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PTSD And DID: Post-Traumatic Stress

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Question:

Discuss about the PTSD and DID for Post-Traumatic Stress.

 

Answer:

Introduction

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that is experienced by a person after he or she is subjected to a serious accident or has been involved or witnessed death (Skortz, 2015). The chances of acquiring this disorder sometime in their lives based on the U.S. population are approximately 7-8% (Jaimie L. Gradus, DSc, MPH, February 23, 2016).  Apart from PTSD Dissociative identity disorder (DID) also occur as a result of traumatic experiences witnessed by an individual. The most visible characteristic of this disorder is the fact that an individual develops multiple personalities which take control of their original self. Although the disease is not common, it has been previously reported at around 1% (James , Chen and Jacky 2000-2015).

The objective of this written paper is to provide detailed analysis of Dissociative identity disorder and Post Traumatic Stress in a broader way based on  movie “Secret Window”. The following was discussed based on this movie: synopsis and the main characters, signs, and symptoms of the disorder, its prevalence, how it was treated, psychosocial and ethical issue, discrimination that occurred and finally recommendations are identified which could bring about positive results in the life of a patient

Keywords:, psychosocial issues ,Dissociative identity disorder, Post-Traumatic Stress Disorder ,prevalence, discrimination and Treatment.

 

Body

Synopsis of the movie and analysis of the main character:

The movie opens with a person dressed in a hat and wearing glasses. The person who is called Mort is driving his car near a hotel conversing to himself and looks thoughtful. Mort stops near the Hotel, moves in hurriedly picks a key and rushes to a room where he gets shocked upon opening the door and finding a man in bed inside the room. The woman in bed with another man is his wife Amy, and the man she is in bed with is her boyfriend, Tod. The second scene shows Mort being woken up from his sofa, his usual place of sleeping by a knock on the door by a strange man named Shooter who accuses Mort of stealing his written story the secret window. The strange man asks Mort to produce magazines to confirm that the story indeed belongs to him in three days failure to which he will sue Mort’s wife. Shooter then threatens Mort and even kills his dog and Burns the house belonging to Mort and his wife, Amy. After the incidence, Mort requests for help from his friend Ken. Unfortunately, Shooter kills his friends after a few days leaving mort a miserable man. His Misery is compounded by the fact that his wife is pressuring him to sign their divorce papers so that she can be with her boyfriend, Tod. Mort appears quite upset. In a flashback we are shown Amy smiling through a small window and telling Mort that that was the Secret window of the secret garden. We learn that it was through that window that she used to see the current boyfriend, Tod. The story of the secret window was written by mort about his wife. Mort’s time is mostly spent on the sofa sleeping. Mort thinks of Soorter as a friend of Amy’s loved one and tries to find out. He also makes an effort to get hold of the magazine in which his story was published, but unfortunately, the magazine pages that contained the story are missing.

Mort later receives a call from Amy requesting him to sign the divorce papers. The call is followed by Amy’s decision to appear at Mort’s house to have him sign the papers. Mort remembers about the cap he bought while they were living a good life with his wife. He starts speaking to himself and seeing himself everywhere and later realizes that he was the shooter. A conflict ensues when his wife Amy appears an in the incidence Amy gets injured although she manages to escape. Tod also gets hit with a shovel on the face which makes him fall. What follows is killing of both Tod and Amy and hiding of their bodies by Mort. In the end, the police know everything that happened, but they cannot arrest and label any charges on Mort because they have not yet found the bodies of the deceased.

 

Associated signs and symptoms:

Severe trauma can be experienced by some people in their lives. Such trauma leads to numerous changes both physical and psychological and regarding their behavior, thoughts, and habits. Post-traumatic stress disorder resulting from traumatic experiences can make some people develop psychiatric diseases. If this condition remains untreated for long durations, it can have an impact on the mental health of the victims and lead to the development of a mental disorder. Multiple Personality disorder or dissociative disorder develops as a result of this.

The post-traumatic disorder occurs as a result of failed adaptation and is revealed in increased stress levels among the patients. Such is the case when mort opens the door only to find his wife standing there with another man. This incidence makes him helpless. This compounded the suffering that he had had for almost half a year as a result of the traumatic experience he had had. Mort’s personality can be compared to that of an individual who has post-traumatic stress disorder which can have symptoms lasting for at least three months or even years. Research has shown that people who have PTSD show different signs and symptoms which include intensive memory in which an incidence takes over the mind of an individual and keeps repeating itself. This also occurs in the form of repeated nightmares, hallucinations, flashbacks and illusions. However, these do not only occur when an individual is sleeping but even when they are awake such as the case of Mort when he flashbacks about his wife and which makes him lose touch with the reality and have a conviction that traumatic events are over the time(Post-Traumatic Stress Disorder, 2016).

Another major attribute of people suffering from the dissociative disorder is the inability to recall important personal information, which cannot be viewed as the mere act of forgetting due to its pervasiveness. Memory variations and split personality are also common as witnessed in the Movie. The Character has another personality in the name of Shooter which takes over his thoughts and behavior. Among the symptoms associated with dissociative identity disorder are instantaneous mood swings depression, suicidal tendencies and aggressiveness which occur as a result of conflict between their two personalities. Other symptoms associated with this disorder include sleep disorders, alcohol and drug abuse,  eating disorders ,anxiety disorder, visual hallucination, phobia auditory , anxiety disorder as a result of anxiety and distress (Dissociative Identity Disorder, 2016)

Although there is no cure for dissociative identity disorder, its symptoms can be treated by the use of different types of treatments such as pharmacologic treatment which can be used alone or jointly with psychotherapy

 

Prevalence of the diseases:

A study carried out in the year 2014 by among 176 patients by University Psychiatric Outpatient Unit in Turkey on the prevalence of dissociative identity disorder established that the most common age for DID was among teenagers between the ages of 11 and 17 years out of which around 96.8% were as a result of a history of neglect and child abuse. The study also found out that the prevalence of the disease was more on Girls than on boys (Sar, et al.,2014). Diagnostic and Statistical Manual of Mental Disorders in a study carried out in Shangai China, North America, Canada, and Winnipeg found out that there were more cases of DID in North America as compared to China (Ross, C. A. (2011).

Treatment:

According to the World Health Organization, health is a state of complete physical, social and mental wellbeing as contrasted with the mere absence of disease in an individual. Mental wellbeing is, therefore, an essential component of an individual’s life. Although there are different remedies offered through Psychotherapy for different patients depending on their health situations, both speech therapy, and medication may be required by some while others may require only one of them. Psychotherapy sessions require being carried out in a period of between 6 and 12 months. However, an improvement of an individual’s conditions is so much dependent on family support. The changes required in a client’s mental status can be identified through speech therapy.Antidepressants are some of the medications that can be used in PTDS to help manage symptoms such as worry, sadness, feeling numb inside and anger. (Post-Traumatic Stress Disorder, 2016).

Alternatively, special techniques of psychiatric and psychotherapy medical management such as adjunctive therapy and hypnotherapy which involves the induction of deeply relaxed can be applied to manage dissociative identity disorder. Other techniques include pharmacological therapy and psychiatric therapy (Journal of Trauma & Dissociation, 2011)

In conclusion, there are major components emphasized under effective psychotherapy which includes the creation of awareness about the associated symptoms, instilling of skills to help in the identification of trigger symptoms as well as skills meant at managing the symptoms. Medication can also be applied to relieve the symptoms associated with the disease. Goals of treatment of dissociative identity disorder can help facilitate a change in behavior as well as relieving the symptoms and leading to an increased degree of coordination and communication.

 

Psychosocial issues:

Psychosocial issues in a mental disease can be easily developed through low social and family support as well as a reduced self-concept. The impact of this can be felt by friends and family, individuals and at the workplace. In the movie for this report, the main character suffers from post-traumatic stress upon the realization that his wife of 10 years has betrayed him. The impact of this is that he secludes himself, develops hallucinations, sleep disturbances, repeated nightmares, develops a feeling of laziness and lives in fear due to PTSD post-traumatic disorder and dissociative identity disorder. Studies have shown that PTSD can lead to the development of sour and stressful relationships between families and friends whose impact can be divorce, aggression, and violence. The post-traumatic stress experienced by the character [propels him to kill his dog and commit other crimes under shooter personality. The disorder had also cost him his job and reduced his ability to socialize with individuals around him.

Ethical issues:

In the final part of the movie, the police warn Mont of his coming to the city because people are afraid of him. The police already know about the crimes he committed, but due to lack of evidence, they cannot arrest him. This raises a moral question why the police cannot arrest him and whether they should only arrest an offender after gathering proof. As per the ethical principles of autonomy versus nonmalficine, doing no harm to the society is prioritized than the Mort autonomy. So the ethical concern here would be whether Mort’s autonomy is more important than doing no harm for the society.

Discrimination:

Discrimination is a common phenomenon among individuals associated with post-traumatic stress disorder. This occurs through stigmatization because of their mental illness and can have a profound effect on them through first label avoidance, i.e. failure to adhere to medication will make a patient develop the fear of being labeled as a person with a mental health condition which can make them shy of from social events. Secondly, it can affect them by denying them a chance to get life opportunities such as a job of their choice. Additionally, self-stigma can result to negative emotional reactions such as developing a low self-esteem and feeling ashamed. At the end of it all, this will subject to social withdrawal and isolation (Karen-leigh Edward, Ian Munro, Anthony Welch, 2014).Labeling and discrimination are witnessed in the movie in the form of the policeman who approaches Mont and informs him of their awareness regarding the crimes committed by Mont although they lack evidence and out of which they want Mont to stay away from the grocery in the city because he is scaring away potential customers.

Recommendation:

Recommendations are meant to offer a positive response or suitable solutions to an existing issue or problem. In this regard, an early detection of the mental disease analyzed can prevent further complications. Hospitalization becomes necessary in a situation where patients fail to seek medical treatment or fail to comply with their medication requirements which could lead an increase in the possibility of the patients harming themselves or others. Occupation therapy will help in promoting the independence in their daily routine activities and help in the improving the quality of life. In addition, positive stress coping mechanism can be applied to help relieve anxiety and stress. Patients can ventilate by being open to people close to them such as friends and family or professionals like a psychologist. Finally awareness on the signs and symptoms, causes and treatment modules can lead to rising of public awareness regarding the disease.

Conclusion:

In conclusion, according to the movie Post-Traumatic Stress Disorder emerges as the cause of dissociative identity Disorder (DID).However; there exist many different mental diseases which possess unique features. Post-traumatic stress disorder is a disease that occurs to an individual after a traumatic experience. The dissociative disorder does not only affect individuals during childhood but can also be manifested at later ages. The emergence of a new generation of medicine has improved treatment modalities. The movie raises an issue about patients with DID and PTSD which include discrimination, psychological issues and offers recommendations.

 

References

Brown, L. S. (2011). Guidelines for treating dissociative identity disorder in adults, third revision: a tour de force for the dissociation field.

Dissociative Identity Disorder (Multiple Personality Disorder)'.WebMD.N.p.,2016.Web.6Apr.2016.

Jaimie L. Gradus, DSc, MPH. ( February 23, 2016). Epidemiology of PTSD.U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420, 10.

James D;Chen,Jacky. (©2000-2015, June 12). Dissociative Disorder Community. Retrieved from HealthyPlace :https://www.healthyplace.com/abuse/dissociative-identity-disorder/dissociative-identity-disorder-did-statistics-and-facts/

Journal Of Trauma & Dissociation: The Official Journal Of The International Society For The Study Of Dissociation (ISSD), 15(4), 402-419. doi:10.1080/15299732.2013.864748

Karen-leigh Edward, Ian Munro, Anthony Welch. (2014). Mental Health Nursing. Melbourne: in Australia by Oxford University Press.

Post-Traumatic Stress Disorder.(2016, 1 1). Retrieved 4 3, 2016, from https://www.nimh.nih.gov/: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml#part_145375

Sar, V., Onder, C., Kilincaslan, A., Zoroglu, S. S., &Alyanak, B. (2014). Dissociative identity disorder among adolescents: prevalence in a university psychiatric outpatient unit.

Skortz, J. K. (2015). PSYCHOSOCIAL ISSUES .PSYCHOSOCIAL ISSUES WITH POSTTRAUMATIC STRESS DISORDER AND TREATMENT, 28.

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