Case history
Case history #1
A 25-year-old woman presents to the emergency department complaining of sad mood, nervousness, difficulty falling asleep, and disinterest in her friends for the past 2 months. She notes these symptoms started following a rape by a former male friend after a party. She appears visibly uncomfortable when asked further questions about the attack. The patient has disclosed the incident to some of her peers, but did not report it to authorities. She reports nightmares about the rape, concerns for her safety, difficulties in intimate relationships with men, and repeated avoidance of nondangerous situations reminding her of the assault.
Case history #2
A 35-year-old male combat veteran presents with symptoms of poor sleep, crying episodes, flashbacks, and nightmares. He also reports his marriage and friendships have been suffering, in addition to poor work performance. When in a bad mood, he tends to smoke cigarettes and drink alcohol. He has tried to overcome these symptoms on his own, but has been largely unsuccessful and now recognizes a need for formal help. He speaks openly about his experiences and recognizes a direct connection between his combat exposure and current symptoms.
Other presentations
Patients may present for treatment of panic attacks, severely depressed mood, or substance use disorder. Each of these clinical conditions is highly comorbid with PTSD. Cigarettes, alcohol, or drugs may be used by the patient to self-medicate as a coping strategy to reduce distress associated with a traumatic event.
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