Ask the Doctor: PTSD; Changing Sleep Patterns; Language of Mental Illness

Q: I’ve always thought post-traumatic stress disorder (PTSD) as a condition that affects veterans who have been in combat. But after surviving a terrible car accident two years ago, I’m having trouble sleeping and I’m often thinking about the dangers of being on the highway. Could I have PTSD?

A: You’re right that PTSD has been most strongly associated with the experiences of veterans, as well as survivors of child abuse and sexual assault. But the truth is that any type of trauma can trigger PTSD symptoms. In addition to the ones you listed, signs of PTSD can include extreme irritability, aggressive behavior, reckless or self-destructive decisions, trouble concentrating, confusion, nightmares, and feeling overwhelmed.

While any and all of the symptoms should prompt a discussion with your doctor or a mental health professional, it’s critically important that you see someone soon if you have any thoughts of suicide.

The more we are learning about PTSD, the more effective treatments are being developed. Though symptoms may seem like more than you can handle at times, understand that there are some very effective treatments for PTSD.

Q: I have always gone to bed late, but I have started watching my grandson during the week, so I have to wake up early. It’s been hard. Can a night owl become a morning person?

A: Your circadian rhythms, the physiological processes that affect your sleeping and eating patterns, are partly determined by your DNA. You may be genetically “wired” to go to sleep later and wake up later. But finding your inner early bird is possible if you are willing to change your habits.

One of the most important steps you can take is to let sunlight into your room as you awaken. Exposure to sunlight in the morning can help reset your body’s clock. If natural light is in short supply where you liveÑsuch as a northern address in the middle of winterÑyou may benefit from a light box, such as that used by people with seasonal affective disorder. Just 15 minutes of exposure to 20,000 lux (a measurement of light) may be enough to energize you and help you start your day a little earlier and easier. You should check with your doctor first before using a light box.

You also may need to change some habits that affect sleep, such as avoiding afternoon caffeine and reducing exposure to lighted screens (TV, computer, smartphone) right before bed. The light from these screens, like morning sunlight, tells your brain it’s time to wake up.

One other key to effective sleep pattern conversion is sticking with the same wake-up times seven days a week. You may want to sleep in on the weekends, but if you change your sleep routine too dramatically every weekend, you could undermine your efforts to be the early bird watching your grandchild during the week.

Q: Ever since my daughter was diagnosed with bipolar disorder, I’ve become aware how often people casually use terms like “crazy” and “insane.” It’s quite bothersome. Am I being too sensitive?

A: Not at all. People are also quick to unfairly and inaccurately label someone as having a mental disorder. For example, a person might diagnose a coworker as having OCD (obsessive compulsive disorder) if he or she is simply very organized. The misuse of these terms trivializes the seriousness of mental disorders and creates misunderstandings around mental health.

Mental health professionals and advocates are speaking out more to help raise awareness of how these words can be hurtful. You can do the same by pointing out the harm this language can cause. It may take time to change common, everyday speech so that words like “crazy” aren’t tossed around so easily. But if it helps change the way the public thinks and talks about these subjects, it will be worth the effort.

—Editor-in-Chief Maurizio Fava, MD

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