reprocessing (EMDR), and medication such as antidepressants or anti-anxiety drugs. If you or someone you know is struggling with symptoms of PTSD, it is important to seek help from a qualified mental health professional.
