A case study on Post traumatic stress disorder

This case study explores the symptoms, treatment, and impact of post traumatic stress disorder (PTSD) through the story of a child victim of sexual violence. It emphasizes the importance of family support and alternative therapies in treating PTSD.

Reflective Thinking & Writing -
Trauma and Emergency Nursing

TABLE OF CONTENTS
INTRODUCTION ..........................................................................................................................3
Trigger Event ..............................................................................................................................4
Appraisal .....................................................................................................................................5
Exploration ..................................................................................................................................6
Integration ...................................................................................................................................8
CONCLUSION ...............................................................................................................................9
REFERENCES..............................................................................................................................10

Title: A case study on “Post traumatic stress disorder”
INTRODUCTION
Trauma is an emotional response that is caused by terrible response like accident, rape or
natural disaster. There are various types of trauma such as acute trauma, chronic trauma, stressful
events and complex trauma.
I am working as nurse in the traumatic centre wherein I often tackle traumatic patients.
One day, a patient's family member came in the traumatic centre to admit their child. The name
of child was Raina and her age was 12 year. I interacted with the patient's family then they told
me that Raina is suffering from post traumatic stress disorder (PTSD) because she has been
victim of sexual violence. Her parents said that she always keep silence and never communicate
with her friends, Post traumatic stress disorder (PTSD) is one of the major disorder that is
developed in child or youth after experiencing events such as witnessing actual, serious injury,
threatened death, sexual violence (known as trauma). This event often leads a serious injury or
death and they feel fear, helplessness or horror. The traumatic events are domestic or family
violence, dating violence, sexual or physical abuse, natural disasters (i.e. flood, fire, earthquake
etc.), sudden unexpected violence (suicide, accident), major surgery like life threatening event
(childhood cancer) etc. that leads post traumatic stress disorder. PTSD is developed when a child
who is the victim of sexual violence or the person who is witnessed of sudden death. The major
symptoms of post traumatic stress disorder are started after the child or youth experience (Scott
& Brysiewicz, 2016). There are four different types of post traumatic stress reactions such as
child or youth may re-alive the trauma in their minds, child and youth may avoid things which
remind them trauma, avoid thoughts, feelings or conversation related with trauma and child or
youth become extremely alert after trauma.
PTSD symptoms can be seen at different ages such as early childhood, school-aged
children and teenagers young adults. Car accident is considered one of the major trauma for the
men and highly frequent trauma for women. It is essential to treat because if it is not treated
timely that damages brain tissues permanently which arises mental health issues i.e. depression,
depression etc. Most of the time, such traumatic disorder brings death situation. The most
common symptoms of PTSD are nightmare, avoidance of situation which brings back the trauma
etc. which are not good sign for child and young age people.

However, there were various traumatic cases that have seen by in the traumatic centre but
it did not know, I was too affected from the Raina because she was too small when she has
become part of sexual abuse and still she was only 12 year and she has kept herself socially
isolated. That's why I have taken this particular situation to provide deep understanding about
post-traumatic stress disorder (PTSD), symptoms, treatment etc. that will support individuals to
care and treat such patients like Raina who suffers from this disorder. There are various children
and teenagers who have experienced this traumatic situation but due to unawareness or not
taking treatment, they are suffering from depression and anxiety disease. With this situation, I
would like to emphasize over this situation so that people's like Raina 's parents understand
actual reason of the disorder and gives their children's or teenagers level of care and medication,
if they are suffering from this disorder.
This trigger event i.e. post traumatic stress disorder (PTSD) has increased curiosity in me
because there are various examples of my friends who are actually facing this situation but few
of them are unaware (Missouridou, 2017). So I want to support of them and other people who are
suffering from this situation by suggesting some remedies which they can apply own by won at
home. It is quite demotivating thing that no specific medical treatments are available to root out
this disorder. Still, medical professionals can decrease symptoms of this PTSD but can not root
out this disorder. So, I choose this situation to demonstrate it's common and major symptoms and
alternative treatments to cure this disorder.
Trigger Event
As I know Post traumatic stress disorder is one of the most common disorder but after
that people's are unaware about such disorder. If any child or youth suffers from this disorder
then people starts to relate that disorder with mental issue instead of thinking that it can be
happen by PTSD. From past few years number of people have become highly updated about this
disorder but not all. I took the case study of Miss Raina only because she was too small children
who has suffered from the PTSD. I became quite shocked in the traumatic centre when a male
worker was coming towards her then she started to shout on him and through things over him
and was saying stay away for me, don't do this with me. These activities actually made me too
hurt because I could understand in which level she has tortured. Even my cousin has became
victim of sexual violence when she was childhood, But my parents and friends helped her a lot
to overcome such traumatic attacks then I decided to help such children's like Raina and joined

this traumatic centre. When Raina case came to me and listen whole story then genuinely I
become excited to help miss Raina so that she again live her life happily like other child's.
Appraisal
Initially I knew about this disorder that it can be treated by taking healthy diet and
exercise. I had knowledge about common symptoms of this disorder such as nightmares,
avoidance of situations which brings back memories of trauma or flashbacks, anxiety or
depressed mood. People has knowledge only these common symptoms that arises in children or
young generations.
According to Olff, (2017), PTSD is a serious public health concern issue that causes
people suffers from anxiety or depression. This situation takes place when a child or teenager has
faced or witnessed of terrifying situation like car accident, child cancer, sexual violence that
directly damage brain nerves of individuals. This traumatic condition often can be seen last
months or years after the incident with triggers that can lead back memories of trauma which
accompanied by physical reactions. Most of the people relates this situation with mental issue
because they do not have knowledge while other people who are aware about it but they do not
take this in serious manner. Apart from common symptoms, there are other symptoms as well
that arises in patients due to this disorder such as difficulties remembering important aspects of
tragic events, not posses' positive outlooks for the future, negative feelings about self and the
world etc. due to these symptoms adults or teenager starts to segregate themselves from others.
Such avoidance leads negative outlook in PTSD's patients for the future so they start to harm
themselves. There are various examples of people who have experienced terrifying events but
their parents did not take them for the treatment due to unawareness. So, this disorder damages
brain tissues permanently that leads depression or anxiety in individuals. It is important to treat
this disorder from initial stage like childhood age. Hori & Kim, (2019) have quoted in their
published books that insomnia is one of the PTSD symptom that is related with hyper-arousal.
Children or teenagers with PTSD have difficulty staying in a deep sleep and falling asleep
throughout the night. Due to traumatic event, most of the people with PTSD sleeps with light on.
Irritability is another symptom of the PTSD whereas people with PTSD becomes prone to angry
over common issues, short-term memory difficulty. Lots of people are unaware with untreated
post-traumatic stress disorder can create devastating impact for both those who are facing this
situation and their relatives. This disorder is not only impacted relationships with patient's

family, friends and others but also it can trigger serious emotional issues and due to this health
issues can be seen over the period. PTSD affects all ages people, even it can impact he health of
unborn babies when their mother is under this situation.
As per the view of Soder & et.al.,. (2019) there are some common medication available
in the healthcare companies or hospitals across the world which are used to treat PTSD. People
with PTSD requires strong support of their family and relatives because they start to feel socially
isolated, in that state they think that someone wants to harm them and suicidal thoughts are
highly prevalent in them. So, these people requires extra care and medication treatment which
keeps them safe.
Exploration
The above discussed points have affected my sense of understanding positively because
in initial way I did not aware about that traumatic patients needs family supports but I thought
that they need medication treatment. But now I understood that family supports helps people
with PTSD to live happily and makes them feel valuable part of their life. Raina has became
socially isolated in early childhood stage because her parents did not pay attention on her
situation. When her parents got to know that she is suffering from traumatic attacks then her
parents did not pay more attention on her. As resulted Raina was suffering from depression and
anxiety. I though that if Raina's parents take care of her at early childhood stage and came in the
traumatic centre that it may possible that she never suffered from depression disorder. I had
knowledge about some common treatment available that uses to treat post-traumatic stress
disorder such as increase level of serotonin in a person's brain with PTSD that automatically
feels individuals less worried as well as sad (Dickens, Lamont & Gray, 2016). Celexa, prozac,
paxil, zoloft etc. are highly common medicine to treat PTSD that offers by health professional to
treat the people with PTSD. Medication treatment is considered one of the best treatment to keep
control over the disorder and reduces negative impact of traumatic disorder. Unfortunately, this
medication treatment is used to reduce symptoms of post-traumatic stress disorder but cannot
root out. Even this medication therapy gives negative impact on individuals with PTSD health
such as liver disease, sedation, vibration etc. Cognitive behavioural therapy is another method of
treating PTSD, With this therapy, mental health therapists can support person with PTSD
effectively. If a person is experiencing anger or guilt wherein cognitive behavioural therapy
helps them to cope up with their feeling. There is another therapy such as dialectical behaviour

therapy can support individuals to cope with triggers and quickly deals with panic attacks,
communicates effectively with trauma and seeks new ways or method to physical sensation of
trauma or combat flashbacks. When a person have experienced traumatic event then they start to
blame themselves for things which could not have changed. Such feelings are the reason of
significant distress. In this state cognitive therapy supports people to cope up with unnecessary
feelings of guilt and helps them to realize that the outcomes of tragedy is not their fault. With
these therapies, Raina can treated effectively and can improve her social inclusion.
There are some other methods or ways that can effectively self-regulated individuals nervous
symptoms with PTSD. For example mindful breathing is the best option to keep control over
disoriented, confused etc. mindful breathing helps individuals with PTSD to calm themselves. It
is a quick way of keeping calm, in this process a person needs to take 60 breathes that distracts
them to think over flashbacks. Emotional intelligence toolkit is another method that allows
individuals to feel about the trauma which often arises and improves their potential level to
accept them. The person with PTSD must avoid alcohol and drugs because these increases
symptoms of trauma and feelings of depression, anxiety and isolation. Eat a well-balanced diet is
another alternative method that supports to cope up with the stress of trauma. As know an
effective well-balanced diet supports individuals to keep energetic and minimizing mood swings
(Cushing & Braun, 2018). But there are only some people who takes well-balanced diet
otherwise lots of people like to eat surgery and fried foods and have plenty of omega-3 fats i.e.
salmon, walnut, flaxseed's and soybeans that keeps emotional feelings strong. There are some
relaxation techniques i.e. yoga, meditation, deep breathing exercises, schedule period for
activities which brings joy and increases interests in people with PTSD. While working in the
traumatic centre I has knowledge about these processes and techniques to treat traumatic patients
that I applied for Raina as well to treat her effectively.
There are some other new treatments are available to treat PTSD interventions such as
eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is used
to up-setting trauma related memories, feelings and thoughts. EMDR therapy supports people
with PTSD to focus either a sound or back and forth movement instead of thinking about trauma
memory. Present Centred Therapy (PCT) is an alternative therapy that is non-trauma focused
treatment that supports to current mental issues instead of preventing prevalence of trauma. This
therapy provides psycho-education about the impact of trauma on one's life and teaching solving

strategies to deal with issues of current life stressors (PTSD Facts & Treatment. 2020). Selective
serotonin reuptake inhibitors (SSRIs) are one of the most common type of medications that are
used to treat depression mood that is a part of PTSD. Benzodiazepines are quick acting
medications that are also given to people with PTSD. There are other health problems such as
anxiety disorders, depression, self-harm, dissociative disorders and suicidal thoughts caused by
post traumatic stress disorder. Selective serotonin reuptake inhibitors (SSRIs) may support to
treat symptoms of PTSD i.e. sadness, anger, worry and feeling emotionally numb. These
medications are prescribed along with psychotherapy that helps to address specified symptoms
like nightmares and sleep problems. However, this literature review based on the different
authors views and ideas have improved my understanding level and I thought now I can treat
such traumatic patients like Raina more effectively in future.
From the above mentioned therapies and techniques can be treated post-traumatic stress
disorder effectively. My clinical experience as nurse become more effective and now I thought
that if a patient with PTSD like Raina treats at earlier stage then they do not have to take life time
medicines to forget their panic attacks.
Integration
I have gained extensive knowledge about post-traumatic disorder while exploring
treatment of trauma. Priorly, I did not have advanced knowledge about PSTD as I have gained
now. Initially, I knew that it is a trauma that damages brain tissues that directly impacts
individuals daily life and thoughts. It is the reason of depression and anxiety and major
symptoms of the disorder are nightmares, insomnia etc. This disorder arises in people when they
have witnessed of the terrifying event or have faced event. I have limited knowledge about
treatment of PTSD such as medication therapy, centers through which can treat such persons
with PTSD. But now I have extensive knowledge about PTSD such as it is a depression disorder
that is caused by various reasons such as sexual violence, car accident, childhood cancer etc. If
this disorder is untreated prolong time that permanently damaged nerves of brain in that state
people losses their remembering power and unable to take proper sleep because whenever they
try to sleep then such traumatic flashbacks' comes towards (Thompson, Vidgen & Roberts,
2018). I knew that if a person suffers from post-traumatic stress disorder then they like to live
alone and always blame themselves for things if they unable to achieve on time. But I did not
know that it leads suicidal thoughts in people. It is a new information for me. I have listened that

people with PTSD have to take medication for long time to change their feelings and nightmares
which often bothers them whenever they sleep. But now I have knowledge that serotonin is a
happy neurotransmitter that is given indirectly by the health professionals to keep them calm and
maintains their mental state. Health professionals always says to patient's family to give well-
balanced diet and breathing exercises but never know that why they suggest for it. But now I got
it that well-balanced diet plan helps people with PTSD to take plenty of sleep over night and
keep energy up in them that reduces anger consequences. SSRIs (selective serotonin reuptake
inhibitors) are one of the major medication therapy that is used by various health professional to
keep such people calm and happy.
I had knowledge about this medication therapy but there have some other alternative
therapies available to treat this disorder but I did not aware. For example cognitive behavioural
therapy is one of the most common therapy that is used to reduce treat people with PTSD who
considers guilty themselves for all situations and thinks to attempt suicide. With this therapy,
health professionals understand behaviour of such people with PTSD so that they can control
over trauma attacks which occurs when they see same situation. I have learned about another
latest therapies like eye movement desensitization and reprocessing, present centred therapy,
dialectical behaviour therapy and emotional intelligence toolkit that can be practised to treat
people with post-traumatic stress disorder (Cipriani, & et.al., 2018). These therapies have minor
side effects like increase blood pressure, sedation etc. but gives significant impacts on
individuals' health. Thus, I can say I have gained extensive knowledge through which I can help
such people with PTSD to treat effectively in the future. In post-traumatic stress disorder,
patients often gets panic attacks but I can help them to keep them calm and worried free. In
future if I get such opportunity to help person with PTSD then I can make them help them much
better as compared others (Roberts & et.al., 2016).
CONCLUSION
In this report has been concluded about trauma and it's symptoms, It highlighted post-
traumatic stress disorder because it is one of the most common disorder but after that people are
unaware. The brief study has improved my learning over post-traumatic stress disorder and now
I could help such people in the future. It has summarized about different therapies like cognitive
behavioural therapy, SSRIs, EMDR, PCT, emotional intelligence toolkit etc. that used by health
professional currently to treat this disorder. Thus, this brief study about PTSD has built up new

knowledge and portrait out new learning and professional development which will help to work
in such centres in the future.

REFERENCES
Books and Journals
Scott, P., & Brysiewicz, P. (2016). African emergency nursing curriculum:: Development of a
curriculum model. International emergency nursing.
Missouridou, E. (2017). Secondary posttraumatic stress and nurses' emotional responses to
patient's trauma. Journal of Trauma Nursing. 24(2). 110-115.
Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: an
update. European Journal of Psychotraumatology. 8(sup4). 1351204.
Hori, H., & Kim, Y. (2019). Inflammation and post‐traumatic stress disorder. Psychiatry and
Clinical Neurosciences. 73(4). 143-153.
Soder, H. E& et.al.,. (2019). Baseline resting heart rate variability predicts post‐traumatic stress
disorder treatment outcomes in adults with co‐occurring substance use disorders and
post‐traumatic stress. Psychophysiology. 56(8). e13377.
Dickens, G. L., Lamont, E., & Gray, S. (2016). Mental health nurses’ attitudes, behaviour,
experience and knowledge regarding adults with a diagnosis of borderline personality
disorder: systematic, integrative literature review. Journal of Clinical Nursing. 25(13-
14). 1848-1875.
Cushing, R. E., & Braun, K. L. (2018). Mind–body therapy for military veterans with post-
traumatic stress disorder: a systematic review. The Journal of Alternative and
Complementary Medicine. 24(2). 106-114.
Thompson, C. T., Vidgen, A., & Roberts, N. P. (2018). Psychological interventions for post-
traumatic stress disorder in refugees and asylum seekers: A systematic review and meta-
analysis. Clinical Psychology Review. 63. 66-79.
Cipriani, A & et.al., (2018). Comparative efficacy and acceptability of pharmacological
treatments for post-traumatic stress disorder in adults: a network meta-
analysis. Psychological medicine. 48(12). 1975-1984.
Roberts, N. P & et.al., (2016). Psychological therapies for post‐traumatic stress disorder and
comorbid substance use disorder. Cochrane Database of Systematic Reviews. (4).
Online
PTSD Facts & Treatment. 2020. [Online]. Available Through:- <https://adaa.org/understanding-
anxiety/posttraumatic-stress-disorder-ptsd/treatment>
Post-Traumatic Stress Disorder. 2019. [Online]. Available Through:-
<https://keltymentalhealth.ca/post-traumatic-stress-disorder>