PTSD

Criteria for TBI

• Any period of confusion, disorientation, or impaired consciousness

• Any dysfunction of memory around the time of the injury

• Loss of consciousness — Lasts <30 min

• Onset of observed neurological or neuropsychological s/s

Symptoms of TBI

Cognitive

• Impaired memory, reasoning, problem-solving, judgement, insight, word finding

Physical

• Changes in appetite, weight, energy, urinary control, libido vision, light sensitivity, possible vertigo, seizures, pain, and HA

Emotional and behavioral

• Dec affective oscillation

• Aggression

• Substance abuse

• Avoltion

• ADHD

• Disinhibition

• Irritability

• Major depression

• PTSD

• Psychosis

PTSD

• Develop following a terrifying event

• Re-experincing of a trauma relive

• Avoidance of stimuli associated with trauma

• Persistent symptoms of inc arousal — Easily startled

• Alterations in mood

• Flashbacks

• Nightmares

• Hyperarousal

  • Hyperviligance

  • Exaggerated startle reflex

  • Insomnia

  • Irritability

  • Difficulty concentrating

Tx

• Reduc primary symptoms

• Improving functioing

• Strengthening resilience

• Relieving comorbid symptoms

• Preventing relapse

• Antidepressants

• Venlafaxine & Mirtazapine

• Antipsychotis

• Divalproex & Carbamaepine — Anticonvulsants

• TBI

  • Varies among individuals

  • Pt may be overly sensitive to psychotropic meds

  • Start meds at low dose and adjust as needed

  • Non opioids pain mngt, antidepressants, antipsychotics, mood stabilizers, cognitive enhancers (Mehtylphenidate) & anxiolytics

Interventions PTSD

• Listen to clients description of recollection and acknowledge troubling symptoms

• Refrain from encouraging the client to talk if it inc anxiety but remain with the client

• Conduct a suicide assessment by observing the client for self destructive thoguhts and behaviors

• Protect clients and others from out of control anger and aggression

• Refer client to PTSD therapist

Interventions TBI

• Develop programs to inc family/social support

• Offer programs for problem solving skills, coping skills, and socialization

• Educate about physical, cognitive, medical, and behavior status and prognosis

• Martial counseling

• Assist with rehab

• Web based tx programs

• Support networks for physical, emotional, financial, domestic, transportation, and respite

• Telephoning for psychosocial support

• Encourage time for SELF

• Materials for access to outpt and community services