Post-traumatic stress disorder (PTSD)

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Preparing for your appointment

By Mayo Clinic staff

If you have thoughts of suicide, go to an emergency room or call 911 or your local emergency number immediately.

If you have less urgent symptoms of post-traumatic stress disorder, make an appointment with your family doctor or general practitioner. Your doctor can help you begin the process of understanding whether your physical and emotional symptoms may be related to a traumatic experience. In many cases, your doctor may refer you to a mental health professional who can help make a diagnosis and create the right treatment plan for you.

Here's some information to help you prepare for your appointment, and what to expect from your doctor.

What you can do

  • Write down any symptoms you've been experiencing, and for how long.
  • Write down your key personal information, especially events or experiences — even in your distant past — that have made you feel intense fear, helplessness or horror. It will help your doctor to know if there are memories you can't directly access without feeling an overwhelming need to push them out of your mind.
  • Make a list of your medical information, including other physical or mental health conditions with which you've been diagnosed. Also write down the names of any medications, including over-the-counter medications, you're taking.
  • Take a trusted family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor in advance so that you can make the most of your appointment.

For PTSD, some basic questions to ask your doctor include:

  • What do you believe is causing my symptoms?
  • Are there any other possible causes?
  • How will you determine my diagnosis?
  • Is my condition likely temporary or chronic?
  • Do you recommend treatment? If yes, with what types of therapy?
  • How soon do you expect my symptoms to improve?
  • Does PTSD increase my risk of other mental health problems?
  • Should I see a mental health specialist?
  • Do you recommend any temporary changes at home, work or school to encourage recovery?
  • Would it help my recovery to tell my teachers or work colleagues about my diagnosis?
  • Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Being ready to answer your doctor's questions may reserve time to go over any points you want to talk about in-depth. You should be prepared to answer the following questions from your doctor:

  • What are your symptoms?
  • When did you or your loved ones first notice your symptoms?
  • Have you ever experienced or witnessed an event that was life-threatening to you or someone else?
  • Have you ever been physically, sexually or emotionally harmed?
  • Do you have disturbing thoughts, memories or nightmares of the trauma you experienced?
  • Do you ever feel as if you are reliving the traumatic event, through flashbacks or hallucinations?
  • Do you avoid certain people, places or situations that remind you of the traumatic experience?
  • Have you lost interest in things or felt numb?
  • Do you feel jumpy, on guard, or easily startled?
  • Do you frequently feel irritable or angry?
  • Are you having trouble sleeping?
  • Is anything happening in your life right now that is making you feel unsafe?
  • Have been having any problems at school or work?
  • Have you been having problems in your personal relationships?
  • Have you ever thought about harming yourself or others?
  • Do you drink alcohol or use illicit drugs? How often?
  • Have you been treated for other psychiatric symptoms or mental illness in the past? If yes, what type of therapy was most beneficial?

What you can do in the meantime
There are steps you can take to improve your ability to cope while you're waiting for your appointment with a doctor. What works best for you is likely to be highly personal. Talking with friends or family about your feelings or trauma you've experienced may be helpful, but don't push yourself beyond what's emotionally tolerable in terms of how much to share, and with whom.

If possible, you may find it especially helpful to talk with others who have gone through a traumatic experience similar to yours. Exercise and relaxation techniques such as yoga or meditation also may improve your symptoms.

Tests and diagnosis Complications
References
  1. Posttraumatic stress disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 3, 2009.
  2. Hollander E, et al. Posttraumatic stress disorder. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed March 3, 2009.
  3. Ciechanowski P, et al. Overview of post-traumatic stress disorder. http://www.uptodate.com/home/index.html. Accessed March 3, 2009.
  4. How common is PTSD? National Center for Posttraumatic Stress Disorder. http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_how_common_is_ptsd.html. Accessed March 3, 2009.
  5. Nakell L. Adult post-traumatic stress disorder: Screening and treating in primary care. Primary Care: Clinics in Office Practice. 2007;34:593.
  6. How common is PTSD? National Center for Posttraumatic Stress Disorder. http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_how_common_is_ptsd.html. Accessed March 3, 2009.
  7. Treatment of patients with acute stress disorder and posttraumatic stress disorder. American Psychiatric Association Practice Guidelines. Arlington, Va.: American Psychiatric Association; 2004. http://psychiatryonline.com/pracGuide/pracGuideTopic_11.aspx. Accessed March 3, 2009.
  8. Self-care and self-help following disasters. National Center for Posttraumatic Stress Disorder. http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_self_care_disaster.html. Accessed March 3, 2009.
  9. Feldman MD, et al. Posttraumatic stress disorder. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/123833839-2/811458959/1701/472.html. Accessed March 3, 2009.
  10. What is posttraumatic stress disorder (PTSD)? Center for Posttraumatic Stress Disorder. http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_what_is_ptsd.html. Accessed March 3, 2009.
  11. Helping a family member who has PTSD. Center for Posttraumatic Stress Disorder. http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/helping_a_family_member.html. Accessed March 3, 2009.
  12. Taylor HR, et al. Prazosin for treatment of nightmares related to PTSD. American Journal of Health-System Pharmacy. 2008;65:716.

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April 10, 2009

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