Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after one has experienced or witnessed a traumatic event. This serious, potentially debilitating condition can follow a serious accident or natural disaster, a terrorist incident, war, or the sudden death of a loved one. It can also be brought on by a violent personal assault such as rape, or by other life-threatening events in adulthood or childhood. Most people who experience such events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event.
Individuals with PTSD will continue to have intense, disturbing thoughts and feelings related to their experience. They may relive the event through flashbacks or nightmares; they may suffer sadness, fear, or anger; and they may feel detached or estranged from other people. People 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 a loud noise or an accidental touch.
How common is PTSD?
PTSD affects nearly eight million American adults – approximately 3.5% of the adult population. Although most commonly associated with members of the military returning from war, post-traumatic stress afflicts more individuals than just combat veterans. PTSD occurs in men, women and children, in people of any ethnicity, nationality or culture. Women are twice as likely to develop posttraumatic stress disorder as men. The risk of developing PTSD over one’s lifetime is estimated at 8.7 percent.
Who can get PTSD?
- Anyone who was a victim of, or who witnessed or has been exposed to, a life-threatening situation
- Survivors of violent acts, such as domestic violence; rape; sexual, physical and/or verbal abuse; or physical attacks
- Survivors of unexpected dangerous events, such as a car accident, natural disaster (e.g. fire, hurricane, earthquake, flood, tornado), or terrorist attack
- Combat veterans or civilians exposed to war
- People who have learned of or experienced an unexpected, sudden death of a friend or relative
- Emergency responders who help victims during traumatic events
- Children who are neglected and/or abused (physically, sexually or verbally)
Signs and Symptoms
There are four types of symptoms of PTSD:
- Reliving the event (also called re-experiencing symptoms). Individuals may have bad memories, nightmares or flashbacks – feeling like they’re going through the event again.
- Avoiding reminders of the trauma. People may try to avoid situations or people that trigger memories of the traumatic event. They may avoid talking or thinking about the event.
- Negative changes in beliefs and feelings. The traumatic event may cause people to feel fear, guilt, sadness or shame, or to become emotionally numb and detached from friends in family. It is also common to lose interest in activities once enjoyed –another way to avoid memories.
- Feeling constantly keyed up, alert or on guard (also known as hyperarousal). Traumatized individuals may be jittery, irritable, easily angered or startled, and always on the lookout for danger. They may also have trouble sleeping or concentrating.
Trauma survivors with PTSD may have problems functioning at work, in school or in social situations. They may have trouble with their close family relationships or friendships. Their symptoms can cause problems with trust, closeness, communication and problem solving, which may affect the way the survivor acts with others.
PTSD symptoms by gender
Women are more than twice as likely to develop PTSD as men and are more prone to certain symptoms. For example, they are more likely to be jumpy, to have more trouble feeling emotions, and to avoid things that remind them of the trauma than men. In contrast, men are more likely to feel angry and to have trouble controlling their anger than women. More often, women with PTSD will feel depressed and anxious, while men are more likely to have problems with alcohol or drugs.
PTSD and children
The expression of PTSD in children will depend on their age:
- Children from birth to age 6 may get upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom.
- Children age 7 to 11 may act out the trauma through play, drawings or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
- Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.
A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD. The diagnosis is made after the doctor talks with the person who has symptoms of PTSD.
People with post-traumatic stress disorder often struggle with other mental issues as well. Common coexisting conditions include:
- Panic attacks: a feeling of intense fear, with shortness of breath, dizziness, sweating, nausea and racing heart
- Substance abuse : using drugs or alcohol to cope with the emotional pain
- Depression: persistent sad, anxious or empty mood; loss of interest in once-enjoyed activities; feelings of guilt and shame; or hopelessness about the future. Other symptoms of depression may also develop.
- Suicidal thoughts: thoughts about taking one’s own life. If you or someone you know is thinking about suicide, call 1-800-273-TALK(8255). Get help now
Physical symptoms include headaches, chronic pain, stomach pain or digestive problems, tightness or burning in the chest, or lower-back pain.
PTSD can be treated successfully, enabling people to manage their response to painful memories, and to experience symptoms that are less intense and frequent. It is important to be treated by a mental health care professional who is experienced with PTSD. Often, a combination of psychotherapy (also known as counseling or talk therapy) and medication is most effective.
Medicines are used to help people suffering from PTSD feel less afraid and tense. The most commonly used medications are a type of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. These are designed to reduce anxiety and depression, and help with other symptoms. In addition, a physician may prescribe other anti-anxiety drugs and/or sedatives to counter sleep problems.
Working through the trauma with the help of a mental health professional helps individuals learn new ways to address and overcome distressing emotions. The primary types of psychotherapy used for PTSD include:
- Cognitive behavioral therapy (CBT), which helps people process their emotions from the traumatic event and change the thought patterns that keep them from overcoming their anxiety.
- Exposure therapy, whichhelps people face and control their fear by exposing 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.
Support groups. This form of therapy, led by a mental health professional, involves groups of four to 12 people with similar issues to talk about. Talking to other survivors of trauma can be a helpful step in recovery.
American Psychiatric Association
Anxiety and Depression Association of America
Mental Health America
National Center for PTSD (U.S. Dept. of Veterans Affairs)
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