Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) develops in some people after they experience a traumatic situation. The fear triggers a “fight-or-flight” meant to protect a person from harm; however, in PTSD, the person continues to feel stressed or frightened, even when they are not in danger.
Anyone can develop PTSD at any age. This includes war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or other serious events.
What Are the Symptoms That Would Indicate That A Person Is Experiencing Post Traumatic Stress Disorder?
Not everyone with PTSD has been through a dangerous event. Some, for example, who experience the sudden unexpected death of a loved one, can also have PTSD. Symptoms usually begin within 3 months of a traumatic incident, but sometimes begin years afterward.
The course of the illness varies but always lasts at least one month and is severe enough to interfere with relationships and life activities. During the month, the individual will experience at a minimum the following symptoms:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
Re-experiencing symptoms include:
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Frightening thoughts
Avoidance symptoms include:
- Staying away from places, events, or objects that are reminders of the traumatic experience
- Avoiding thoughts or feelings related to the traumatic event
Arousal and reactivity symptoms include:
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping
- Having angry outbursts
Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
Cognition and mood symptoms include:
- Trouble remembering the key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities
Cognition and mood symptoms can begin or worsen after the traumatic event but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.
It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
Some factors that increase the risk for PTSD include:
- Living through dangerous events and traumas
- Getting hurt
- Seeing another person hurt, or seeing a dead body
- Childhood trauma
- Feeling horror, helplessness, or extreme fear
- Having little or no social support after the event
- Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
- Having a history of mental illness or substance abuse
Some factors that may promote recovery after trauma include:
- Seeking out support from other people, such as friends and family
- Finding a support group after a traumatic event
- Learning to feel good about one’s own actions in the face of danger
- Having a positive coping strategy, or a way of getting through the bad event and learning from it
- Being able to act and respond effectively despite feeling fear
The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD.
If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.
Antidepressants help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside. Other medications may be helpful for treating specific PTSD symptoms, such as sleep problems and nightmares.
Psychotherapy involves talking with a mental health professional to treat mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy for PTSD usually lasts 6 to 12 weeks, but it can last longer.
Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly while others focus on social, family, or job-related problems.
Effective psychotherapies tend to emphasize a few key components such as recognizing triggers to symptoms and developing skills to manage them. One form of therapy called cognitive-behavioral therapy (CBT) helps to control fears through exposure therapy and cognitive restructuring.
This helps people face and control their fear. It gradually exposes them to the trauma they experienced safely. It uses imagining, writing, or visiting the place where the event happened to help people with PTSD cope with their feelings.
This helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about something that is not their fault. The therapist helps people with PTSD look at what happened realistically.
How Talk Therapies Help People Overcome PTSD
Talk therapy teaches useful ways to overcome the adverse reactions to triggers from PTSD symptoms. Through therapy, people learn
- About trauma and its effects,
- How to use relaxation techniques and anger-control skills,
- Tips for better sleep, diet, and exercise habits, and
- To identify and deal with guilt, shame, and other feelings about the event.
What are the Symptoms that Children Display When They Experience PTSD?
Children and teens can have extreme reactions to trauma, but some of their symptoms may not be the same as adults. Symptoms sometimes are seen in very young children (less than 6 years old), these symptoms can include:
- Wetting the bed after having learned to use the toilet
- Forgetting how to or being unable to talk
- Acting out the scary event during playtime
- Being unusually clingy with a parent or other adult
Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.