Tag Archives: nightmares

Comparing PTSD and Somatization Disorder


Comparing PTSD and Somatization Disorder shows that there are some similarities in the symptoms but for the most part they are different.  Somatization Disorder has a lot more physical symptoms while PTSD has more symptoms leaning toward emotional.  The symptoms the two disorders have in common are headaches and stomachaches.  In both cases symptoms can be so severe and last so long that it completely disrupts the person’s life.

Do you have medically unexplained physical, or somatic, symptoms?

Somatization disorder can cause a person towards an emotional reaction such as depression or even suicide because they feel so much pain and can never get a diagnosis for it.  The symptoms often lead to substance abuse.  Thereby leaving them to feel hopeless, as if they will never get the help they need.  Somatization disorder has a wide range of physical symptoms.  A person with this disorder will report many different symptoms over a period of time with no real medical explanation.  These symptoms are often pain throughout the body, but not usually all at the same time.  Pain in the form of headaches, stomach ache, joint or muscle pain.  It could also be internal, such as vomiting, or it could come about as a sexual or menstrual problem.  Neurological symptoms are also common, often occurring as problems with balance or vision and even paralysis.

Generally for a patient to be diagnosed they will have experienced a minimum of eight symptoms.  There will be a minimum number of symptoms from a given category.  An example of this is that a patient will experience four or more symptoms from the pain category, two or more symptoms from the gastrointestinal category, one or more symptoms from the sexual symptoms category, and one or more symptoms from the pseudoneurological symptoms.  When a person is showing signs of these symptoms they will be unexplainable and a medical diagnosis is not usually possible.  Generally the person will explain the pain they are having in a fashion that makes it seem as if they are in more pain than you think they should be in, as if they are over exaggerating the symptoms.

Somatization Disorder lasts for a very long time which is one thing this disorder has in common with PTSD.  PTSD symptoms can last anywhere from months to years.   Most PTSD symptoms are different from Somatization Disorder because they come from more of a psychological background than a physical background.  PTSD symptoms are generally geared more towards an emotional aspect, some examples are worry over dying, acting younger than the chronological age, having an impaired memory or obsessiveness.  It seems that PTSD actually transforms a person’s behavior instead of changing them physically.  This is because when traumatic experiences occur, the feelings they experience, such as shock, nervousness or fear continue on for a length of time and gradually get stronger.  The stronger they get the less of a normal life the person is able to lead.

These increased symptoms can include nightmares or night terrors, hypervigilance, panic attacks, hypersensitivity, low self-esteem and shattered self-confidence or a physical or mental paralysis.  There are three categories often used by clinicians in order to type or group people who are diagnosed with PTSD.  The categories used are re-living, avoiding, and increased arousal.  The people in the re-living group are people who suffer from living through the trauma they have been through over and over again.  This can happen through a flashback or a hallucination or just by being reminded even in small ways.  The people in the avoiding group tend to try to stay away from people, places or things that can remind them of the event.  Unfortunately the person can start to isolate themselves and eventually can turn completely inward from detachment.  The people in the increased arousal group lean towards either having difficulty showing their emotions or on the other end of the spectrum showing overly exaggerated emotions.  This group is also the group who has some physical symptoms such as higher blood pressure, muscle tension and nausea.

In conclusion, it has become very apparent to me that while there are some similarities between PTSD and Somatization Disorder, there are a lot more differences.  It has also become very apparent to me that the people who suffer from these disorders are dealing with a lot of pain, and whether it is physical or emotional, this pain can cause the person suffering from it to shut down and disable them from enjoying the life they were meant to lead.

References

Netherton, S.D., Holmes, D., Walker, C.E. (1999). Child and Adolescent Psychological Disorders.   New York, NY: Oxford University Press.

Blaney, P.H., Millon, T. (2009). Oxford Textbook of Psychopathology.

New York, NY: Oxford University Press.

(2009, February 9). Anxiety & Panic Disorders Guide. WebMD.com. Retrieved October 5, 2009, from http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder

(Retrieved 2009, October 5). Somatization Disorder. Intelihealth.com.  http://www.intelihealth.com/IH/ihtPrint/W/8271/25759/187986.html?d=dmtHealthAZ&hide=t&k=base

(Retrieved 2009, October 5). Posttraumatic Stress Disorder. American Academy of Child & Adolescent Psychiatry. AACAP.org

http://www.aacap.org/cs/root/facts_for_families/posttraumatic_stress_disorder_ptsd

(Retrieved 2009, October 5). Somatization Disorder. PsychNet-UK.

http://www.psychnet-uk.com/dsm_iv/somatization_disorder.htm

Kinchin, D. (2005). Post Traumatic Stress Disorder The Invisible Injury.

Didcot, Oxfordshire OX11 9YS, UK.  Retrieved October 5, 2009, from http://www.successunlimited.co.uk/books/ptsympt.htm

 

Sleep/Wake Disorders


Historically, sleep disorders have long been commonly recognized within the context of other psychopathological conditions, but they have been frequently minimized or otherwise ignored as distinct entities or stand-alone psychopathological situations.  Research supporting the current DSM-IV-TR classification system is extremely limited, despite the common sense approach (in my opinion) of grouping sleep disorders primarily on the basis of underlying constellation of symptoms.

Add to FacebookAdd to DiggAdd to Del.icio.usAdd to StumbleuponAdd to RedditAdd to BlinklistAdd to TwitterAdd to TechnoratiAdd to Yahoo BuzzAdd to Newsvine

Primary insomnia is the hallmark diagnosis in this category.  It is “characterized by chronic difficulty initiating and/or maintaining sleep or persistent poor-quality sleep.”  (Blaney & Millon, 2009, p. 508)  Individually commonly suffer from mild anxiety, mood disturbances, concentration/memory dysfunction, somatic concerns, and general malaise… but these conditions are generally viewed as symptoms rather than causes.  Insomnia prevalence increases with age, in contrast with sleep onset difficulties are more common in young adults.  It has also been suggested that, generally speak, women are more susceptible than men.  Societal prevalence is between 1% and 2%.  (Blaney & Millon, 2009, p. 508)

I was intrigued by the statement that “the majority of insomnia sufferers tend to overestimate the time it takes them to fall asleep and to underestimate the time they actually sleep to some degree.”  (Blaney & Millon, 2009, p. 510)  This might give some basis to a cognitive-behavioral approach if we can reset those expectations.  A stated by the text, the main problem is that most clinicians don’t have access to the raw data to confirm or refute this subjective complaint.  My question… is it out of the realm of possibility for us to send a client home with a measurement device so we can accumulate that data?

Narcolepsy is characterized by recurrent, irresistible day time sleep episodes.  The “classic tetrad” indicative of narcolepsy includes excessive daytime sleepiness and unintended sleep episodes during situations where most persons could stay awake, abrupt and reversible decrease or loss of muscle tome (without loss of consciousness, also known as cataplexy), and/or awakening from nocturnal or diurnal sleep with an inability to move (sleep paralysis), and finally vivid images and dreams that are evoked just as sleep develops (hypnagogic hallucinations).  (Blaney & Millon, 2009, p. 510)  Narcolepsy generally first appears during adolescence or young adulthood, and is believed to be genetically predisposed.   Life events may precipitate the onsite of this disorder… although it is not clear to me whether they are causes or effects?

Breathing related sleep disorders encompass what is widely known as sleep apnea.  This condition manifests as loud snorting, pauses in breathing, gasping for breath during sleep, headaches on wake, and automatic behaviors during wakefulness or excessive daytime sleepiness.  The headaches on waking part turned my head because I get that all the time… although I haven’t really noticed any other signs or symptoms.  Odd…

Circadian Rhythm Sleep Disorders (CRSDs) represent a mismatch between natural sleep/wake rhythms and the schedule imposed by occupational or social demands.  (Blaney & Millon, 2009, p. 512)  Individuals typically report insomnia at certain times of the day (generally when they want to be sleeping) and excessive sleepiness at other times (generally when they should be awake).

Parasomnias encompass nightmares, night terrors, and sleepwalking.  Nightmare disorder is characterized by repeated awakenings by disturbing dreams.  Sleepwalking and Night Terrors both occur early in the sleep period and appear to represent incomplete arousals from the deepest states of sleep (states 3-4), known as slow wave sleep (SWS).  All of the above are more prevalent in children when compared with adults, and more common in males than in females. (I honestly would have expected it to be more common in females?)

Add to FacebookAdd to DiggAdd to Del.icio.usAdd to StumbleuponAdd to RedditAdd to BlinklistAdd to TwitterAdd to TechnoratiAdd to Yahoo BuzzAdd to Newsvine

Reference

Blaney, P. H., & Millon, T. (2009). Oxford textbook of psychopathology (2nd ed.). New York, New York: Oxford University Press.