What is PTSD?
Post-traumatic stress disorder (PTSD) is a serious disorder that affects some people who have witnessed or experienced a terrifying situation or event such as war, assault, or disasters. While it is completely natural to experience fear during a dangerous situation, those diagnosed with PTSD experience debilitating levels of stress, fear, and anxiety even when they are no longer in immediate danger.
It may be helpful to think of PTSD in terms of a malfunctioning fight-or-flight response. When we are faced with a harmful or life-threatening situation, our autonomic nervous system—the body’s control panel that acts mostly unconsciously to handle our physiological functions such as breathing, heart rate, salivation, digestion, and sexual response—kicks into overdrive, preparing to fight or run away. Some of these physiological changes and their functions include:
- Increased blood flow to the muscles to prepare for fighting or fleeing
- Elevated levels of heart rate, blood pressure, blood sugars, and fats to provide the body with more energy sources to react to the present danger
- Increased blood clotting mechanism in case the body suffers injury
- Increased muscle tension to provide the body with more strength and speed
- Increased sweating to help cool down the body in this heightened metabolic state
This response works well for immediate threats. But sufferers of PTSD experience these types of physiological changes and stress responses even when danger is long gone.
What are the symptoms of PTSD?
Symptoms of PTSD are many and varied, but fall into three main symptom categories: intrusive recollections, avoidant/numbing symptoms, and hyperarousal symptoms.
Intrusive recollection symptoms refer to the person reliving the traumatic event they previously experienced. PTSD sufferers re-experience the trauma in at least one of the following ways:
- Recurrent and intrusive thoughts and memories about the traumatic event
- Distressing nightmares about the traumatic event
- Flashbacks, or acting or feeling as if the event is occurring right then and there
- Intense psychological distress when exposed to a trigger that symbolizes or resembles an aspect of the traumatic event
- Physiological reactions when exposed to factors that trigger recollection of trauma, i.e. those malfunctioning fight-or-flight responses such as increased heart rate, blood pressure, and cortisol (a hormone produced by the body when under stress) levels present in the body when recalling the trauma
Avoidant/numbing symptoms are described as attempts of the PTSD sufferer to avoid triggers associated with their traumatic experience and/or display a numbed response or lack of emotion (at odds with their general emotional response preceding the traumatic event).
People diagnosed with PTSD report at least three of the following symptoms:
- Avoiding thoughts, feelings, or conversations associated with the trauma
- Avoiding activities, places, or people that arouse recollections of the trauma
- Inability to recall an important aspect of the trauma
- Markedly diminished interest or participation in significant activities
- Feeling detached or estranged from others
- Restricted emotional range (e.g., unable to have loving feelings)
- Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
Hyperarousal means the nervous system is on high alert, even when there is no immediate danger present. People diagnosed with PTSD persistently experience at least two of the following symptoms:
- Insomnia, either difficulty falling or staying asleep
- Anger management problems, irritability or outbursts of anger
- Difficulty concentrating
- Hyper-vigilance or always feeling “on guard”
- Exaggerated startle response
Who is at risk?
Anyone who experiences a traumatic event such as those listed below will have a stress response. But if someone reports symptoms of intrusive recollections, avoidant/numbing, and hyperarousal lasting longer than a month, they may have PTSD.
Soldiers are often the most common group associated with PTSD, but other traumas besides combat exposure can cause PTSD too. These include:
- Childhood sexual or physical abuse
- Sexual or physical assault including domestic violence
- Serious accident
- Natural disaster
- Violence such as a mugging or school-shooting
- Terrorist attack
It appears that overall, women may be more likely to experience PTSD, though men are more likely to experience at least one traumatic event during their lives. Whether a person develops PTSD can depend on a number of variables like:
- How intense the trauma was and/or how long it lasted
- If the person lost someone or was hurt as a result
- How close the person was to the event
- How strong the reaction was
- How in control the person felt
- How much help and support the person got after the event
Other factors that may make a person more at risk include:
- Having an earlier traumatic event
- Having a preexisting mental health problem
- Having a family member with a mental health problem
- Having little support from family or friends
- Having had recent, stressful, life changes
Some people may not suffer PTSD immediately after experiencing a traumatic event, but begin to display symptoms six or more months after the trauma. This is known as delayed onset PTSD.
70% of adults in the U.S have experience some type of traumatic event at least one time in their lives. Up to 20% of these people will experience PTSD (approximately 44.7 million people). – PTSD United
How do I know if I or someone I know has PTSD?
Only a qualified mental health care practitioner can diagnose PTSD. If you read through the symptoms and recognize yourself or someone else, please make an appointment with a mental health professional to assess the risk. If you or someone else is in immediate danger or crisis, call 911.
What kind of treatment is effective?
There is no single treatment that will work for every person who has PTSD. Detailed information on various evidence based treatment options is available. It is important to seek out a mental health professional experienced in treating PTSD to make sure that the most appropriate treatments are pursued.
PTSD sufferers are as unique as the traumas they experience, thus they have individual needs and respond differently to various treatment options. Some people find talk therapy helpful, particularly in a group with others who have experienced the same or a similar trauma. They may find that this reduces their sense of isolation or alienation and helps them overcome feeling numb or detached.
People who are struggling with hyperarousal and avoidance may find that that talk therapy or support groups are over-stimulating. For them, treatments such as mindfulness-based stress reduction, guided imagery, journal writing, or cognitive-behavioral therapies may be more helpful.
Medications for PTSD can also be prescribed. Common medications include certain classes of anti-depressants. Providers may also prescribe sleep medications and/or anti-anxiety drugs.
Many people with PTSD experience at least a degree of recovery. For most, a significant amount of recovery occurs as a result of practicing evidence-based techniques on their own. They may learn these from a therapist, through a support group, or own their own. Active participation in recovery helps many people experience a significant reduction in their symptoms and/or better coping mechanisms to manage their symptoms. Many people find they are able to restore some to all of their capacity to function.