The rate of diagnoses of mental conditions has increased in recent years due to the pandemic.
Joalex Antongiorgi, psychiatrist and child specialist at the University of Puerto Rico Medical Sciences Campus. Photo: Provided by Dr. Antongiorgi to the Journal of Medicine and Public Health.
It is common to hear the term posttraumatic stress (PTSD) when referring to war veterans, as well as people who have witnessed or experienced any type of aggression, accident, catastrophe or other serious events.
All these types of circumstances can unleash a psychiatric condition capable of generating dysfunction in the normal behavior of people, also affecting the quality of their interpersonal relationships and, therefore, their quality of life.
In a conversation held by the Journal of Medicine and Public Health with the Dr. Joalex Antongiorgi, who is a psychiatrist at the University of Puerto Rico Medical Sciences Campusthe expert explained the main symptoms of posttraumatic stress.
“First of all, these people tend to have intrusive thoughts that are very recurrent. They also adopt avoidance behavior, that is, they avoid the subject and avoid talking about how they feel about it. They become hyperreactive towards some stimuli around them and become their mood is affected”.
And it is that according to the medical literature, these signs usually appear within three months after the traumatic event, although sometimes they can appear even later. Now, it is important to clarify that the presence of some of these symptoms is not synonymous with this disorder, since it is diagnosed in people whose prevalence of the clinical picture reaches or exceeds four weeks, and its manifestations interfere with various aspects of their daily life such as personal and work relationships.
“By having that combination of factors already established, we can then do an analysis of what is posttraumatic stressbut not everyone is going to develop it,” he stressed. “If we look, for example, at the incidence of the veteran population compared to the general population of Puerto Rico, we are going to see a higher prevalence in veterans due to the number of high-risk stimuli to which they were exposed.
However, this does not mean that all people who have been directly or indirectly affected by traumatic circumstances will develop posttraumatic stressand the presence of one of the aforementioned symptoms does not mean that the person suffers from it.
“Maybe they can be reactive people who have always been that way in their life, but it doesn’t mean it’s PTSD. There has to be a dysfunction, and there has to be an effect on the four categories I mentioned to be able to make a diagnosis,” he clarified.
Posttraumatic stress in the pediatric population, how does it manifest in children?
Children are highly vulnerable to suffering from these types of conditions, and even more so if we take into account the events that have occurred in Puerto Rico, not only due to the pandemic, but also due to climatic and environmental events that, in some way, have interfered in its normal development.
“When we think of normal growth, school is an important factor, not only because of everything they learn academically, but because of the social relationships they forge there, sharing with other people and how they deal with conflicts,” he mentioned. .
We can take as a reference, for example, the passage of Hurricane Maria through the island in 2017 and the impact it left as a consequence on Puerto Ricans; In fact, the studies carried out suggest that after this natural disaster, between 8% and 10% of infants were experiencing symptoms associated with the disorder. posttraumatic stress.
“They still do not have the maturity to be able to handle things, although we have seen that they are more resilient,” he added.
Additionally, it is common for a person, including children and adolescents, with PTSD to develop symptoms associated with depression, such as low self-esteem, frustration, and a predisposition to resort to high-risk actions that should be treated by a mental health specialist. .
“Depressive symptoms are seen in many conditions, but being sad is not necessarily a psychiatric condition. By this, I’m not saying that we shouldn’t treat sadness or that we shouldn’t care about sad children; we should validate those emotions and provide the support to the patient, but recognizing that their mood is not part of a severe major depression picture”.
Unlike adults, depressive symptoms in children and adolescents are manifested through irritability, very noticeable changes in behavior, alterations in grades, social isolation, dysfunction patterns, among others.
Return to normality: the challenge for patients with PTSD
Regarding the recent shooting that occurred in an elementary school in Uvalde, Texas, the expert pointed out that it is important to highlight that there is a high level of social stigmatization against people who are diagnosed with a mental health condition, since they would be blaming and relating to acts of violence and aggressiveness similar to said event that occurred in the United States.
“These behaviors are not secondary to the pathologies and, in fact, most of our patients are not aggressive or a danger to society. On the contrary, everything that is happening are problems that we have to see,” he said. “Hate is not a psychiatric condition.”
Taking this as a reference, the specialist referred to how the reintegration process of the minors who were present during the event to their daily lives should be, since he assures that many of them could develop PTSD.
“The first thing we should do is try to get them back to normality as soon as possible; the more time they spend out of school out of their routine, the more they will be affected because they will spend more time remembering what happened,” he said. . “The other thing is that we should avoid asking him or making him remember what happened, because we would be making him relive the moment.”
Certainly, in situations like this, education strategies should be sought, not only for minors or parents, but also for teachers and staff who may be involved.
“We must teach them what the symptoms associated with the dysfunction are so that they are aware, and once we identify them, we must start working on them early,” he concluded.
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