We now know that PTSD can result from a wide array of traumatic experiences, including severe accidents, intense physical or sexual abuse, violent criminal episodes, and certain life-threatening medical conditions. A number of victims of Adult Respiratory Distress Syndrome, or ARDS, have reported symptoms consistent with PTSD.

The "distressing event" that triggers PTSD usually falls outside the range of normal human experience. Rarely does it result from simple bereavement, or a chronic illness, marital problems, or similar personal or medical difficulties that many of us undergo. Rather, the stressor that instigates PTSD is one that would be terribly upsetting to almost anyone, and it usually accompanied by intense fear, terror, and an overwhelming sense of helplessness.

Most often, PTSD occurs after a serious threat to one’s life or the life of a loved one, or following a sudden and traumatic loss, such as of one’s home. PTSD has been caused by such varied stressors as violent assault, rape, military combat, tornadoes, earthquakes, airplane crashes, torture, fires, kidnapping or severe car accidents. As some ARDS patients and their family members realize, it can also be caused by a sudden life-threatening illness.

Also, we now know that you don’t have to be a direct victim of one of these traumas to experience PTSD. Sometimes, family members or friends of victims are so traumatized by witnessing or learning about the stressful event happening to a loved one, that they develop the symptoms as well.

Here are the primary symptoms of PTSD

1. The individual re-experiences the traumatic event on a fairly persistent basis in one of these ways:

• Recurring and disturbing memories of the event

• Distressing dreams of the event

• A sudden sense or feeling that one is re-experiencing the event itself,

Sometimes involving illusions, hallucinations and "flashbacks".

• Intense fear of distress during exposure to events or circumstances that resemble or symbolize the past traumatic event

1. The individual attempts to avoid situations associated with the trauma that

may trigger a memory, bad dream, or "flashback".

2. The individual has persistent feelings of increased arousal or vigilance that

were not present before the trauma occurred, such as:

• Trouble falling or staying asleep
• Intense irritability or angry outbursts
• Trouble concentrating
• Hypervigilance (being "on guard")
• An exaggerated startle response when surprised
• Signs of increased stress response (rapid breathing, higher heart rate, sweating, etc.) when exposed to situations that resemble the earlier trauma

Sometimes, the onset of PTSD symptoms is delayed. Some individuals have developed symptoms months or, in a few cases, even years after the precipitating traumatic episodes. This disorder can occur in individuals of any age, including young children, and it is unrelated to factors such as gender, family of origin, education, etc. In other words, any one of us can develop PTSD provided we are exposed to a sufficiently traumatic event.

ARDS certainly can qualify in this regard. Often, the onset of the disease is sudden. The intensity of the symptoms and the life-threatening nature of this illness can create pronounced fear, outright terror, and a debilitating sense of helplessness in both the patient and his or her loved ones.

There is an unfortunate tendency in our culture to look at syndromes such as PTSD as being "all in your head." The implication is that people who develop PTSD have an underlying psychological weakness or lack the fortitude to pull themselves together in the face of stress.

There is convincing evidence that PTSD is caused by a rapid "wiring in" of synaptic responses in the brain, and that these, in turn, catalyze alterations in brain chemistry and functioning. In other words, PTSD is not "all in your head" but it may be "all in your neurons." People cannot mentally will themselves over an illness that is based on complex neurochemical process occuring in the brain.

ARDS patients of family members experiencing symptoms of PTSD that persist more than a month should seek professional evaluation and, if indicated, treatment. Remember, PTSD may not emerge during the acute phase of ARDS or even in conjunction with the early stages of recovery. It could begin long after the disease crisis has passed.

Determining a diagnosis of PTSD requires both the medical and psychological evaluations. Some of the symptoms associated with PTSD can occur in conjunction with other illnesses psychological conditions, or neurological disorders. A good place to begin is with a psychologist who is trained in neuropsychological assessment. She or he should insist that you have a medical or neurological evaluation to rule out other causes. If you or the psychologist have any doubts about the accuracy of the diagnosis, get a second opinion. If you are found to have PTSD, a number of treatment approaches may be recommended. These could include:

• Counseling for both you and your family
• Medication focused on positively influencing your brain chemistry or controlling you symptoms
• Desensitization training designed to help reduce your emotional responses to situations or stimuli that trigger a re-experiencing of the earlier trauma.
• Support of self-help groups or resources

The majority of PTSD sufferers show demonstrable improvement in their symptoms following proper treatment. Some recover entirely, while others must learn to live with chronic but less severe symptoms that graually ease over time. It appears that the intenslity of the traumatic event that caused the PTSD influences the outcome of treatment efforts, with the more severe cases posing the greatest impediments to full recovery.

While there is little solid research on the incidence of PTSD among ARDS patients, clinical evidence suggests that some do develop this syndrome. If you believe you may be experiencing some of the symptoms associated with PTSD, and these symptoms have persisted for more than a month, obtain a thorough medical and psychological evaluation.