Post Traumatic Stress Disorder

Post-Traumatic stress disorder (PTSD) can develop after a person has been directly exposed to, witnessed or heard about a traumatic event(s) involved involving a threat of severe bodily harm or loss of life to themselves or others.

Some examples of traumatic events that could lead to the development of PTSD are: car accidents; natural disasters such as hurricanes or earthquakes; being or physically or sexually assaulted; being emotionally, physically, or sexually abused; combat exposure; or learning about the unexpected death or injury of a loved one.

Although not all individuals exposed to a trauma develop PTSD, some individuals experience a number of distressing psychological and physical symptoms including re-experiencing, avoidance or numbing, and hyperarousal.

Re-experiencing symptoms include: recurrent and intrusive thoughts about the event; upsetting dreams or nightmares; flashbacks to the trauma; becoming extremely upset or anxious when reminded of the trauma.

Avoidance and numbing symptoms include: avoiding thinking or talking about the trauma; avoiding places, situations or people reminiscent of the trauma; being unable to recall certain parts of what happened; losing interest in previously valued activities; feeling distant or detached from others; having difficulty experiencing strong emotions; feeling a lack of interest or hope in the future (e.g., feeling one will never have a career, get married, live to old age).

Symptoms of hyperarousal include: difficulty falling or staying asleep; feeling irritable or having outbursts of anger; difficulty concentrating; feeling hypervigilant even if there is no reason to be; and being easily startled.

In order to receive a PTSD diagnosis, symptoms must persist for at least one month and cause significant distress, interference, or impairment in work, school, or social functioning. Symptoms may last for several months, or become even more chronic. For some, PTSD symptoms emerge six months or more after the traumatic event.

Medications Available

There are a number of effective medications available to treat the symptoms of PTSD, including antidepressants and some newer anti-anxiety or mood-stabilizing medications. Many individuals with PTSD do well with treatment that includes both psychotherapy and medication. Cognitive-behavioral therapy (CBT), including prolonged exposure (PE), Cognitive Processing Therapy (CPT), and Skills Training in Affect and Interpersonal Regulation (STAIR) is effective for many patients with PTSD and involve working closely with a therapist to systematically process the traumatic event, identify and modify negative thoughts that interfere with recovery from the trauma, and learn to face situations or feelings associated with the trauma. In addition, CBT helps individuals learn skills for managing difficult emotions and overcoming difficulties in interpersonal relationships.

The Home Base Program

The Home Base Program is an affiliation between Massachusetts General Hospital and the Boston Red Sox dedicated to improving the lives of veterans who deployed in support of the conflicts in Iraq and Afghanistan and live with deployment- or combat-related stress and/or traumatic brain injury. They provide clinical care to veterans as well as support for their families. The Home Base Program also offers educational courses and materials for health care providers and the public. Please follow this link for more information about this program.

Please explore our site to find out more about PTSD at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston.

Social Anxiety

Social Anxiety Disorder (Social Phobia) is characterized by a persistent fear of social or performance situations, with worry about potential scrutiny or embarrassment. Individuals with social phobia typically feel extremely anxious about being the focus of attention, and often avoid social and performance situations.

When an individual with social phobia enters or thinks about entering a feared situation, anxiety increases and for some may result in symptoms of a panic attack. Examples of feared situations include persistent fear of public speaking, meeting new people, attending parties, going to school, or having social contact through a job.

Although most people have some anxiety about social and/or performance situations, these fears are more severe, persist and may limit participation in or enjoyment of every day activities for an individual with social phobia. Social anxiety symptoms may interfere with success or completion of school, making new friends or relationships, and employment. Nonetheless, many individuals suffer with social phobia for many years without a diagnosis or treatment. However, there are a number of effective treatments available. Options include medications such as antidepressants or benzodiazepines ("Valium-like" medications), and psychotherapy (counseling or "talk therapy"), especially cognitive-behavioral therapy.

Please explore our site tofind out more about participating in a treatment study for social anxiety disorderat the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston.

Complicated Grief

Complicated Grief (CG) is a clinically significant grief reaction that occurs at least 6 months after the death of a loved one.

It has also been called at times Traumatic Grief or Pathological Grief. Individuals with CG may find that they are unable to accept the death, and that their feelings remain very strong and persistent. In addition, there may be certain types of disturbing ideas that seem to inhibit the natural process of gradual diminishing grief intensity. Another way of saying this is that grief isn't working and the bereaved person is "stuck" in the grieving process. When this happens, grief intensity remains high and adjustment does not occur.

Complicated Grief is characterized by symptoms including marked depression, anxiety, preoccupation with the deceased, disbelief, longing, anger, guilt, withdrawal, and avoidance that continue for 6 months or more after a loss. These symptoms can cause substantial distress and have been associated with impaired quality of life, poor medical outcomes, and increased rates of suicide.

Standard treatments include medications aimed at specific symptoms such as antidepressants, anti-anxiety medications, and sleep-aids. Recent studies suggest that antidepressants such as bupropion (Wellbutrin) and paroxetine (Paxil) may help relieve symptoms of CG. There is also a short-term therapy recently developed and still being studied by Dr M. Katherine Shear specifically for complicated grief called "Complicated Grief Therapy."

Brief Questionnaireon Complicated Grief: Take this questionnaire to see if your symptoms might suggest the presence of the syndrome of Complicated Grief.

Find out more aboutparticipating in a treatment study for Complicated Griefat the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston.

Learn more about Complicated Grief atThe Complicated Grief Program.




Panic Disorder

Panic disorder is characterized by recurrent unexpected panic attacks, followed by at least a month of persistent concern about having more attacks, worry about the implications of having an attack (e.g., is there something wrong with my heart?), or a change in behavior related to the attacks (e.g., avoidance).

Panic attacks are periods of marked fear or anxiety which tend to come on quickly, peak within 10 minutes and are accompanied by distressing symptoms of arousal such as palpitations, heart racing, shortness of breath, sweating, lightheadedness, abdominal distress, flushing, spaciness, or feeling as if you may be going crazy, dying or losing control.

Many patients with panic disorder develop agoraphobia, which is a concern about being in places or situations in which help or easy escape may not be available in the event of having an attack, or in which previous attacks have occurred.

Some individuals with agoraphobia avoid the situations they are afraid of or require a companion to accompany them - others endure them with a great deal of distress.

Panic disorder can cause significant difficulties, including marked distress, social and job related dysfunction, increased utilization of medical services (e.g., visits to doctors and emergency rooms), and increased rates of depression and alcohol abuse. A number of effective treatments are available, including medications such as antidepressants or benzodiazepines ("Valium-like" medications), and psychotherapies such as cognitive-behavioral therapy.

Please explore our site tofind out more about participating in a treatment study for panic disorderat the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston. Generalized Anxiety

Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety and worry about a number of life issues or day to day concerns that occurs more days than not for at least six months.

Individuals with GAD also often experience a number of associated symptoms such as: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

The anxiety and worry is considered a disorder if it is severe enough to cause an individual significant distress or interferes with social or occupational functioning. Adults with GAD often worry excessively about everyday, routine life circumstances such as possible job responsibilities, finances, or the health of family members. A number of effective treatments are available for GAD, such as anti-anxiety medications and cognitive-behavioral therapy (reduces worry through changes in thinking and behavior patterns).

Please explore our site tofind out more about participating in a treatment study for GADat the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston.

If you are interested in participating in a treatment study, please call 1-866-44-WORRY for our confidential phone line or email us at




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