Post-Traumatic Stress Disorder

The American Psychiatric Association estimates that one in 11 people will be diagnosed with post-traumatic stress disorder (PTSD) in their lifetime. Though PTSD is relatively common, managing PTSD symptoms can be a lonely and isolating experience. Understanding the signs and symptoms of PTSD can encourage people to seek treatment and live happier and more peaceful lives.

What is PTSD?

PTSD is a psychiatric disorder that occurs in people who have experienced a traumatic event or events. This can include a car accident, natural disaster, violence, or sexual assault. PTSD can occur in anyone regardless of age, nationality, ethnicity, social status, or gender expression. Women, however, are twice as likely as men to develop PTSD. Veterans of war are also at risk of developing PTSD.

People with PTSD experience thoughts and feelings related to the traumatic event long after the danger has passed. They often relive the traumatic event through flashbacks or nightmares. They can experience feelings of anger, fear, and sadness, struggle with sleep and memory, feel distant, and be unable to connect with others, or lose interest in the things they once loved (American Psychiatric Association).

PTSD-related conditions

There are several conditions related to PTSD.

  • Acute stress disorder can develop in a short amount of time, about three days to one month after a traumatic event. Acute stress disorder can often progress into PTSD.
  • Adjustment disorder is characterized by a severe or intense behavioral or emotional response to stress, whether from a single event or compounding events. Symptoms include impulsivity and feelings of hopelessness, as well as tremors and headaches.
  • Complex PTSD most often develops in people who have experienced chronic trauma over a sustained period of time. Someone with complex PTSD may have particular difficulty in regulating their emotions, forming relationships with others, and maintaining a healthy perception of themselves.
  • Reactive attachment disorder develops in children under age 5 who have experienced severe neglect or deprivation. Children with reactive attachment disorder struggle to connect with caregivers, respond to comfort, or show positive emotion (American Psychiatric Association).

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Causes of PTSD

People can develop post-traumatic stress disorder from seeing, experiencing, or learning about a traumatic event. Events that can lead to PTSD can include combat exposure, child physical abuse, sexual violence, or physical assault (Mayo Foundation for Medical Education and Research, 2018). Some people even experience PTSD from a bad relationship.

PTSD signs and symptoms

PTSD symptoms can fall into four categories.

Re-experiencing symptoms:

  • Flashbacks
  • Reoccurring memories or dreams related to the traumatic event
  • Distressing thoughts
  • Physical signs of stress

Avoidance symptoms:

  • Avoiding places, events, thoughts, or feelings that remind a person of the traumatic event
  • Arousal and reactivity symptoms:
  • Difficulty concentrating
  • Difficulty falling or staying asleep
  • Engaging in risky behavior
  • Feeling on edge

Cognition and mood symptoms:

  • Feelings of isolation
  • Loss of interest in previous activities
  • Difficulty feeling positive emotions
  • Negative emotions such as fear, guilt, or shame

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How is PTSD diagnosed?

PTSD is most often diagnosed by a mental health clinician, such as a psychiatrist, psychologist, or social worker. PTSD is generally diagnosed at least one month after the person experiences the traumatic event and when symptoms begin to adversely affect their quality of life.

PTSD symptoms can vary widely. Some people experience symptoms up to three months after the traumatic event. Other people experience symptoms much later. These symptoms can continue for years (American Psychiatric Association).

When diagnosing PTSD, clinicians might:

  • Perform a physical exam to check for any medical problems
  • Conduct a psychological evaluation to assess symptoms
  • Use the PTSD diagnosis criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders

Treatments for PTSD

Therapy and medication are the most common treatments for PTSD. Therapy can help you address negative thinking patterns, learn to cope with traumatizing memories, and better manage reactions to triggers. Treatment is recommended if PTSD symptoms are interfering with work, at home, and in your relationships (Mayo Foundation for Medical Education and Research, 2018).

Therapy

Common therapy treatments for PTSD include cognitive behavioral therapy (CBT), exposure response prevention (ERP), and eye-movement desensitization reprocessing (EMDR). CBT can help you become aware of the thought patterns, self-beliefs, and fear holding you back. With ERP, your therapist will safely expose you to frightening situations and memories and give you skills to cope. EMDR focuses on processing trauma through a combination of exposure therapy and guided eye movements.

Medication

Medications used to treat PTSD can include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Antidepressants
  • Mood stabilizers
  • Antipsychotics

References