What is PTSD?
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event. Children, teens, and adults can all experience PTSD. In recent history, this mental health condition has been known by many names, such as “shell shock” during World War I and “combat fatigue” after World War II, however, PTSD doesn’t only affect veterans. Anyone, at any age, can develop PTSD following a traumatic event. However, those who experience events involving deliberate harm such as a physical or sexual assault, or who have had repeated traumatic experiences throughout their life, such as childhood abuse, domestic violence, or living in a war zone, are at greater risk
What are the statistics of PTSD?
- According to the National Alliance on Mental Health (NAMI), PTSD affects 3.6% of the U.S. adult population — approximately 9 million individuals.
- About 37% of those diagnosed with PTSD are classified as having serious symptoms.
- Women are significantly more likely to experience PTSD than men.
Post-Traumatic Stress Disorder Symptoms & Behaviors
Although most people who experience a traumatic event often have severe reactions that may include anger, shock, nervousness, fear and guilt, those experiencing PTSD have their symptoms linger for over a month and aren’t able to function as well as before the triggering event occurred. This distinction differentiates PTSD from trauma and helps determine a clinical PTSD diagnosis. Even though the symptoms of PTSD can surface within a month of the traumatic event, sometimes they don’t appear until years after.
PTSD symptoms often coexist with other conditions such as substance use disorders, depression and anxiety, so it can sometimes be challenging to understand whether or not someone is suffering from PTSD. A comprehensive medical evaluation with an individualized treatment plan laid out by a professional is the best way to move forward, but it’s imperative to familiarize yourself with the symptoms of PTSD so you can best understand the condition. There are also PTSD assessments that can help you get started.
Symptoms of PTSD fall into four categories:
Post-traumatic stress disorder can present with a range of symptoms or behaviors that generally fall into four categories.
Intrusion: Intrusion occurs when something reminds you of the trauma and you feel that initial fear again. Examples include: flashbacks, nightmares, vivid, unpleasant memories of the event, and intense mental or physical distress when you think about the event.
Avoidance: Those who experience avoidance try to circumvent situations or people that trigger memories of what is causing the distress. For example, if the traumatic event was a car accident, that person might stop driving. Additionally, those who experience avoidance try to avoid thoughts or feelings related to the cause. They might make themselves overly busy to avoid thinking about what happened and their feelings. One can also experience avoidance by feeling emotionally numb or cut off from their feelings in general daily life.
Arousal and reactivity: These symptoms can include feeling on edge, being easily startled, irritability, angry outbursts, and reckless, self-destructive behavior.
Cognition and mood: PTSD doesn’t always show itself in nightmares and outbursts, sometimes it appears in mood changes completely unrelated to the cause of the PTSD. A person can suddenly have negative thoughts about themselves or the world in general, distorted feelings of guilt and blame, or loss of interest in activities that were once enjoyable to the individual. They may have a hard time remembering the original traumatic events and feel increasingly detached from others as well as their emotions.
Although it is natural to have some of these symptoms for a few weeks after a traumatic event, it’s when the symptoms above last longer, and seriously affect a person’s ability to function, that are indicative of PTSD and may be a sign to consult a mental health professional about.
Post-traumatic Stress Disorder Causes & Risk Factors
PTSD can develop after experiencing or witnessing a traumatic event, or after a prolonged traumatic experience. This can include a wide range of traumatic events, but not all people who experience traumatic events will develop PTSD.
What’s the difference between PTSD and trauma? According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person must have been exposed to “actual or threatened death, serious injury, or sexual violence” in order to be diagnosed with PTSD. Other than that, there is no formal definition for whether something is traumatic enough to cause PTSD. It depends on the person’s interpretation of the event and how long the symptoms last.
So, what makes one person susceptible to PTSD while another person who experienced the same trauma is able to move on over time? There are a number of risk factors that make someone more likely to develop PTSD. For example, if someone suffered from depression or anxiety before the trauma, they may be more likely to experience PTSD. Additionally, if you have a lack of support from family or friends, you may be more prone to developing PTSD.
Research also shows that there may be a genetic factor involved in PTSD. In a large PTSD genetic study, scientists from University of California San Diego School of Medicine, along with over 130 additional institutions who participated in the Psychiatric Genomics Consortium, have found that PTSD has a strong genetic component similar to other psychiatric disorders. The conclusion of the study is that genetics accounts for 5-20% of the variability in PTSD risk following a traumatic event. While more research still needs to be done, the study shows that people with these genes are at a higher potential risk for developing PTSD after traumatic events. However, PTSD is like other mental illnesses and can affect anyone, regardless of their background.
Types of PTSD Explained
Research has shown that there are what can be considered several different types of PTSD, depending on how symptoms present and trauma circumstances. Researchers continue to explore PTSD symptoms that can require different treatment methods.
Dissociative PTSD: This type of PTSD is a newer classification from the last few years, but it is characterized by dissociative episodes instead of reactive episodes in reaction to triggers. Dissociative PTSD is associated with high PTSD severity, prevalence of depersonalization and derealization symptoms, more significant early life trauma, and higher levels of co-existing psychiatric disorders. Also, people with dissociative PTSD typically present different physical and neural symptoms. instead of a higher heart rate, decreased prefrontal brain activation, and increased amygdala activation– dissociative PTSD shows the opposite pattern.
Complex PTSD: Complex PTSD is also known as complicated PTSD and is the result of multiple traumas. This type of PTSD is common in situations involving abuse or domestic violence or repeated exposure to war. Individuals who experience this type of PTSD are often diagnosed with borderline or antisocial personality disorder or dissociative disorders, too. As a result, treatment for this type of PTSD can take much longer.
Comorbid PTSD: Comorbid PTSD is when an individual has more than one mental health concern and/or a substance use disorder in addition to PTSD. This type of PTSD is extremely common. As previously mentioned, many people suffer from more than one psychiatric disorder at a time. If an individual is diagnosed with comorbid PTSD, it’s best to treat both mental health conditions at the same time. More often than not, the same treatments used for uncomplicated PTSD are used for those experiencing comorbid PTSD.
Post-traumatic Stress Disorder Treatment Options
When you have PTSD, it can feel like you’ll never get your life back to the way it was before, but know that your PTSD symptoms can be treated. Short- and long term psychotherapy and PTSD medications can help an individual overcome the symptoms of PTSD. But, it’s also important to remember that everyone is different. A treatment that works for one person may not work for another. You may need to try different treatments to find what works best for you. Regardless of what treatment options you chose, it is important to seek treatment from a mental health professional who is experienced with PTSD.
Online therapy can help
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- Cognitive processing therapy (CPT): There are a few PTSD therapy options, and most of them fall under the umbrella of cognitive behavioral therapy (CBT). The idea is to change the thought patterns that are disturbing your life. Cognitive processing therapy is a specific type of CBT that focuses on how your traumatic event is perceived and how you tend to cope with the emotional and mental part of your experience. Typically, at first, you talk about the traumatic event with your therapist and how your thoughts related to it have affected your life. Then you write in detail about what happened. This process helps you examine how you think about the trauma you experienced and figure out new ways to live with it.
- Prolonged exposure therapy (PE): This is another form of CBT that relies more heavily on behavioral therapy techniques to help individuals with PTSD gradually approach their trauma related memories, situations and emotions. The main goal of exposure therapy for PTSD is to focus on exposures to help you stop avoiding trauma reminders.
- Cognitive behavior therapy (CBT): This type of therapy is commonly used by people with PTSD. Therapists typically center their treatment around trauma-focused cognitive behavior therapy, which means they focus on the traumatic event(s) that caused the PTSD. CBT focused on identifying, understanding and modifying behavior to help patients feel better.
- Stress inoculation training (SIT): With this form of CBT, you focus on changing how you deal with the stress from the event that is causing the PTSD. You work with a healthcare professional to learn breathing techniques and other ways to stop negative thoughts from taking over your body and mind. SIT works to reduce anxiety by teaching coping skills to deal with PTSD-accompanying stress.
- Eye movement desensitization and reprocessing (EMDR): EMDR is a relatively new treatment that asks patients to pay attention to either a sound or a back and forth movement while thinking about the trauma memory.
- Present centered therapy (PCT): This is a type of non-trauma focused treatment that centers around current issues rather than directly processing the trauma that is causing the PTSD. It involves increasing adaptive responses to current life stressors and difficulties that are directly or indirectly related to trauma or PTSD symptoms.
- SSRI medications Selective serotonin reuptake inhibitors, commonly known as SSRIs, are a type of medication usually prescribed to help with symptoms of depression and anxiety. Examples of common SSRIs that may be used in the treatment of PTSD include Zoloft, Paxil and Prozac.
- SNRI medications: Serotonin-noripinephrine reuptake inhibitor (SNRI) medications are less common medications for PTSD, but they can be used as well. Your mental health care provider can help determine which type of medication will work best for you.
Psychiatric treatment from a licensed prescriber
Talk therapy can also be combined with other therapies to help someone with PTSD learn new ways to react to their triggers, manage their anxiety and anger, and help process with shame or guilt resulting from their trauma. This type of therapy can help process traumatic events and change how someone with PTSD reacts to their symptoms.