Dealing with stress disorders: Focus on coping strategies and therapy approaches

Stress disorders are a highly topical issue among children and adults, especially in light of events such as the flood of the century in 2021, which severely affected communities such as Ahrweiler and Erftstadt. Many people, both those directly affected and relatives of the deceased, suffer from severe stress disorders due to this traumatic event.

Similarly, the challenges of the coronavirus pandemic have left deep scars, both through the loss of loved ones and the disturbing images of body bags being dumped in containers. These events have caused stress for many people and some may be suffering from stress disorders.

Russia's recent war of aggression against Ukraine has brought back grim memories of World War II, even triggering flashbacks of that era in some older people. Even police and firefighters, who face daily stressors, are not immune to stress disorders and are at increased risk.

It is important to understand that stress disorders occur when a person experiences overwhelming stressors that exceed their coping abilities!

A prominent example of this is post-traumatic stress disorder (PTSD), which can occur after experiencing traumatic events such as war, abuse or natural disasters. People with PTSD can suffer from flashbacks, nightmares and severe anxiety, which can significantly affect their daily lives.

Differences between posttraumatic stress disorder and adjustment disorder

characteristic	PTSD	Adjustment disorder
Triggering Event	Traumatic event such as war, abuse, natural disaster	Life-changing situation (e.g. loss of a loved one, job problems)
Symptoms	Flashbacks, nightmares, extreme anxiety	Anxiety, depressive mood, difficulties in adjustment
Duration of the disruption	Lasting longer than one month	Lasting longer than one month
Severity of stress	Significant impairment of daily life	Impairment of well-being and functionality
Diagnostic criteria in the ICD-10	F43.1 (Posttraumatic stress disorder)	F43.2 (Adjustment disorder)
Treatment	- Psychotherapy - Medication if required	- Psychotherapy - Support in coping with life situations
Therapy methods	- Cognitive behavioral therapy (CBT) - EMDR (Eye Movement Desensitization and Reprocessing) - Drug treatment - Systemic therapy - Relaxation techniques - Social support	- Cognitive behavioral therapy (CBT) - Drug treatment - Systemic therapy - Relaxation techniques - Social support

Case study: Therapy course for PTSD after a natural disaster – an individual path to recovery!

Step	Description
Diagnosis and treatment planning	After the rescue, Peter is seen by a therapist who diagnoses PTSD. An individualized treatment plan is created that includes a combination of cognitive behavioral therapy (CBT), systemic therapy, and a systems approach.
Cognitive Behavioral Therapy (CBT)	Peter begins regular CBT sessions to identify and change negative thought patterns and develop coping strategies. He keeps a thought diary, questions irrational beliefs, develops alternative thoughts and learns relaxation exercises.
Relaxation exercises	Peter learns various relaxation techniques such as progressive muscle relaxation, breathing exercises and mindfulness exercises to reduce stress and promote physical relaxation.
Exposure therapy	Under the guidance of his therapist, Peter is gradually confronted with anxiety-provoking situations or stimuli in order to reduce his anxiety reactions and process traumatic memories.
Systemic therapy	Peter and his therapist work to identify and understand the family and social dynamics that may be influencing his stress disorder, and incorporate family members or loved ones into therapy to encourage healthy communication patterns and build supportive relationships.
Monitoring for possible depression	During the course of therapy, Peter is regularly monitored for possible depression, as there is an increased risk after traumatic experiences such as the flood disaster. His therapist looks for signs of depression and makes an appropriate diagnosis if necessary.
Dealing with setbacks	Despite progress, Peter occasionally experiences setbacks. His therapist encourages him to share his feelings openly, supports him in activating his coping strategies and integrates the systemic approach. Peter uses the techniques he has learned and the support of his social network to deal with his symptoms.

It is important to emphasize that monitoring for possible signs of depression is crucial during the course of therapy. Symptoms such as persistent sadness, loss of interest, insomnia or excessive fatigue may indicate concurrent depression. Should such symptoms occur, it is advisable to immediately consult a specialist or psychiatrist in order to receive appropriate treatment.

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Dealing with stress disorders: Focus on coping strategies and therapy approaches