Three years back a woman suffered during an earthquake and she was successfully saved. After recovery, she has nightmares about the episode and she also gets up in the night and feels terrified. The most probable diagnosis is –
**Core Concept**
Post-traumatic stress disorder (PTSD) is a complex psychological condition that can develop after an individual experiences a traumatic event, such as an earthquake. This condition is characterized by symptoms like flashbacks, nightmares, and avoidance behaviors, which can significantly impair the individual's quality of life.
**Why the Correct Answer is Right**
The woman's symptoms, including nightmares about the earthquake episode and feelings of terror at night, are indicative of PTSD. These symptoms are thought to be a result of the individual's brain processing the traumatic event, leading to the formation of a memory that is difficult to erase. The hypothalamic-pituitary-adrenal (HPA) axis is activated, releasing stress hormones like cortisol and adrenaline, which contribute to the development of PTSD symptoms.
**Why Each Wrong Option is Incorrect**
**Option A:** Acute stress disorder is a condition that develops within days of a traumatic event, whereas PTSD typically develops weeks or months after the event. This individual's symptoms have persisted for three years, making acute stress disorder less likely.
**Option B:** Major depressive disorder can present with symptoms like anxiety and sleep disturbances, but it does not typically involve flashbacks or nightmares about a specific traumatic event.
**Option C:** Anxiety disorder is a broad term that encompasses various conditions, including PTSD. However, the specific symptoms described in the scenario are more characteristic of PTSD than a general anxiety disorder.
**Clinical Pearl / High-Yield Fact**
PTSD can be diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, which include symptoms like flashbacks, nightmares, and avoidance behaviors. It is essential to recognize the complex interplay between psychological, social, and biological factors in the development of PTSD.
**Correct Answer:** B.