From the TORONTO STAR September 24, 2000 By Sarah Jane Growe Toronto Star Columnist

ACCORDING TO the American Psychiatric 
Association's Diagnostic And 
Statistical Manual Of Mental Disorders 
(DSM), people with post-traumatic 
stress disorder respond to normal 
events as if they were repetitions 
of the trauma that caused their PTSD, 
exhibiting clinically significant 
distress that impairs their function 
in social, occupational or other 
important areas.








They avoid stimuli associated with the trauma 
and their general responsiveness is numbed. 

This distancing, not present before the trauma, 
must, according to the manual, show up in at 
least three of the following ways: avoiding 
thoughts, feelings and/or conversations 
associated with the trauma; avoiding associated 
people, activities and/or places; an inability 
to recall an important aspect of the trauma; 
diminished interest in significant activities; 
a feeling of detachment from others; an 
inability to have loving feelings; a sense of 
a foreshortened future. 

At the same time as they withdraw from stimuli, 
people diagnosed with PTSD also must show signs 
of increased arousal, as indicated by two of the 
following: difficulty falling or staying asleep, 
irritability or outbursts of anger, difficulty 
concentrating, hyper-vigilance or an exaggerated 
startle response. 

Symptoms in all these categories must last more 
than one month. After three months, the illness 
is said be chronic. But its onset can be delayed. 

Sexual abuse victims often don't experience 
symptoms until the third or fourth decade of 
life, Dr. Herman says, and the United States 
now is seeing a flare-up of PTSD in Korean War 
veterans nearing retirement and facing illness 
or experiencing the death of a spouse. 

The heightened physiological response may be set 
off by any physical stress, not just by traumatic 
reminders. 

``Anxiety, panic and other symptoms can be triggered 
by pretty well anything,'' says British Columbia 
psychologist David Lingley, who works with PTSD
-stricken emergency services workers. 

``It can be something different each time.'' 

The correlation between actual external threat and 
the physical emergency responses is lost. In fact, 
a single instance of overwhelming terror can alter 
the chemistry of the brain, making people more 
sensitive to adrenaline surges even many decades 
later, according to recent research at the U.S. 
National Center for Post-Traumatic Stress Disorder. 

Mandated by the U.S. Congress in 1989 and run by 
the U.S. Department of Veterans' Affairs, the 
centre's divisions in Vermont, Massachusetts, 
California, Hawaii and Connecticut provide research 
and education on PTSD for the professionals 
treating the syndrome in war veterans at the 
hundreds of community clinics, hospitals and medical 
centres that have developed across the U.S. since 
October, 1979. 

The new findings are the first evidence that PTSD 
may have a biological basis, resetting ``fight or 
flight'' signals in the autonomic nervous system. 
A sudden rush of adrenaline heightens relaxation 
under pleasant circumstances, but it increases anger 
or anxiety under frustrating conditions.






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