Stressful and even traumatic – that is, emotionally disturbing or distressing — events happen in life. After a traumatic event, you may experience a greater level of fear or terror; feel out of control; or think that one or others’ lives are in danger.
Most people who experience a traumatic event may have problems adjusting and coping in the aftermath. With time and self-care, they generally feel better in the long run. However, if your symptoms get worse over time, persist for weeks, months, or even years, and interfere with daily functioning, you may have Post-Traumatic Stress Disorder or PTSD.
PTSD is an anxiety disorder that can develop following a trauma. Trauma exposure in a PTSD diagnosis need not be first-hand; for example, an individual learning about the death of a close family member could develop PTSD, though they did not witness the death firsthand.
It is unclear why some people get PTSD and some people do not after experiencing trauma.
While the symptoms of PTSD can be debilitating, a variety of management and treatment options are available.
What Is Post-Traumatic Stress Disorder (PTSD)?
PTSD affects about 8 million Americans at some point over the course of their lives – 10% of women experience PTSD at some point, compared to 5% of men. Traumas can include anything from a serious car accident, to physical or sexual assault or abuse, to traumatic events at work, to health problems (such as a cancer diagnosis or being admitted to intensive care). Members of the military who have worked in combat zones are at high risk of PTSD, for example, due to their exposure to the traumas of war, and about 11-20% of veterans returning from Iraq or Afghanistan have PTSD.
People who have PTSD may have intrusive memories of the traumatic event. They may avoid thinking or talking about the event or avoid visiting places, activities, or people that remind you of the traumatic event. Those with PTSD may also experience negative changes in thinking and mood, and may be easily startled or feel like they are always looking out for danger.
PTSD can affect relationships with friends, family, and coworkers, and can cause one to lose interest in activities they once enjoyed. Cognitive and sleep problems are also a part of PTSD. In response to these symptoms, those with PTSD may resort to unhealthy coping mechanisms such as alcohol and drug abuse, which can actually make symptoms worse and lead to new problems. That’s why it’s so important to get help dealing with PTSD.
A very severe type of PTSD called complex PTSD or C-PTSD can develop in response to prolonged, repeated traumatic experiences that may persist or repeat for months or even years. C-PTSD can cause behavioral, emotional, cognitive, and interpersonal problems. C-PTSD is frequently associated with substance abuse, mood and personality disorders. Traumas that begin in childhood and persist can cause C-PTSD. Examples of events that can trigger C-PTSD include concentration or prisoner of war camps, long-term domestic violence, long-term child physical abuse, and child exploitation.
The good news is that there are many treatments available for PTSD, including C-PTSD, that can help patients recover and deal with the trauma to improve day-to-day functioning.
PTSD symptoms can start as soon as one month after a traumatic event, or appear years after the event has occurred. PTSD symptoms can be grouped into four main categories: intrusive memories, avoidance, hyperarousal, and negative changes in mood.
Those with PTSD may experience recurring, unwanted distressing memories of the traumatic event. They may experience flashbacks in which they are reliving the traumatic event as if it was occurring again. Nightmares and upsetting dreams can be common as well. Reminders of the traumatic event can cause severe emotional distress or physical reactions in an individual with PTSD.
A person with PTSD may avoid thinking or talking about the traumatic event. They may also avoid people, places, activities, or other things that remind them of the event.
Negative changes in mood and cognition
Negative thoughts and feelings are a component of PTSD. The individual may hold distorted beliefs about themselves or others; feel fear, horror, anger, guilt, or shame; and have depressive symptoms. For example, the individual may have less interest in activities they once enjoyed, or feel hopeless, sad, or angry. Those with PTSD may also have memory problems, including an inability to remember important details of the trauma they experienced.
Hyperarousal and hyper-reactivity
People with PTSD may be easily startled – flinching severely to a loud noise or an accidental touch. They may always feel ‘on guard,’ constantly monitoring the environment for danger. They may have trouble concentrating or sleeping. They may also have irritable or angry outbursts, acting out in reckless or destructive ways.
It’s important to note that these symptoms can also coexist with other mental illnesses. PTSD frequently co-occurs with other psychiatric disorders such as depression, obsessive-compulsive disorder, or substance abuse, which can make symptoms more severe.
If you or someone you know are experiencing these symptoms for over one month after a trauma, and they are interfering with daily functioning, it may be a good idea to talk to a doctor or other health professional.
Risk Factors and Causes
It’s not exactly clear why some people develop PTSD after experiencing a traumatic event and some do not. Risk factors for developing PTSD include repeated trauma, having a past mental illness such as anxiety or depression, a history of trauma or abuse in childhood, having a poor support network after experiencing a trauma, and experiencing extra stressors after the trauma.
Scientists have made an effort to tease apart the contributions of genetics and environment in PTSD. Environment plays a large role in PTSD, as the experience of a traumatic event precipitates onset of the disorder. Evidence suggests that, like other psychiatric disorders, PTSD also has a strong genetic component. However, genetic tests for PTSD currently do not exist, nor is there a reliable way to predict who will develop the disorder following trauma.
While there’s no cure for PTSD, proper diagnosis, treatment, and management can help people cope with symptoms and live full and productive lives.
Treatments for PTSD can involve a combination of behavioral/psychotherapy and medication. People with PTSD will need to work with healthcare and mental health professionals to determine the best treatment options for their particular needs and goals.
There are many types of psychotherapy options for PTSD. The overall goal of therapy in PTSD is to offer a safe and supportive environment for patients to work on improving symptoms, teach patients how to deal with the disorder, and boost their self-esteem.
Cogntive Behavioral Therapy: Most PTSD therapies can be considered cognitive-behavioral therapy or CBT. CBT works on changing thought patterns that are disturbing one’s life. CBT for PTSD may include talking through traumas, focusing on where fears come from, or working on developing coping mechanisms to deal with the stress from the traumatic event.
Eye Movement Desensitization and Reprocessing: Another type of treatment for PTSD is called Eye Movement Desensitization and Reprocessing or EMDR. EMDR is a complex, months-long type of therapy which relies primarily on eye movements, body sensations, and focused attention to improve beliefs about self and help process traumatic memories.
Medications can help dampen some of the symptoms of PTSD. Antidepressants can reduce nightmares and flashbacks and help improve mood. Two antidepressants have been approved by the FDA to specifically treat PTSD. However, several other medications may be an option as well.
Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are typically used to treat PTSD. Paroxetine (Paxil) and sertraline (Zoloft) are the only two SSRI medications that are currently FDA-approved for treating PTSD. These drugs work by improving the availability of neurotransmitters in the patient’s brain so that it can function better.
Many drugs can be used “off-label” to treat PTSD, meaning that they are not FDA-approved to treat the disorder, but studies show that they are nevertheless effective. These medications can include other antidepressants, monoamine oxidase inhibitors or MAOIs, antipsychotics, beta-blockers, or benzodiazepines.
If you have or think you have PTSD, talk with a doctor to determine the best treatment options for you.
PTSD can be scary and confusing for individuals and their loved ones, but recovery is attainable. Allowing the symptoms to interfere with daily functioning and cause other problems is perhaps the biggest risk associated with untreated PTSD. Many established and experimental therapies are available and can help individuals live normal lives, less encumbered by the devastating symptoms of PTSD.