What is Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) can develop following a scary, shocking or dangerous event. This can happen whether the event has happened to a person or they have witnessed it.
At least fifty percent of people in the US will have experienced a traumatic event in their lives. Of these, one in ten men and two in ten women develop post-traumatic stress disorder (PTSD). (1)
Many people experience short term difficulty coping after a traumatic event. However when “time does not heal the wounds” and symptoms get worse, lasting weeks, months or years, it could be post-traumatic stress disorder (PTSD).
There are many things which can lead to a person developing post-traumatic stress disorder (PTSD).
Many events might lead to this condition. Serious traffic accidents or violent personal assaults, like robbery or sexual assault, might be causes. Prolonged violence, sexual abuse or neglect and witnessing violent deaths can also contribute.
Other situations such as terrorist attacks, being in a hostage situation or engaged in military combat might result in this condition.
There are also natural disasters like hurricanes, tsunamis, floods and earthquakes which might leave people traumatized. (2)
There are other experiences which cause post-traumatic stress disorder. These include: the sudden loss of a loved one or being close to someone that has survived a traumatic event. The violent death of someone close could also trigger this condition.
The symptoms of post-traumatic stress disorder sometimes manifest within a few months. At other times it can be years later.
Symptoms are divided into four categories and these are:
Reliving The Trauma
People might experience flashbacks of the event. They might relive the trauma time and time again. They might also feel their heart racing and sweat profusely.
Nightmares involving the trauma are often common as are frightening thoughts.
There might be triggers in everyday life which make people relive their experience. These could be a news report of a similar event or an article in a magazine.
There might be places, objects or events which remind people of the trauma, and they will be avoided at all costs. Thoughts or feelings relating to the events can also bring it back.
For example a person might no longer associate with a friend who also experienced the trauma. If they were assaulted on the subway they will no longer use this method of travel. Changes will be made to a person’s life to avoid reminders.
Reactive and Physical Symptoms
Changes in physical reactions and emotional responses are experienced by some people. Called arousal symptoms, they are constant and not set off by specific triggers.
A person might always be on their guard for danger or can become startled or easily frightened. They could experience difficulty sleeping or have trouble maintaining concentration.
Behavior can become self-destructive. It could manifest, for example as an abuse of alcohol or disregard for safety by driving too fast.
People could become more aggressive and prone to outbursts of anger or irritability. It is likely they will also feel constantly on edge.
Mood and Cognitive Symptoms
These symptoms can begin or worsen soon after a traumatic event. They can make someone feel detached or alienated from family and friends.
Recalling exact details of the traumatic event might be difficult. People can have feelings of blame and guilt. These feelings are often distorted and unfounded.
They may lose interest in activities which they previously enjoyed. Negative thoughts, about the world in general and themselves, are common.
Symptoms in Children
Reactions to a traumatic event might be different in children and teenagers.
Very young children might start bed wetting, even after they have learned to use the toilet. Their speech might regress, being unable to or forgetting how to talk. They could relive the events through play and be unusually in need of attention.
Older children can experience similar symptoms to adults. They could also display disruptive, destructive or disrespectful behavior. They might have thoughts of seeking revenge or feel guilt for being unable to prevent death or injury. (3, 4, 5)
People might experience symptoms lasting a few weeks following a traumatic event. This is classed as acute stress disorder (ASD). When symptoms last for longer than a month it could be post-traumatic stress disorder (PTSD). There are criteria set which doctors follow for diagnosis.
Set out by the American Psychiatric Association, they are:
A person has been exposed to at least one of the following:
Threatened or actual death, threatened or actual serious injury, or threatened or actual sexual assault.
This could be direct exposure, witnessing a trauma. It could also be knowing that a close friend or relative was exposed to trauma.
It includes indirect exposure to unpleasant details of the trauma. This often affects medics, first responders, or other professionals.
One of the following will apply in respect of reliving the traumatic incident:
Nightmares, flashbacks or upsetting memories which are unwanted.
A person could also experience emotional distress or physical reactions. This happens after being exposed to reminders of the traumatic event.
Avoiding thoughts or feelings relating to the trauma, or avoiding reminders.
A person will experience negative thoughts or feelings which started or got worse after the trauma in two of the following ways.
They might be unable to remember key details of the event. They have very negative thoughts about themselves or the world and display negative emotions.
It also includes feeling isolated, decreased interest in activities and difficulty feeling positive. Blame might be apportioned on themselves or others for using the traumatic event.
Two symptoms of reactivity or arousal will be felt which started after the incident or are getting worse.
These include being irritable or aggressive, behaving in a risky or destructive way, being over-vigilant or being startled easily.
Difficulty sleeping or concentrating are also included in these symptoms.
The symptoms associated with the trauma will last for at least one month or more.
The symptoms interfere with a person’s ability to function either socially or at work, or cause distress.
The symptoms are not a result of medication, another illness or substance abuse.
Symptoms of post-traumatic stress disorder (PTSD) can manifest immediately, but they will be present for at least six months for diagnosis.
There are also two further specifications. The first is depersonalization, the feeling of being in a dream or that something is not actually happening to them. The second is derealization, the experience of distance, distortion or feeling things aren’t real. (6)
Treatments for post-traumatic stress disorder (PTSD) include medications and psychotherapy. Different treatments or a combination of treatments might be advised as everyone is different and reacts in different ways.
If there are other issues, such as a panic disorder, substance abuse, feeling suicidal or depression, these will also be addressed.
A doctor who specializes in mental health will work with a person to find the best course of treatment on an individual basis.
Medications used to treat post-traumatic stress disorder are antidepressants and drugs to help people sleep better.
The aim is to alleviate the associated symptoms and allow people to get their lives back.
This is sometimes referred to as talk therapy and can happen on a one to one basis or as part of a group. A mental health professional will assess which suits an individual best.
The usual duration of these type of therapies is six to twelve weeks, but they can last longer. Support from family and friends can help with recovery.
Exposure therapy will help people face their fears and learn to control them. It involves a gradual exposure to memories of the trauma in a safe manner. This helps people cope with their feelings about the trauma.
Cognitive restructuring helps people deal with, and make sense of, their bad memories. It helps them look at the incident in a realistic way.
There are other types of therapy which aim to teach people the skills they need to manage symptoms and return to their normal every activities.
Whatever talk therapy a doctor decides is best for an individual, the overall aim is to help people deal with the trauma and its lasting effects. It can help people relax and control their anger, and also deal with feelings of guilt or shame. (7)
What is post-traumatic stress disorder (PTSD)? Post-traumatic stress disorder (PTSD) is a condition which can develop following experience of a scary, shocking or dangerous event. This can happen whether the event has happened to a person or they have witnessed it.
What are the signs of post-traumatic stress disorder (PTSD)? There are many symptoms associated with this condition. They include: reliving the event, emotional changes and avoidance of memories of the trauma.
How do you develop post-traumatic stress disorder (PTSD)? Witnessing, being involved in, or being close to someone who was involved in a traumatic event can trigger symptoms of this condition.
How are you diagnosed for post-traumatic stress disorder (PTSD)? Diagnosis will be made following set criteria based on symptoms and their duration.
What is the best treatment for post-traumatic stress disorder (PTSD)? This condition is treated with medication, therapy or both.
What are the long term complications of post-traumatic stress disorder (PTSD)? This condition can have a negative impact on both social and work life. It can also lead to other mental health conditions like depression, anxiety or suicidal thoughts as well as eating disorders and substance abuse.
Is post-traumatic stress disorder (PTSD) considered a disability? There are occasions, based on medical records, when disability benefits might be paid for this condition. (8)
Is there a cure for post-traumatic stress disorder (PTSD)? Treatments for this condition are often successful in managing the symptoms, and helping people deal with what they have experienced.
Is post-traumatic stress disorder (PTSD) life threatening? In most cases post-traumatic stress disorder (PTSD) can be managed. It can however lead to suicidal thoughts and tendencies.
Post-traumatic stress disorder (PTSD) is a condition which can develop following a scary, shocking or dangerous event. This can happen whether the event has happened to a person or they have witnessed it.
Many people are able to deal with and recover from the effects of a traumatic experience. Fortunately, for those who don’t, help is available and treatments are generally successful.