Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced or witnessed a traumatic event.
It is natural to feel afraid or anxious during and after such a situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.
Signs and Symptoms
While most but not all traumatized people experience short term symptoms, the majority do not develop ongoing (chronic) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms of PTSD can include recurring flashbacks, nightmares, avoidance of certain places and feelings, being easily startled, frequent angry outbursts, frequent tense moods, distorted feelings of guilt and blame, negative thoughts, memory issues and loss in interest of enjoyable activities.
While it is natural to have some of these symptoms for a few weeks after a traumatizing event, symptoms lasting more than a month begin to have a serious effect on one’s ability to function. However, some people with PTSD don’t show any symptoms for weeks or months. Some people recover within 6 months, while others have symptoms that eventually become chronic. Furthermore, PTSD is often accompanied by depression, substance abuse or one or more of the other anxiety disorders.
A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose 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 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.
Some factors that increase risk for PTSD include:
- Living through dangerous events and traumas
- Getting hurt
- Seeing another person hurt, or seeing a dead body
- Childhood trauma
- Feeling horror, helplessness or extreme fear
- Having little or no social support after the event
- Dealing with extra stress after the event, such as loss of a loved one, pain and injury or loss of a job or home
- Having a history of mental illness or substance abuse
Some 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 act 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 to prevent it.
Treatments and Therapies
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 are 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. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.
Psychotherapy (sometimes called “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.
Effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms and skills to manage the symptoms. One helpful form of therapy is called cognitive behavioral therapy, or CBT.
There are other types of treatment that can help as well. People with PTSD should talk about all treatment options with a therapist. Treatment should equip individuals with the skills to manage their symptoms and help them participate in activities that they enjoyed before developing PTSD.
Beyond Treatment: How can I help myself?
It may be very hard to take that first step to help yourself. It is important to realize that although it may take some time, with treatment, you can get better. If you are unsure where to go for help, ask your family doctor or utilize the resources available to you through the Department of Veterans’ Affairs’ website: ptsd.va.gov/index.asp.
