Is This PTSD & What to Do
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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,

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

Published August, 2002


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