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Post-Traumatic Stress disorder (PTSD)
What is it?
What Causes it?
Signs / Symptoms
Treatment / Therapies
Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that may occur in individuals who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or who have been threatened with death, sexual violence, rape, or serious injury. Individuals with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares. They may feel sadness, fear, or anger and they may feel detached or estranged from other people.
Individuals with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as smells, a loud noise, or an accidental touch.
A diagnosis of PTSD requires exposure to an upsetting traumatic event. However, the exposure could be indirect rather than firsthand. For example, PTSD could occur in an individual learning about the violent death of a close family or friend. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.
Source: American Psychiatric Association (APA), National Institute of Mental Health (NIMH)
Anyone can develop PTSD at any age. This includes war veterans, children, and individuals who have been through a physical or sexual assault, abuse, accident, disaster, or other serious event. According to the National Center for PTSD, 7- 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men and genes may make some people more likely to develop PTSD than others.
Not everyone with PTSD has been through a dangerous event. Some people develop PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also lead to PTSD.
Why do some people develop PTSD and other people do not? It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.
Many factors play a part in whether or not a person will develop PTSD. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.
Factors that increase the risk for PTSD include:
Living through dangerous events or traumas
Seeing another person hurt, or seeing a dead body
Younger age/ Childhood trauma
Feeling horror, helplessness, or extreme fear
Having little or no social support after a traumatic event
Dealing with extra stress after a traumatic event, such as the loss of a loved one, pain and injury, or loss of a job or home
History of mental illness or substance abuse
Having higher-stress living conditions on top of the trauma
Factors that may promote resilience and reduce the risk of the disorder include:
Being resourceful and having good problem-solving skills
Connecting with others/ Available social support
Finding positive meaning in the trauma
Coping with stress effectively and in a healthy manner (not avoiding)
Holding the belief that there is something you can do to manage your feelings
Identifying as a survivor as opposed to a victim
Self-disclosure of the trauma to loved ones
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 react and respond effectively despite feeling fear
Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and thus, to prevent it.
Source: American Psychiatric Association (APA), National Institute of Mental Health (NIMH), Dr. Hilary Brenner from Psychology Today, Dr. Tull from VeryWellMind
Symptoms of PTSD fall into four categories. Specific symptoms can vary in severity.
1. Intrusion: Intrusive thoughts such as repeated, involuntary memories, distressing dreams, or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes.
2. Avoidance: Avoiding reminders of the traumatic event may include avoiding people, places, activities, objects and situations that may trigger distressing memories. People may try to avoid remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
3. Alterations in cognition and mood: Inability to remember important aspects of the traumatic event, negative thoughts and feelings leading to ongoing and distorted beliefs about oneself or others (e.g., “I am bad”, “No one can be trusted”), distorted thoughts about the cause or consequences of the event leading to wrongly blaming self or other, ongoing fear, horror, anger, guilt or shame, much less interest in activities previously enjoyed, feeling detached or estranged from others, or being unable to experience positive emotions (a void of happiness or satisfaction).
4. Alterations in arousal and reactivity: Arousal and reactive symptoms may include being irritable and having angry outbursts, behaving recklessly or in a self-destructive way, being overly watchful of one's surroundings in a suspecting way, being easily startled, or having problems concentrating or sleeping.
Many people who are exposed to a traumatic event, experience symptoms similar to those described above in the days following the event. For a person to be diagnosed with PTSD, however, symptoms must last for more than a month and must cause significant distress or problems in the individual's daily functioning. Many individuals develop symptoms within three months of the trauma, but symptoms may appear later and often persist for months and sometimes years. PTSD often occurs with other related conditions such as depression, substance use, memory problems and other physical and mental health problems.
Source: American Psychiatric Association (APA), National Institute of Mental Health (NIMH)
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. Some people with PTSD may 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 addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.
The most studied type of medication for treating PTSD is antidepressants, which may 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 (talk therapy) involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.
Another form of therapy is EMDR. Eye Movement Desensitization and Reprocessing or EMDR therapy (Shapiro, 2001) was initially developed in 1987 for the treatment of Post Traumatic Stress Disorder (PTSD) and is guided by the Adaptive Information Processing model (Shapiro 2007). EMDR is an individual therapy typically delivered one to two times per week for a total of 6-12 sessions, although some people benefit from fewer sessions. Sessions can be conducted on consecutive days.
Unlike other treatments that focus on directly altering the emotions, thoughts, and responses resulting from traumatic experiences, EMDR therapy focuses directly on the memory and is intended to change the way that the memory is stored in the brain, thus reducing and eliminating the problematic symptoms.
During EMDR therapy, clinical observations suggest that an accelerated learning process is stimulated by EMDR’s standardized procedures, which incorporate the use of eye movements and other forms of rhythmic left-right (bilateral) stimulation (e.g., tones or taps). While clients briefly focus on the trauma memory and simultaneously experience Bilateral Stimulation (BLS), the vividness and emotion of the memory are reduced. This form of treatment is conditionally recommended for the treatment of PTSD.
EMDR therapy is the most common form of treatment for individuals who have witnessed the loss of their loved one. Talk to your doctor or mental health professional to discuss possible options & side effects.