post-traumatic stress disorder (ptsd)

What is PTSD?

Post-traumatic Stress Disorder happens when an individual experiences a horrifying ordeal that involves physical harm or the threat of physical harm. The physical harm or threat could have happened to the individual with PTSD, or the individual could have witnessed it happen to a loved one or a stranger. PTSD was first brought to public attention in relation to war veterans but a variety of traumatic events can cause PTSD including:

  • Combat exposure
  • Child sexual or physical abuse
  • Terrorist attack
  • Sexual or physical assault
  • Serious accidents, like a car wreck
  • Natural disasters, like a fire, tornado, hurricane, flood, or earthquake

Not everyone who goes through a traumatic event will develop PTSD and it is unclear why some people develop PTSD and some do not.

Symptoms

PTSD symptoms typically start soon after the traumatic event occurs, but symptoms can also occur months or years later. Symptoms can come and go over a course of years, or they can be consistent. If symptoms last more than 4 weeks, interfere with your work or home life, or cause you a great amount of anguish, you might have PTSD.

Below are the 4 types of symptoms of PTSD:

  1. Reliving the event (also called re-experiencing symptoms)
    • Flashbacks- reliving trauma numerous times. This includes physical symptoms such as a racing heart, shaking or sweating
    • Nightmares
    • Frightening thoughts- you may even feel like you’re going through the event again
  2. Avoiding situations that remind you of the event
    • Staying away from people, places, or things that are reminders of the experience
    • Avoiding speaking or even thinking about the experience
    • Feeling numb
  3. Negative changes in beliefs and feelings
    • Feeling fear, guilt or shame
    • Losing interest in activities that were enjoyable in the past
    • Having trouble remembering the traumatic event
  4. Hyperarousal symptoms
    • Feeling tense or “on the edge”
    • Having difficulty concentrating or sleeping
    • Angry outbursts or being easily startled

Risk Factors

» Who can get PTSD?

Anyone at any age can get PTSD. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters and many other traumatic events. Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also cause PTSD.

» Why do some people get PTSD and other people do not?

Not everyone who lives through a traumatic event gets PTSD. In fact, most will not get the disorder. Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event.

» Risk factors for PTSD include:

  • Living through dangerous events and traumas
  • Having a history of mental illness
  • Getting hurt
  • Seeing people hurt or killed
  • 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

» Resilience factors that may reduce the risk of PTSD include:

  • Seeking out support from other people, such as friends and family
  • Finding a support group after a traumatic event
  • Feeling good about one’s own actions in the face of danger
  • Having a 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.

Researchers are studying the importance of various risk and resilience factors. With further researcher, it should become possible to predict who is likely to get PTSD, how resilience can be learned and prevent it.

 

 

Detection and Treatment

» How is PTSD detected?

The PTSD diagnosis can be made by a medical doctor, or mental health professionals such as a psychologist, social worker, or psychotherapist. The diagnosis is made after the doctor talks with the person who has symptoms of PTSD.

 To be diagnosed with PTSD, a person must have all of the following for at least 1 month:

  • At least one re-experiencing symptom
  • At least three avoidance symptoms
  • At least two hyper-arousal symptoms
  • Symptoms interfere with daily life, such as going to school or work, being with friends, taking care of important tasks.

» How is PTSD treated?

The main treatments for people with PTSD are cognitive behavioral therapy (CBT), medications, or a combination of the two. There are several parts to CBT, including:

  • Exposure therapy. This therapy helps people face and control their fear. It exposes them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
  • Cognitive restructuring. This therapy 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 what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
  • Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way.

Everyone is different, 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 care professional who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms. If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse and feeling suicidal.

 

Children and PTSD

» Can children have PTSD?

Yes, children can have PTSD. However, a child can have a very different reaction to a traumatic event than an adult.  Some of the possible symptoms include:

  • Bedwetting, when they’ve already learned to use the toilet
  • Forgetting how or being unable to talk
  • Drawing the scary event on paper or acting it out in playtime
  • Being upset if parents aren’t near by

Below is a checklist of problems or symptoms that people with PTSD can exhibit. Remember, you must seek a professional for an accurate diagnosis of PTSD. This checklist is provided only as a tool to help you talk with your doctor or treatment provider about your concerns and develop an action plan for successful recovery.

  •  I have repeated, disturbing memories, thoughts, or images of a stressful experience from the past.
  • I have repeated, disturbing dreams of a stressful experience from the past.
  • I avoid activities or situations because they remind me of a stressful experience from the past.
  • I have lost interest in things that I used to enjoy.
  • I feel distant or cut off from other people.
  • I am “super alert” or watchful.
  • I suddenly act or feel as if a stressful experience were happening again (as if you were reliving it).
  • I feel very upset when something reminds me of a stressful experience from the past.
  • I have trouble remembering important parts of a stressful experience from the past.
  • I feel as if my future will somehow be cut short.
  • I have trouble falling or staying asleep.
  • I feel jumpy or easily startled.
  • I have physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminds me of a stressful experience from the past.
  • I avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it.
  • I feel emotionally numb or unable to have loving feelings for people close to me.
  • I feel irritable.
  • I have angry outbursts.
  • I have difficulty concentrating.