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POST TRAUMATIC STRESS
DISORDER (PTSD).
KADAMBARI SINGH.
(BANARAS HINDU UNIVERSITY)
Application number- e8c3ea23f33011e9b547ad134e8d386f
ACADEMIC WRITING.
POST TRAUMATIC STRESS DISORDER.
• Post traumatic stress disorder (PTSD) is a psychiatric disorder that can occur in
people who have experienced or witnessed a traumatic event such as a natural
disaster, a serious accident, a terrorist act, war/combat, rape or other violent
personal assault.
• PTSD has been known by many names in the past, such as “shell shock” during
the years of World War I and “combat fatigue” after World War II. But PTSD does
not just happen to combat veterans. PTSD can occur in all people, in people of
any ethnicity, nationality or culture, and any age.
• Women are twice as likely as men to have PTSD. Children are less likely to
experience PTSD after trauma than adults, especially if they are under 10 years of
age.
• A diagnosis of PTSD requires exposure to an upsetting traumatic event. However,
exposure could be indirect rather than first hand. For example, PTSD could occur
in an individual learning about the violent death of a close family. It can also
occur as a result of repeated exposure to horrible details of trauma such as police
officers exposed to details of child abuse cases.
CLASSIFICATION.
The current Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, is a manual that
clinical professionals use to diagnose mental health conditions. In previous years, PTSD fell
under the category of anxiety related conditions. The current version of the manual has placed
post-traumatic stress disorder under the category of trauma- and stressor-related disorders.
The characteristic symptoms are not present before exposure to the violently traumatic event.
Typically the individual with PTSD persistently avoids all thoughts, emotions and discussion of
the stressor event and may experience amnesia for it. However, the vent is commonly relived by
the individual through intrusive, recurrent recollections, flashbacks and nightmares. The
characteristic symptoms are considered Acute if lasting less than three months, Chronic if
persisting three months or more, and With Delayed Onset if the symptoms first occur after six
months or some years later. PTSD is distinct from the briefer Acute Stress Disorder, and can
cause clinical impairment in significant areas of functioning.
WHAT ARE THE CAUSES OF PTSD?
PTSD is believed to be caused by the experience of a wide range of traumatic events and
particularly if the trauma is extreme, can occur in persons with no predisposing conditions.
Persons considered at risk include military personnel, victims of natural disasters,
concentration camp survivors and victims of violent crimes. Individuals not infrequently
experience “survivor’s guilt” for remaining alive while others died. Causes of the symptoms
of PTSD are the experiencing or witnessing of a stressor event including death, serious injury
or such threat to self or others in a situation in which the individual felt intense terror, horror
or powerlessness. Persons who are employed in occupations that expose them to violence
(such as, soldiers) or disasters (such as, emergency workers) are also at risk. Children and
adults may develop PTSD symptoms by experiencing bullying or mobbing.
RISK FACTORS.
• Anyone can develop PTSD at any age.
• This includes war veterans, children, and people who have been through a physical or sexual
assault, abuse, accident, disaster, or other serious events.
• According to the National Centre for PTSD, about 7 or 8 out of every 100people will
experience PTSD at some point in their lives.
• Women are more likely to develop PTSD than men, and genes may make some people more
likely to develop PTSD than others.
• Not everyone with PTSD has been through a dangerous event. Some people develop PTSD
after a friend or family member experiences danger or harm.
• The sudden, unexpected death of a loved one can also lead to PTSD.
Why do some people develop PTSD and other
people do not?
It is important to remember that not everyone who lives through a dangerous
event develops PTSD. In fact, most people will not develop the disorder.
Many factors play a part in whether a person will develop PTSD. Some examples are
listed below. Risk factors make a person more likely to develop PTSD. Other factors,
called resilience factors, can help reduce the risk of the disorder.
Some factors that increase risk for PTSD include:
• Living through dangerous events and traumas.
• Getting hurt.
• Seeing another person hurt, or seeing a dead body.
• Childhood trauma.
• Feeling horror, helplessness, or extreme fear.
• Having little or no social support after the event.
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss
of a job or home.
• Having a history of mental illness or substance abuse.
• Previous traumatic experiences, especially in early life.
• Family history of PTSD or depression.
• History of physical or sexual abuse.
• History of substance abuse.
• History of depression, anxiety, or another mental illness.
• High levels of stress in everyday life.
• Lack of support after trauma.
• Lack of coping skills.
• Being involved in a car crash.
• Being violently attacked.
• Being raped or sexually assaulted.
• Being abused, harassed or bullied.
• Being kidnapped or held hostage.
• Extreme violence or war, including military combat
surviving a terrorist attack
• Surviving a natural disaster, such as flooding or an earthquake
• Being diagnosed with a life-threatening condition
• Losing someone close to you in particularly upsetting circumstances
• Learning that traumatic events have affected someone close to you (sometimes
called secondary trauma)
• Any event in which you fear for your life.
• Doing a job where you repeatedly see distressing images or hear details of traumatic events..
• Traumatic childbirth, either as a mother or a partner witnessing a traumatic birth.
Some factors that may promote recovery after trauma include:
• Seeking out support from other people, such as friends and family.
• Finding a support group after a traumatic event.
• Learning to feel good about one’s own actions in the face of danger.
• Having a positive coping strategy, or a way of getting through the bad event and learning
from it.
SYMPTOMS.
Post-traumatic stress disorder symptoms may start within one month
of a traumatic event, but sometimes symptoms may not appear until
years after the event.
These symptoms cause significant problems in social or work situations
and in relationships. They can also interfere with your ability to go
about your normal daily tasks.
PTSD symptoms are generally grouped into four types: intrusive
memories, avoidance, negative changes in thinking and mood, and
changes in physical and emotional reactions.
Symptoms can vary over time or vary from person to person.
Intrusive memories.
Symptoms of intrusive memories may include:
• Recurrent, unwanted distressing memories of the traumatic
event.
• Reliving the traumatic event as if it were happening again
(flashbacks).
• Upsetting dreams or nightmares about the traumatic event.
• Severe emotional distress or physical reactions to something
that reminds you of the traumatic event. (examples; pounding
heart, rapid breathing, nausea, muscle tension, sweating.)
Avoidance.
Symptoms of avoidance may include:
• Trying to avoid thinking or talking about the traumatic
event.
• Avoiding places, activities or people that remind you of
the traumatic event.
Negative changes in thinking and mood.
Symptoms of negative changes in thinking and mood may include:
• Negative thoughts about yourself, other people or the world.
• Hopelessness about the future.
• Memory problems, including not remembering important aspects of
the traumatic event.
• Difficulty maintaining close relationships.
• Feeling detached from family and friends.
• Lack of interest in activities you once enjoyed.
• Difficulty experiencing positive emotions.
• Feeling emotionally numb.
Changes in physical and emotional reactions.
Symptoms of changes in physical and emotional reactions (also called
arousal symptoms) may include:
• Being easily startled or frightened.
• Always being on guard for danger.
• Self-destructive behaviour, such as drinking too much or driving too
fast.
• Trouble sleeping.
• Trouble concentrating.
• Irritability, angry outbursts or aggressive behaviour.
• Overwhelming guilt or shame.
Cognition and mood symptoms.
• Trouble remembering key features of the traumatic event.
• Negative thoughts about oneself or the world.
• Distorted feelings like guilt or blame.
• Loss of interest in enjoyable activities.
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not
due to injury or substance use.
These symptoms can make the person feel alienated or detached from friends or family
members.
It is natural to have some of these symptoms for a few weeks after a dangerous event.
When the symptoms last more than a month, seriously affect one’s ability to function, and
are not due to substance use, medical illness, or anything except the event itself, they might
have PTSD.
Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often
accompanied by depression, substance abuse, or one or more of the other anxiety
disorders.
Symptoms of PTSD in children and
adolescents.
For children 6 years old and younger, signs and symptoms may also include:
• Re-enacting the traumatic event or aspects of the traumatic event through play.
• Frightening dreams that may or may not include aspects of the traumatic event.
• Fear of being separated from parents.
• Losing previously-acquired skills (such as toilet training).
• Sleep problems and nightmares without recognizable content.
• Sombre, compulsive play in which themes or aspects of the trauma are repeated.
• New phobias and anxieties that seem unrelated to the trauma (such as fear of
monsters).
• Acting out trauma through play, stories, or drawings.
• Aches and pains with no apparent cause.
• Irritability and aggression.
Other common symptoms of PTSD.
• Anger and irritability.
• Depression and hopelessness.
• Guilt, shame, or self-blame.
• Suicidal thoughts and feelings.
TYPES OF PTSD.
Within the diagnosis of PTSD there can be certain specifiers identified,
which means there are distinct features present that make it different from
the more broad diagnosis of PTSD.
Some of these specifiers are identified in the DSM-5 including:
• Dissociative.
• Delayed onset/expression.
Preschool.
• One of the changes made in the most recent update of the diagnostic
manual for clinicians is the inclusion of specific PTSD symptoms for
children six years or younger.
• As children witness and live through traumatic events they, too, can
experience emotionally distressing symptoms after the event.
• Just as with adults (and anyone over six years old) there are certain
criteria that need to be met in order for a young child to be diagnosed
with PTSD.
Dissociative.
• The dissociative specifier within the PTSD diagnosis refers to the
presence of persistent or recurrent depersonalization or derealisation
symptoms.
• Depersonalization means that someone is experiencing something as
if they are an observer to themselves, observing from outside of their
body.
• Derealisation refers to sensing as if things around you are not real,
almost as if you are unfamiliar and disconnected from the world
around you.
Delayed Onset
• The term delayed onset was recently changed to delayed expression
in the DSM-5.
• Although people with this particular specifier do meet the necessary
criteria for PTSD, the criteria are not fully met until at least six months
after the traumatic event.
• A person could experience the onset and expression of some of the
symptoms more immediately, however, the full symptom criteria for
diagnosis would not have been met until after that six month mark.
Complex.
• Sometimes people can experience isolated, acute instances of trauma
such as a horrific car accident or being robbed at gunpoint, for example.
• These would be considered acute because they are not likely to become
recurring experiences.
• There are other types of traumatic events that can be more recurring,
such as domestic violence, sexual abuse, or childhood neglect. The
person would experience the event again and again over the course of
time.
• When people have experienced this type of more chronic trauma, it is
sometimes referred to as complex PTSD.
TREATMENT OF PTSD.
The main treatments for people with PTSD are:
• Psychotherapy.
• Medication, or a combination of the two.
Everyone is different, so a treatment that works for one person may not work for
another.
Some people may need to try different treatments to find what works best for
their symptoms.
Regardless of what treatment option you chose, it is important for anyone with
PTSD to be treated by a mental health professional who is experienced with
PTSD.
Psychotherapy.
• Psychotherapy (sometimes called “talk therapy”) involves talking with a mental
health professional to treat a mental illness. Psychotherapy can occur one-on-one
or in a group.
• Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer.
Research shows that support from family and friends can be an important part of
recovery.
• Many types of psychotherapy can help people with PTSD. Some types target the
symptoms of PTSD directly. Other therapies focus on social, family, or job-related
problems. The doctor or therapist may combine different therapies depending on
each person’s needs.
• Effective psychotherapies tend to emphasize a few key components, including
education about symptoms, teaching skills to help identify the triggers of
symptoms, and skills to manage the symptoms.
Cognitive Behaviour Therapy (CBT).
• CBT is a type of psychotherapy that has consistently been found to be the most
effective treatment of PTSD both in the short term and the long term.
• CBT for PTSD is trauma-focused, meaning the trauma event(s) are the centre of
the treatment.
• It focuses on identifying, understanding, and changing thinking and behaviour
patterns.
• CBT is an active treatment involved the patient to engage in and outside of
weekly appointments and learn skills to be applied to their symptoms.
• The skills learned during therapy sessions are practiced repeatedly and help
support symptom improvement. CBT treatments traditionally occur over 12 to
16 weeks.
What is Cognitive Behavioural Therapy?
• It is important for anyone with PTSD to be treated by a mental health care professional who
is experienced with PTSD. Some people will need to try different treatments to find what
works for their symptoms.
Description of Specific CBTs for PTSD:
1. Cognitive Processing Therapy (CPT).
• It is a form of CBT that utilizes cognitive therapy to evaluate and change trauma related
thoughts.
• CPT focuses on the way people view themselves, others, and the world after experiencing a
trauma. Often times inaccurate thoughts after a trauma keep you stuck and prevent recovery
from trauma.
• In CPT you look at why the trauma occurred and the impact it has had on the persons beliefs.
• CPT focuses on learning skills to evaluate whether you thoughts are supported by facts and if
there are more helpful ways to think about your trauma.
• There is strong research support showing CPTs effectiveness across a wide range of traumas.
2. Prolonged Exposure (PE).
• It is another form of CBT that relies more heavily on behavioural therapy techniques to
help individuals gradually approach trauma related memories, situations, and
emotions.
• PE focuses on exposures to help people with PTSD stop avoiding trauma reminders.
• Avoiding these reminders may help in the short term, but in the long term it prevents
recovery from PTSD.
• PE uses imaginal exposures, which involve recounting the details of the trauma
experience, as well as in vivo exposures, which involve repeatedly confronting trauma-
related situations or people in their life that they have been avoiding.
• There is strong research support showing PEs effectiveness across a wide range of
traumas.
2. Eye Movement Desensitization and Reprocessing (EMDR).
• It is a form of psychotherapy that involves processing upsetting trauma-related memories,
thoughts and feelings.
• EMDR asks people to pay attention to either a sound or a back and forth movement while
thinking about the trauma memory.
• This treatment has been found to be effective for treating PTSD, but some research has
shown that the back and forth movement is not the active treatment component but
rather the exposure alone is.
3. Stress Inoculation Training (SIT).
• It is another type of CBT that aims to reduce anxiety by teaching coping skills to
deal with stress that may accompany PTSD.
• SIT can be used as a standalone treatment or may be used with another types
of CBTs.
• The main goal is to teach people to react differently to react differently to their
symptoms.
• This is done through teaching different types of coping skills including, but is
not limited to, breathing retraining, muscle relaxation, cognitive restructuring,
and assertiveness skills.
• There is modest research support showing PEs effectiveness across a wide
range of traumas.
Main Components of CBT.
While different CBTs have different amounts of both exposure and cognitive interventions,
they are the main components of the larger category of CBTs that have been repeatedly
found to result in symptom reduction.
• Exposure therapy- This type of intervention helps people face and control their fears by
exposing them to the trauma memory they experiences in the context of a safe
environment. Exposure can use mental imagery, writing, or visits to places or people
that remind them of their trauma. Virtual reality (creating a virtual environment to
resemble the traumatic event) can also be used to expose the person to the
environment that contains the feared situation. Virtual reality, like other exposure
techniques can assist in exposures for treatment for PTSD when the technology is
available. Regardless of the method of exposure, a person is often gradually exposed
to the trauma to help them become less sensitive over time.
• Cognitive Restructuring- This type of intervention helps people make sense of bad
memories. Oftentimes people remember their trauma differently than how it happened
(e.g., not remembering certain parts of the trauma, remembering it is a disjointed
way). It is common for people to feel guilt of shame about aspects of their trauma that
were not actually their fault. Cognitive restructuring helps people look at what
happened with fact to get a realistic perspective on the trauma.
Medications.
• The brains of people with PTSD process "threats" differently, in part because
the balance of chemicals called neurotransmitters is out of whack.
• They have an easily triggered "fight or flight" response, which is what makes
one jumpy and on-edge. Constantly trying to shut that down could lead to
feeling emotionally cold and removed.
• Medications help one stop thinking about and reacting to what happened,
including having nightmares and flashbacks.
• They can also help one to have a more positive outlook on life and feel more
"normal" again.
• The most studied type of medication for treating PTSD are antidepressants,
which may help control PTSD symptoms such as sadness, worry, anger, and
feeling numb inside.
• Other medications may be helpful for treating specific PTSD symptoms, such
as sleep problems and nightmares.
• Doctors and patients can work together to find the best medication or
medication combination, as well as the right dose.
Several types of drugs affect the chemistry in your brain related to fear and
anxiety.
Doctors will usually start with medications that affect the neurotransmitters
serotonin or norepinephrine (SSRIs and SNRIs), including:
• Fluoxetine (Prozac).
• Paroxetine (Paxil).
• Sertraline (Zoloft).
• Venlafaxine (Effexor).
DSM-V : Posttraumatic Stress Disorder.
Diagnostic Criteria 309.81 (F43.10)
Posttraumatic Stress Disorder Note: The following criteria apply to adults, adolescents,
and children older than 6 years. For children 6 years and younger, see corresponding
criteria below. A. Exposure to actual or threatened death, serious injury, or sexual
violence in one (or more) of the following ways:
• 1. Directly experiencing the traumatic event(s).
• 2. Witnessing, in person, the event(s) as it occurred to others.
• 3. Learning that the traumatic event(s) occurred to a close family member or close
friend. In cases of actual or threatened death of a family member or friend, the
event(s) must have been violent or accidental.
• 4. Experiencing repeated or extreme exposure to aversive details of the traumatic
event(s) (e.g., first responders collecting human remains: police officers repeatedly
exposed to details of child abuse).
• Note: Criterion A4 does not apply to exposure through electronic media, television,
movies, or pictures, unless this exposure is work related.
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic
event(s), beginning after the traumatic event(s) occurred:
• 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
Note: In children older than 6 years, repetitive play may occur in which themes or aspects of
the traumatic event(s) are expressed.
• 2. Recurrent distressing dreams in which the content and/or affect of the dream are related
to the traumatic event(s). Note: In children, there may be frightening dreams without
recognizable content.
• 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the
traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most
extreme expression being a complete loss of awareness of present surroundings.) Note: In
children, trauma-specific re-enactment may occur in play.
• 4. Intense or prolonged psychological distress at exposure to internal or external cues that
symbolize or resemble an aspect of the traumatic event(s).
• 5. Marked physiological reactions to internal or external cues that symbolize or resemble an
aspect of the traumatic event(s).
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the
traumatic event(s) occurred, as evidenced by one or both of the following:
• 1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or
closely associated with the traumatic event(s).
• 2. Avoidance of or efforts to avoid external reminders (people, places, conversations,
activities, objects, situations) that arouse distressing memories, thoughts, or feelings about
or closely associated with the traumatic event(s).
D. Negative alterations in cognitions and mood associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more)
of the following:
• 1. Inability to remember an important aspect of the traumatic event(s) (typically due to
dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
• 2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the
world (e.g., “I am bad,” “No one can be trusted,” ‘The world is completely dangerous,” “My
whole nervous system is permanently ruined”).
• 3. Persistent, distorted cognitions about the cause or consequences of the traumatic
event(s) that lead the individual to blame himself/herself or others.
• 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
• 5. Markedly diminished interest or participation in significant activities.
• 6. Feelings of detachment or estrangement from others.
• 7. Persistent inability to experience positive emotions (e.g., inability to experience
E. Marked alterations in arousal and reactivity associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more)
of the following:
• 1. Irritable behaviour and angry outbursts (with little or no provocation) typically expressed
as verbal or physical aggression toward people or objects.
• 2. Reckless or self-destructive behaviour.
• 3. Hypervigilance.
• 4. Exaggerated startle response.
• 5. Problems with concentration.
• 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G. The
disturbance causes clinically significant distress or impairment in social, occupational,
or other important areas of functioning. H. The disturbance is not attributable to the
physiological effects of a substance (e.g., medication, alcohol) or another medical
condition.
Specify whether: With dissociative symptoms: The individual’s symptoms meet the
criteria for posttraumatic stress disorder, and in addition, in response to the stressor,
the individual experiences persistent or recurrent symptoms of either of the following:
• 1.Depersonalization: Persistent or recurrent experiences of feeling detached from,
and as if one were an outside observer of, one’s mental processes or body (e.g.,
feeling as though one were in a dream; feeling a sense of unreality of self or body or
of time moving slowly).
• 2. Derealisation: Persistent or recurrent experiences of unreality of surroundings
(e.g., the world around the individual is experienced as unreal, dreamlike, distant, or
distorted).
Note: To use this subtype, the dissociative symptoms must not be attributable to the
physiological effects of a substance (e.g., blackouts, behaviour during alcohol intoxication) or
another medical condition (e.g., complex partial seizures).
Specify if: With delayed expression: If the full diagnostic criteria are not met until at least 6
months after the event (although the onset and expression of some symptoms may be
immediate).
CASE STUDIES.
LADY GAGA - In 2016, Lady Gaga opened up about her struggle with post traumatic
stress disorder (PTSD) in a blog post on the Born This Way Foundation website. She gave a
detailed account of struggling to perform in mental and physical pain as her concerns
were not taken seriously, leaving her with lasting trauma.
• In the interview, Gaga described her PTSD symptoms as being like "that feeling when
you're on a roller coaster and you're just about to go down the really steep slope."
• "[You know] that fear and the drop in your stomach?" she said. "My diaphragm seizes
up. Then I have a hard time breathing, and my whole body goes into a spasm. And I
begin to cry. That's what it feels like for trauma victims every day, and it's...miserable... I
always say that trauma has a brain. And it works its way into everything that you do."
• Gaga said in the interview that "it took years" for her to talk about first the assault, and
then the PTSD. "It was almost like I tried to erase it from my brain. And when it finally
came out, it was like a big, ugly monster. And you have to face the monster to heal," she
said. "For me, with my mental health issues, half of the battle in the beginning was, I felt
like I was lying to the world because I was feeling so much pain but nobody knew. So
that's why I came out and said that I have PTSD, because I don't want to hide—any more
than I already have to."
LADY GAGA’S STRUGGLE WITH
PTSD.
Whoopi Goldberg- is one such celebrity who has dealt with post-traumatic stress
disorder on a long-term basis. The comedian-turned-actor-turned-talk show host
witnessed a mid air collision between two planes in 1978 and has had a severe fear of
flying ever since. “Some people are meant to fly,” Goldberg told CNN in 2011. “And I
don’t know if I was meant to fly.”
Unfortunately the nature of Goldberg’s job means that she has to fly from time to time,
and in several instances she has suffered severe panic attacks as a result. Goldberg’s
fear of flying is so acute that for decades she’s travelled around the United States on a
private bus, driving coast to coast between Los Angeles and New York when required.
“I feel like I shouldn’t be flying,” said Goldberg. “I should be rolling in my bus.”
Goldberg has openly discussed that she receives therapy for her fear of flying and
associated anxiety.
Mick Jagger- Sir Mick Jagger is celebrated around the world for being the front man
of the wildly successful band The Rolling Stones. But fame doesn’t protect people
from suffering from acute traumatic stress disorder or PTSD.
He developed the condition after his 49-year-old long-term partner L’Wren Scott took
her own life. After one month of acute traumatic stress, a person can be diagnosed
with PTSD.
Mick Jagger was reportedly “deeply upset” when his mental health condition was
shared with the world. For the rest of us, it’s good to see that nobody is immune to
suffering the effects of PTSD.
Jacqueline Kennedy Onassis- Jacqueline Kennedy Onassis (Jackie Kennedy for
short) was the wife of President John F. Kennedy. Her world was turned upside down
when she witnessed JFK’s assassination.
She suffered in silence and little was known about her struggles, until Barbara
Leaming wrote “Jacqueline Bouvier Kennedy Onassis: The Untold Story,” which
outlines the first lady’s emotional struggles that were hidden behind a veil of glamour.
Mental Health is one such topic that even today isn’t taken very seriously about.
In the more recent times, emphasis is being made on creating awareness about
Mental Health.
This process is being catapulted as a result of more and more world renowned
personalities speaking openly about their struggles with mental health.
One such inspiring instance was seen at the UNICEF’S meeting of 2019 where the
world famous Korean Band : BTS (BANGTAN SONYEONDAN) spoke about their
campaign with UNICEF : LOVE YOURSELF building on their belief that “true love first
begins with loving myself.”
Kim Namjun (RM) of BTS addressed the UN Assembly :
"Maybe I made a mistake yesterday, but yesterday’s me is still me. I am who I am today, with all my
faults. Tomorrow I might be a tiny bit wiser, and that’s me, too. These faults and mistakes are what I
am, making up the brightest stars in the constellation of my life. I have come to love myself for who I
was, who I am, and who I hope to become.
"I would like to say one last thing.
"So, let’s all take one more step. We have learned to love ourselves, so now I urge you to “speak
yourself.”
"I would like to ask all of you. What is your name? What excites you and makes your heart beat?
"Tell me your story. I want to hear your voice, and I want to hear your conviction. No matter who you
are, where you’re from, your skin colour, gender identity: speak yourself.
"Find your name, find your voice by speaking yourself.
"I’m Kim Nam Jun, RM of BTS.
"I’m a hip-hop idol and an artist from a small town in Korea.
"Like most people, I made many mistakes in my life.
"I have many faults and I have many fears, but I am going to embrace myself as hard as I can, and I’m
starting to love myself, little by little.
"What is your name? Speak Yourself!“
LOVE YOURSELF. LOVE MYSELF.

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POST TRAUMATIC STRESS DISORDER (PTSD)

  • 1. POST TRAUMATIC STRESS DISORDER (PTSD). KADAMBARI SINGH. (BANARAS HINDU UNIVERSITY) Application number- e8c3ea23f33011e9b547ad134e8d386f ACADEMIC WRITING.
  • 2. POST TRAUMATIC STRESS DISORDER. • Post traumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. • PTSD has been known by many names in the past, such as “shell shock” during the years of World War I and “combat fatigue” after World War II. But PTSD does not just happen to combat veterans. PTSD can occur in all people, in people of any ethnicity, nationality or culture, and any age. • Women are twice as likely as men to have PTSD. Children are less likely to experience PTSD after trauma than adults, especially if they are under 10 years of age. • A diagnosis of PTSD requires exposure to an upsetting traumatic event. However, exposure could be indirect rather than first hand. For example, PTSD could occur in an individual learning about the violent death of a close family. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.
  • 3. CLASSIFICATION. The current Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, is a manual that clinical professionals use to diagnose mental health conditions. In previous years, PTSD fell under the category of anxiety related conditions. The current version of the manual has placed post-traumatic stress disorder under the category of trauma- and stressor-related disorders. The characteristic symptoms are not present before exposure to the violently traumatic event. Typically the individual with PTSD persistently avoids all thoughts, emotions and discussion of the stressor event and may experience amnesia for it. However, the vent is commonly relived by the individual through intrusive, recurrent recollections, flashbacks and nightmares. The characteristic symptoms are considered Acute if lasting less than three months, Chronic if persisting three months or more, and With Delayed Onset if the symptoms first occur after six months or some years later. PTSD is distinct from the briefer Acute Stress Disorder, and can cause clinical impairment in significant areas of functioning.
  • 4. WHAT ARE THE CAUSES OF PTSD? PTSD is believed to be caused by the experience of a wide range of traumatic events and particularly if the trauma is extreme, can occur in persons with no predisposing conditions. Persons considered at risk include military personnel, victims of natural disasters, concentration camp survivors and victims of violent crimes. Individuals not infrequently experience “survivor’s guilt” for remaining alive while others died. Causes of the symptoms of PTSD are the experiencing or witnessing of a stressor event including death, serious injury or such threat to self or others in a situation in which the individual felt intense terror, horror or powerlessness. Persons who are employed in occupations that expose them to violence (such as, soldiers) or disasters (such as, emergency workers) are also at risk. Children and adults may develop PTSD symptoms by experiencing bullying or mobbing.
  • 5. RISK FACTORS. • Anyone can develop PTSD at any age. • This includes war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or other serious events. • According to the National Centre for PTSD, about 7 or 8 out of every 100people will experience PTSD at some point in their lives. • Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others. • Not everyone with PTSD has been through a dangerous event. Some people develop PTSD after a friend or family member experiences danger or harm. • The sudden, unexpected death of a loved one can also lead to PTSD.
  • 6. Why do some people develop PTSD and other people do not? It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder. Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some factors that increase risk for PTSD include: • Living through dangerous events and traumas. • Getting hurt. • Seeing another person hurt, or seeing a dead body. • Childhood trauma. • Feeling horror, helplessness, or extreme fear. • Having little or no social support after the event.
  • 7. • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home. • Having a history of mental illness or substance abuse. • Previous traumatic experiences, especially in early life. • Family history of PTSD or depression. • History of physical or sexual abuse. • History of substance abuse. • History of depression, anxiety, or another mental illness. • High levels of stress in everyday life. • Lack of support after trauma. • Lack of coping skills. • Being involved in a car crash. • Being violently attacked. • Being raped or sexually assaulted. • Being abused, harassed or bullied. • Being kidnapped or held hostage.
  • 8. • Extreme violence or war, including military combat surviving a terrorist attack • Surviving a natural disaster, such as flooding or an earthquake • Being diagnosed with a life-threatening condition • Losing someone close to you in particularly upsetting circumstances • Learning that traumatic events have affected someone close to you (sometimes called secondary trauma) • Any event in which you fear for your life. • Doing a job where you repeatedly see distressing images or hear details of traumatic events.. • Traumatic childbirth, either as a mother or a partner witnessing a traumatic birth. Some factors that may promote recovery after trauma include: • Seeking out support from other people, such as friends and family. • Finding a support group after a traumatic event. • Learning to feel good about one’s own actions in the face of danger. • Having a positive coping strategy, or a way of getting through the bad event and learning from it.
  • 9. SYMPTOMS. Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks. PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
  • 10. Intrusive memories. Symptoms of intrusive memories may include: • Recurrent, unwanted distressing memories of the traumatic event. • Reliving the traumatic event as if it were happening again (flashbacks). • Upsetting dreams or nightmares about the traumatic event. • Severe emotional distress or physical reactions to something that reminds you of the traumatic event. (examples; pounding heart, rapid breathing, nausea, muscle tension, sweating.)
  • 11. Avoidance. Symptoms of avoidance may include: • Trying to avoid thinking or talking about the traumatic event. • Avoiding places, activities or people that remind you of the traumatic event.
  • 12. Negative changes in thinking and mood. Symptoms of negative changes in thinking and mood may include: • Negative thoughts about yourself, other people or the world. • Hopelessness about the future. • Memory problems, including not remembering important aspects of the traumatic event. • Difficulty maintaining close relationships. • Feeling detached from family and friends. • Lack of interest in activities you once enjoyed. • Difficulty experiencing positive emotions. • Feeling emotionally numb.
  • 13. Changes in physical and emotional reactions. Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include: • Being easily startled or frightened. • Always being on guard for danger. • Self-destructive behaviour, such as drinking too much or driving too fast. • Trouble sleeping. • Trouble concentrating. • Irritability, angry outbursts or aggressive behaviour. • Overwhelming guilt or shame.
  • 14. Cognition and mood symptoms. • Trouble remembering key features of the traumatic event. • Negative thoughts about oneself or the world. • Distorted feelings like guilt or blame. • Loss of interest in enjoyable activities. Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members. It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might have PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
  • 15. Symptoms of PTSD in children and adolescents. For children 6 years old and younger, signs and symptoms may also include: • Re-enacting the traumatic event or aspects of the traumatic event through play. • Frightening dreams that may or may not include aspects of the traumatic event. • Fear of being separated from parents. • Losing previously-acquired skills (such as toilet training). • Sleep problems and nightmares without recognizable content. • Sombre, compulsive play in which themes or aspects of the trauma are repeated. • New phobias and anxieties that seem unrelated to the trauma (such as fear of monsters). • Acting out trauma through play, stories, or drawings. • Aches and pains with no apparent cause. • Irritability and aggression.
  • 16. Other common symptoms of PTSD. • Anger and irritability. • Depression and hopelessness. • Guilt, shame, or self-blame. • Suicidal thoughts and feelings.
  • 17. TYPES OF PTSD. Within the diagnosis of PTSD there can be certain specifiers identified, which means there are distinct features present that make it different from the more broad diagnosis of PTSD. Some of these specifiers are identified in the DSM-5 including: • Dissociative. • Delayed onset/expression.
  • 18. Preschool. • One of the changes made in the most recent update of the diagnostic manual for clinicians is the inclusion of specific PTSD symptoms for children six years or younger. • As children witness and live through traumatic events they, too, can experience emotionally distressing symptoms after the event. • Just as with adults (and anyone over six years old) there are certain criteria that need to be met in order for a young child to be diagnosed with PTSD.
  • 19. Dissociative. • The dissociative specifier within the PTSD diagnosis refers to the presence of persistent or recurrent depersonalization or derealisation symptoms. • Depersonalization means that someone is experiencing something as if they are an observer to themselves, observing from outside of their body. • Derealisation refers to sensing as if things around you are not real, almost as if you are unfamiliar and disconnected from the world around you.
  • 20. Delayed Onset • The term delayed onset was recently changed to delayed expression in the DSM-5. • Although people with this particular specifier do meet the necessary criteria for PTSD, the criteria are not fully met until at least six months after the traumatic event. • A person could experience the onset and expression of some of the symptoms more immediately, however, the full symptom criteria for diagnosis would not have been met until after that six month mark.
  • 21. Complex. • Sometimes people can experience isolated, acute instances of trauma such as a horrific car accident or being robbed at gunpoint, for example. • These would be considered acute because they are not likely to become recurring experiences. • There are other types of traumatic events that can be more recurring, such as domestic violence, sexual abuse, or childhood neglect. The person would experience the event again and again over the course of time. • When people have experienced this type of more chronic trauma, it is sometimes referred to as complex PTSD.
  • 22. TREATMENT OF PTSD. The main treatments for people with PTSD are: • Psychotherapy. • Medication, or a combination of the two. Everyone is different, so a treatment that works for one person may not work for another. Some people may need to try different treatments to find what works best for their symptoms. Regardless of what treatment option you chose, it is important for anyone with PTSD to be treated by a mental health professional who is experienced with PTSD.
  • 23. Psychotherapy. • Psychotherapy (sometimes called “talk therapy”) involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. • Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery. • Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs. • Effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms, and skills to manage the symptoms.
  • 24. Cognitive Behaviour Therapy (CBT). • CBT is a type of psychotherapy that has consistently been found to be the most effective treatment of PTSD both in the short term and the long term. • CBT for PTSD is trauma-focused, meaning the trauma event(s) are the centre of the treatment. • It focuses on identifying, understanding, and changing thinking and behaviour patterns. • CBT is an active treatment involved the patient to engage in and outside of weekly appointments and learn skills to be applied to their symptoms. • The skills learned during therapy sessions are practiced repeatedly and help support symptom improvement. CBT treatments traditionally occur over 12 to 16 weeks.
  • 25. What is Cognitive Behavioural Therapy? • It is important for anyone with PTSD to be treated by a mental health care professional who is experienced with PTSD. Some people will need to try different treatments to find what works for their symptoms. Description of Specific CBTs for PTSD: 1. Cognitive Processing Therapy (CPT). • It is a form of CBT that utilizes cognitive therapy to evaluate and change trauma related thoughts. • CPT focuses on the way people view themselves, others, and the world after experiencing a trauma. Often times inaccurate thoughts after a trauma keep you stuck and prevent recovery from trauma. • In CPT you look at why the trauma occurred and the impact it has had on the persons beliefs. • CPT focuses on learning skills to evaluate whether you thoughts are supported by facts and if there are more helpful ways to think about your trauma. • There is strong research support showing CPTs effectiveness across a wide range of traumas.
  • 26. 2. Prolonged Exposure (PE). • It is another form of CBT that relies more heavily on behavioural therapy techniques to help individuals gradually approach trauma related memories, situations, and emotions. • PE focuses on exposures to help people with PTSD stop avoiding trauma reminders. • Avoiding these reminders may help in the short term, but in the long term it prevents recovery from PTSD. • PE uses imaginal exposures, which involve recounting the details of the trauma experience, as well as in vivo exposures, which involve repeatedly confronting trauma- related situations or people in their life that they have been avoiding. • There is strong research support showing PEs effectiveness across a wide range of traumas.
  • 27. 2. Eye Movement Desensitization and Reprocessing (EMDR). • It is a form of psychotherapy that involves processing upsetting trauma-related memories, thoughts and feelings. • EMDR asks people to pay attention to either a sound or a back and forth movement while thinking about the trauma memory. • This treatment has been found to be effective for treating PTSD, but some research has shown that the back and forth movement is not the active treatment component but rather the exposure alone is.
  • 28. 3. Stress Inoculation Training (SIT). • It is another type of CBT that aims to reduce anxiety by teaching coping skills to deal with stress that may accompany PTSD. • SIT can be used as a standalone treatment or may be used with another types of CBTs. • The main goal is to teach people to react differently to react differently to their symptoms. • This is done through teaching different types of coping skills including, but is not limited to, breathing retraining, muscle relaxation, cognitive restructuring, and assertiveness skills. • There is modest research support showing PEs effectiveness across a wide range of traumas.
  • 29. Main Components of CBT. While different CBTs have different amounts of both exposure and cognitive interventions, they are the main components of the larger category of CBTs that have been repeatedly found to result in symptom reduction. • Exposure therapy- This type of intervention helps people face and control their fears by exposing them to the trauma memory they experiences in the context of a safe environment. Exposure can use mental imagery, writing, or visits to places or people that remind them of their trauma. Virtual reality (creating a virtual environment to resemble the traumatic event) can also be used to expose the person to the environment that contains the feared situation. Virtual reality, like other exposure techniques can assist in exposures for treatment for PTSD when the technology is available. Regardless of the method of exposure, a person is often gradually exposed to the trauma to help them become less sensitive over time. • Cognitive Restructuring- This type of intervention helps people make sense of bad memories. Oftentimes people remember their trauma differently than how it happened (e.g., not remembering certain parts of the trauma, remembering it is a disjointed way). It is common for people to feel guilt of shame about aspects of their trauma that were not actually their fault. Cognitive restructuring helps people look at what happened with fact to get a realistic perspective on the trauma.
  • 30. Medications. • The brains of people with PTSD process "threats" differently, in part because the balance of chemicals called neurotransmitters is out of whack. • They have an easily triggered "fight or flight" response, which is what makes one jumpy and on-edge. Constantly trying to shut that down could lead to feeling emotionally cold and removed. • Medications help one stop thinking about and reacting to what happened, including having nightmares and flashbacks. • They can also help one to have a more positive outlook on life and feel more "normal" again. • The most studied type of medication for treating PTSD are antidepressants, which may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside. • Other medications may be helpful for treating specific PTSD symptoms, such as sleep problems and nightmares. • Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.
  • 31. Several types of drugs affect the chemistry in your brain related to fear and anxiety. Doctors will usually start with medications that affect the neurotransmitters serotonin or norepinephrine (SSRIs and SNRIs), including: • Fluoxetine (Prozac). • Paroxetine (Paxil). • Sertraline (Zoloft). • Venlafaxine (Effexor).
  • 32. DSM-V : Posttraumatic Stress Disorder. Diagnostic Criteria 309.81 (F43.10) Posttraumatic Stress Disorder Note: The following criteria apply to adults, adolescents, and children older than 6 years. For children 6 years and younger, see corresponding criteria below. A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: • 1. Directly experiencing the traumatic event(s). • 2. Witnessing, in person, the event(s) as it occurred to others. • 3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. • 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse). • Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
  • 33. B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: • 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed. • 2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content. • 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific re-enactment may occur in play.
  • 34. • 4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). • 5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: • 1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). • 2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
  • 35. D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: • 1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). • 2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” ‘The world is completely dangerous,” “My whole nervous system is permanently ruined”). • 3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. • 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). • 5. Markedly diminished interest or participation in significant activities. • 6. Feelings of detachment or estrangement from others. • 7. Persistent inability to experience positive emotions (e.g., inability to experience
  • 36. E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: • 1. Irritable behaviour and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. • 2. Reckless or self-destructive behaviour. • 3. Hypervigilance. • 4. Exaggerated startle response. • 5. Problems with concentration. • 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
  • 37. F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Specify whether: With dissociative symptoms: The individual’s symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following: • 1.Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly). • 2. Derealisation: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).
  • 38. Note: To use this subtype, the dissociative symptoms must not be attributable to the physiological effects of a substance (e.g., blackouts, behaviour during alcohol intoxication) or another medical condition (e.g., complex partial seizures). Specify if: With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).
  • 39. CASE STUDIES. LADY GAGA - In 2016, Lady Gaga opened up about her struggle with post traumatic stress disorder (PTSD) in a blog post on the Born This Way Foundation website. She gave a detailed account of struggling to perform in mental and physical pain as her concerns were not taken seriously, leaving her with lasting trauma. • In the interview, Gaga described her PTSD symptoms as being like "that feeling when you're on a roller coaster and you're just about to go down the really steep slope." • "[You know] that fear and the drop in your stomach?" she said. "My diaphragm seizes up. Then I have a hard time breathing, and my whole body goes into a spasm. And I begin to cry. That's what it feels like for trauma victims every day, and it's...miserable... I always say that trauma has a brain. And it works its way into everything that you do." • Gaga said in the interview that "it took years" for her to talk about first the assault, and then the PTSD. "It was almost like I tried to erase it from my brain. And when it finally came out, it was like a big, ugly monster. And you have to face the monster to heal," she said. "For me, with my mental health issues, half of the battle in the beginning was, I felt like I was lying to the world because I was feeling so much pain but nobody knew. So that's why I came out and said that I have PTSD, because I don't want to hide—any more than I already have to."
  • 41. Whoopi Goldberg- is one such celebrity who has dealt with post-traumatic stress disorder on a long-term basis. The comedian-turned-actor-turned-talk show host witnessed a mid air collision between two planes in 1978 and has had a severe fear of flying ever since. “Some people are meant to fly,” Goldberg told CNN in 2011. “And I don’t know if I was meant to fly.” Unfortunately the nature of Goldberg’s job means that she has to fly from time to time, and in several instances she has suffered severe panic attacks as a result. Goldberg’s fear of flying is so acute that for decades she’s travelled around the United States on a private bus, driving coast to coast between Los Angeles and New York when required. “I feel like I shouldn’t be flying,” said Goldberg. “I should be rolling in my bus.” Goldberg has openly discussed that she receives therapy for her fear of flying and associated anxiety.
  • 42. Mick Jagger- Sir Mick Jagger is celebrated around the world for being the front man of the wildly successful band The Rolling Stones. But fame doesn’t protect people from suffering from acute traumatic stress disorder or PTSD. He developed the condition after his 49-year-old long-term partner L’Wren Scott took her own life. After one month of acute traumatic stress, a person can be diagnosed with PTSD. Mick Jagger was reportedly “deeply upset” when his mental health condition was shared with the world. For the rest of us, it’s good to see that nobody is immune to suffering the effects of PTSD. Jacqueline Kennedy Onassis- Jacqueline Kennedy Onassis (Jackie Kennedy for short) was the wife of President John F. Kennedy. Her world was turned upside down when she witnessed JFK’s assassination. She suffered in silence and little was known about her struggles, until Barbara Leaming wrote “Jacqueline Bouvier Kennedy Onassis: The Untold Story,” which outlines the first lady’s emotional struggles that were hidden behind a veil of glamour.
  • 43. Mental Health is one such topic that even today isn’t taken very seriously about. In the more recent times, emphasis is being made on creating awareness about Mental Health. This process is being catapulted as a result of more and more world renowned personalities speaking openly about their struggles with mental health. One such inspiring instance was seen at the UNICEF’S meeting of 2019 where the world famous Korean Band : BTS (BANGTAN SONYEONDAN) spoke about their campaign with UNICEF : LOVE YOURSELF building on their belief that “true love first begins with loving myself.”
  • 44. Kim Namjun (RM) of BTS addressed the UN Assembly : "Maybe I made a mistake yesterday, but yesterday’s me is still me. I am who I am today, with all my faults. Tomorrow I might be a tiny bit wiser, and that’s me, too. These faults and mistakes are what I am, making up the brightest stars in the constellation of my life. I have come to love myself for who I was, who I am, and who I hope to become. "I would like to say one last thing. "So, let’s all take one more step. We have learned to love ourselves, so now I urge you to “speak yourself.” "I would like to ask all of you. What is your name? What excites you and makes your heart beat? "Tell me your story. I want to hear your voice, and I want to hear your conviction. No matter who you are, where you’re from, your skin colour, gender identity: speak yourself. "Find your name, find your voice by speaking yourself. "I’m Kim Nam Jun, RM of BTS. "I’m a hip-hop idol and an artist from a small town in Korea. "Like most people, I made many mistakes in my life. "I have many faults and I have many fears, but I am going to embrace myself as hard as I can, and I’m starting to love myself, little by little. "What is your name? Speak Yourself!“ LOVE YOURSELF. LOVE MYSELF.