Post Traumatic Stress Disorder (PTSD)

PTSD

Post Traumatic Stress Disorder (PTSD) is a disorder that some people can develop after experiencing or witnessing a shocking, dangerous or scary event.The National Center for PTSD, states about seven or eight of every 100 people will experience PTSD at some point. Women are more likely to develop PTSD than men. There are some traumas that increase risk of PTSD. Additionally, other biological factors such as genes may make some people more likely to develop PTSD than others. Anyone can develop PTSD at any age. Some experiences that can lead to PTSD include: war veterans, survivors of physical and sexual assault, abuse, car accidents, disasters, terror attacks, or other serious events. Not everyone who has PTSD has been through a dangerous event. Some experiences, like the sudden or unexpected death of a loved one, can also cause PTSD.

Nearly everyone will experience a range of reactions after trauma, yet most people will recover from those symptoms naturally. It is normal to feel scared or uneasy during and after a traumatic experience. Most people may have some temporary feelings of anxiety or sadness dealing with a traumatic experience. However, there are instances when the symptoms may get worse and last for more than a few months and even years. These symptoms can include flashbacks; nightmares and repeated thoughts about what happened that may interfere with work, relationships, or even the ability to get through daily activities. Some people with PTSD may also experience depression, substance abuse and anxiety issues.

The fear created from the traumatic experience may trigger the body to respond to danger and help a person avoid danger in the future. This “fight-or-flight” response is actually a typical reaction that is meant to protect people from harm. Nearly everyone will experience a range of reactions after trauma, yet most people will recover from those symptoms. Those who continue to experience problems such as depression, anxiety, and other signs of distress may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are no longer in danger.

Symptoms

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in one’s thinking and/or mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.

Symptoms of intrusive memories may include:

  • Upsetting memories of the traumatic event
  • Troubling dreams or nightmares about the traumatic event
  • Severe emotional pain or physical reactions to something that reminds one of the traumatic event
  • Flashbacks (Reliving the traumatic event)

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the scary event
    • Things or situations that remind a person of the traumatic event can trigger the need not to be around these upsetting situations. This may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car

Symptoms of negative changes in thinking and/or mood may include:

  • Negative thoughts about oneself, other people or the world
  • Hopelessness about the future
  • Feeling numb or little emotion
  • Detachment from family and friends
  • Lack of interest in activities that were once enjoyable
  • Memory problems can surface, such as not remembering important aspects of the traumatic event

Changes in physical and emotional reactions

Symptoms of changes in physical and emotional reactions can include:

  • Trouble sleeping
  • Easily startled or frightened
  • Irritability, aggressive behavior or angry outbursts at others
  • Feelings of guilt or shame
  • Trouble with concentration
  • Self-destructive choices, such as drinking too much or driving too fast

Risk factors for PTSD include:

  • Living through a dangerous event
  • Seeing others hurt or killed
  • Childhood trauma
  • Feeling helplessness or extremely afraid
  • A history of mental illness or substance abuse
  • Lacking in social support after the event

Resilience factors that may reduce the risk of PTSD include:

  • Seeking out support from others, such as friends and family
  • Finding a support group
  • Learning to feel better about one’s actions in dangerous situations
  • Coping strategies to get through the bad event and learn from it
  • Skills to respond well even when feeling afraid

Children and teens can have reactions to trauma, but their symptoms may not look the same as adults. In very young children (less than 6 years of age), Some examples include:

  • Wetting the bed after a traumatic event
  • Difficulty with talking or expressing themselves
  • Acting out the scary event during playtime
  • Showing more clingy behavior with a parent or other adult

Older children and teens may demonstrate symptoms more like those seen in adults. They may also develop disrespectful or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths.

Treatment

Post-traumatic stress disorder treatment can help to learn a sense of control over your life. Treatment includes:

  • Teaching skills to manage and deal with symptoms more effectively
  • Helping to improve thoughts about oneself, others and the world
  • Learning ways to cope if any symptoms come back
  • Dealing with the other problems often related to trauma, such as depression, anxiety, or misuse of alcohol or drugs

Remember, you don't have to try to handle dealing with PTSD on your own.

  • Cognitive Behavioral Therapy (CBT) helps you recognize the ways of thinking that are keeping you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.
    • CBT helps patients to examine their thinking patterns and assumptions in order to identify unhelpful patterns (called “distortions”) in thoughts, such as overgeneralizing a situation, negative thinking that interferes with positive thinking, to learn more positive thinking patterns. These are intended to help the person understanding their experience and learn to cope more effectively.
    • Exposure to the story of the trauma (narrative), as well as reminders of the trauma or emotions associated with the trauma, are often used to help clients reduce avoidance behaviors related to the trauma. Note, this exposure is done in a controlled way, and planned collaboratively by the CBT therapist and client. The goal is to return a sense of control, and confidence.
    • Education about how trauma can affect the person is quite common as is instruction in various methods to facilitate relaxation. Managing stress and planning for potential crises can also be important components of CBT treatment.

Click here for more info on the National Institute of Mental Health's website.