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Post-Traumatic Stress Disorder (PTSD)

Despite the level of development, the experience of generations, and the newly acquired knowledge and skills, modern society has not freed itself from severe shocks and their impact on human life. Modern conditions involve a hard socio-economic situation, local wars, terrorism, natural and manmade disasters, and an increase in mortality and crime. People find themselves in conditions of acute and chronic mentally traumatic events extremely often. Thus, careful examination of post-traumatic stress disorder (PTSD) is a topical issue both in the clinical and social aspects.

Brief Description of the Disorder

PTSD is a psychogenic disorder caused by exposure to severe stressors. The description of acute disorders in combat trauma characterized the first stage of the historical study of PTSD. In the middle of the 20th century, scientists witnessed several responses of the body to natural disasters, anthropogenic hazards, fires, atomic bombing of Japan, and other catastrophes accompanied by the mass loss of life. These responses included obsessive and depressing event memories, panic attacks, and emotional decline (Fraser, 2013). Then, scientists began to study chronic effects of trauma in former concentration camp prisoners. They found depression and anxiety combined with various somatic symptoms, as well as fear, paranoia, complete distrust of others, and personality changes. All of the above responses and symptoms currently constitute a variety of the PTSD manifestations (Ford, 2009).

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The incidence of PTSD varies depending on the test material, the use of diagnostic criteria, characteristics of the local population, and research methods. According to some authors, the prevalence of PTSD in the population is 8-9% (Cash & Weiner, 2006). Unequivocally, the prevalence of PTSD increases during tragic events that cover the mass number of population. Some authors believe that 61% men and 49% women experienced at least one traumatic event in their life (Cash & Weiner, 2006). The number of people with a mental disorder may be significantly larger than the number of those directly affected because these experiences involve family members, witnesses, and rescuers.

Diagnostic Criteria

The DSM-5 mentions a large number of conditions for the occurrence of PTSD and its symptoms (Schlaepfer & Nemeroff, 2012). They include reactions in the form of fear, dread, and helplessness; intrusive memories of the event; dreams about the event undergone by a person; actions or sensations that recreate the experience; psychological tension when reminding a person about the traumatic event; avoidance of conversations associated with the trauma; and avoidance of places and people related to the trauma. Besides, the PTSD symptoms can include diminished interest in significant activities; a sense of alienation from others; inability to feel love; difficulties in falling asleep; irritability or outbursts of anger; difficulties with concentrating; hypervigilance; enhanced startle reaction; and persistent mental stress. The presence of six or more symptoms simultaneously allows an expert to diagnose PTSD (Schlaepfer & Nemeroff, 2012).

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Residual Impact

Sometimes, excessive dependence and need in others represent the residual impact of the disorder. The person’s conviction that the disease has changed him/her and left its stamp on him/her leads to social exclusion and inability to form and maintain strong interpersonal relationships. There are also resistant complaints of feeling unwell, which may be associated with the hypochondriacal claims and sickly behavior (Krippner, Pitchford, & Davies, 2012).  

Maladaptive Patterns

A decrease in the level of social adaptation is the most obvious maladaptive pattern characteristic of PTSD. Such forms of maladaptive behaviors as alcoholism, drug addiction, and propensity to commit acts of violence are common among veterans of local wars and armed conflicts. Suicide attempts and auto-aggressive behavior in the form of self-harm are also likely to occur (Krippner et. al, 2007). The PTSD maladaptive patterns largely coincide with characteristics of suicidal individuals. They include depressed mood with the loss of appetite and vitality; heavy dependence on drugs or alcohol; a feeling of isolation or rejection; a feeling of hopelessness or helplessness; and inability to communicate with other people because of despair and suicidal thoughts (Bisson, 2007). Moreover, some PTSD patients have the so-called ‘tunnel vision’, which means that a person is unable to see positive things that would be acceptable for him/her (Krippner et. al, 2007).

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One can effectively treat post-traumatic stress disorder by applying some techniques of behavioral therapy, art therapy, and a variety of drugs that allow facilitating painful symptoms. Psychotherapy can help people with PTSD deal more effectively with the current circumstances. Group therapy for people suffering from similar experiences can also be useful (Charney & Nestler, 2011). Besides, importance of immediate treatment of PTSD is worth noting. Recovery is a long process, which has a progressive nature. Therapeutic intervention helps to prevent chronization of PTSD. A doctor creates the treatment and rehabilitation program according to the stage of the disorder (Bisson, 2007). For example, the acute stage needs hypnotherapy, while the chronic stage needs analysis of metaphor to reveal traumatic material.

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Treatment of the disorder is comprehensive and comprises medications and psychotherapy. The fundamental rule of therapy for PTSD is to take the pace of work the patient feels comfortable with (Schlaepfer & Nemeroff, 2012). One needs to inform family members about the reason the work on memories and reproduction of traumatic experiences is necessary because family often supports avoidance behavior of patients with PTSD.

The next technique gives good results. At the beginning of the panic attack, the patient learns to focus on a bright distracting memory. This method eventually forms a habit of mind to switch automatically to neutral or positive emotions, bypassing the traumatic experience in case of a trigger (Charney & Nestler, 2011). As practice shows, all people who have suffered from war, repression, torture, as well as physical and sexual abuse are in need of active psychotherapeutic help even if they do not complain of their condition (Fraser, 2013).

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When planning treatment, it is important to bear in mind that about 80% of patients with posttraumatic stress disorder may have a comorbidity (Schlaepfer & Nemeroff, 2012). Major depression, dysthymia, generalized anxiety disorder, alcohol or chemical dependence, somatization, and panic disorder coexist with PTSD most frequently. In light of this comorbidity, a doctor should focus treatment on the patient’s complaints, which appear to be the most serious at the current moment.

Interventions and Other Considerations

Cognitive-behavioral techniques are among the most studied types of psychosocial treatment of PTSD. They include a variety of therapeutic techniques such as various types of immersion treatments, cognitive restructuring, and anxiety management. Partly thanks to the intensive research, experts most frequently recommend cognitive-behavioral techniques as a psychosocial approach to the treatment of post-traumatic stress disorder (Charney & Nestler, 2011).

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There are cases during the therapeutic work with a patient when the state of self-doubt comes after mental repetition of a word or sentence thematically related to a particular traumatic situation. After returning to the stressful event, the patient cannot get rid of those words that seem to be emotionally significant. Then, the patient remembers the words he/she would like to say at that moment, but which have not been spoken. In such cases, a doctor not only carries out the radical reformation of the content, but also makes such changes that are no longer regarded as stressful (Schlaepfer & Nemeroff, 2012).

Medical therapy may be a useful addition to various types of psychotherapy. As of today, there is no pharmacological standard treatment of PTSD. However, such drugs as tricyclic antidepressants (TCAs), imipramine, amitriptyline, desipramine, and anxiolytic alprazolam give a particular result (Charney & Nestler, 2011). Monoamine oxidase inhibitor and phenelzine are advantageous over TCAs in the treatment of PTSD symptoms, but their side effects and interactions with other groups of medications complicate their application. Several studies have revealed the efficacy of the treatment of PTSD by such serotonergic antidepressants as fluoxetine, paroxetine, and nefazodone (Charney & Nestler, 2011). Given the central role of increased adrenergic activity in the maintenance of the PTSD symptoms, one can use such adrenoblockers as propranolol and clonidine in the treatment of the disorder. Furthermore, there are observations about the positive effect of the appointment of tricyclic antidepressants and sedative neuroleptics.

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In spite of severe suffering, people with PTSD rarely seek professional help from a therapist and turn in on themselves. Sometimes, a person with PTSD symptoms avoids going to a therapist because of the fear of misunderstanding. In such cases, it is important to convince that the psychotherapist can understand the patient and help him/her. The human mind has additional reserves and an expert knows how to activate them.


Thus, the study of post-traumatic stress disorder is of particular importance nowadays. A significant portion of the world’s population is vulnerable to traumatic events; many of them can be life-threatening. Post-traumatic stress disorder is a set of interrelated characteristics, the main criterion of which consists in personality changes. PTSD is an extremely difficult and depressing condition for the person who experiences it, as well as people around. Knowledge of various symptoms of post-traumatic stress disorder can help to understand whether a person is suffering from this disease or not. These events are beyond ordinary human experience. Usually, a standard mental reserve is not sufficient to cope with stressful experiences. Thereby, it is crucial to get into therapy immediately.

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