Understanding Post-traumatic Stress Disorder (PTSD)

A mental health condition triggered by an extremely stressful event, post-traumatic stress disorder (PTSD) affects over 5.2 million Americans each year, and almost 8 million will experience it at some point over their lifetimes. PTSD is a serious mental disorder that can develop at any age and last for years.  Once known as “shell shock” because so many soldiers in combat developed the disorder, PTSD is commonly associated with war veterans.  However, a variety of triggering events can lead to the onset of this disorder, which can affect anyone.

Causes and Risk Factors 

PTSD can be triggered by experiencing any sort of physical or psychological trauma, or even by seeing or learning about such an event.  Feelings of helplessness and intense fear bring on later symptoms.  Examples of traumas can include physical or sexual assault, life-threatening experiences such as combat or accidents, natural disasters, or the death of a loved one. First responders to emergencies, such as EMTs and other rescue workers, can develop the disorder due to exposure to others’ trauma.

Many people face terrifying or extremely stressful experiences in their lives, but not everyone goes on to develop PTSD.  What triggers the disorder in some individuals but not others?  It appears that the following factors may affect an individual’s relative resiliency when exposed to extreme stress:

  • Genetic factors, including inherited mental health risks;
  • Severity and amount of previous trauma, particularly in childhood;
  • An individual’s temperament;
  • How one’s brain regulates hormones and chemicals released during episodes of stress;
  • Presence of lack of a strong support system of friends and family;
  • Intensity and duration of the traumatic experience;
  • One’s gender – women develop PTSD more frequently than men, partially due to the fact their increased vulnerability to domestic violence, rape, and other forms of abuse;
  • Presence of existing mental health problems such as depression or anxiety.

Symptoms of PTSD

In order to be classified at having PTSD, an individual must have symptoms occurring for at least one month and affecting overall functioning.  Most individuals develop symptoms within three months of the traumatic event, but symptoms may not emerge until years later.

People who go through a traumatic event can have reactions that include anxiety, anger, shock, and guilt.  These are common responses that fade away over time.  For an individual with PTSD, these feelings don’t fade but actually increase.

Mental health experts classify post-traumatic stress disorder symptoms in three categories:

  • Reliving.  Flashbacks, hallucinations, and nightmares are common ways in which individuals relive their traumatic ordeals.
  • Avoidance. Individuals often avoid places, people, or situations that remind them of the trauma.  This behavior can lead to social isolation, emotional numbing, and loss of interest in activities.
  • Increased arousal. Individuals may experience volatile emotions, such as anger outbursts, and feel agitated or easily startled. Concentration is often poor. Associated physical symptoms include increased heart rate or blood pressure, rapid breathing, and muscle tension.

The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer.

Treatment of PTSD

While PTSD can be disabling, it is treatable – usually through a combination of medication and psychotherapy.

Medications are often used to control extreme symptoms of the disorder, including anxiety, nightmares, and sleep disturbance.  Antidepressants or anti-anxiety medications may be prescribed to manage anxiety and depression and improve sleep. On a short-term basis, antipsychotics may be given to control emotional outbursts and severe sleeping disturbance.

Other medications may be used to treat specific physical or psychological symptoms.  For example, Prazosin, a drug normally prescribed for hypertension, may also manage insomnia and recurring nightmares.

Professionals also recommend psychotherapy or “talk therapy” to help individuals learn to manage symptoms and cope better with memories and feelings. Common treatment approaches include individual, family, or group therapy. Cognitive behavioral therapies are particularly effective, as they help patients deal with negative thought patterns that trigger stress.

Two strategies often associated with PTSD treatment are exposure therapy and eye movement desensitization and reprocessing (EMDR).  The former is a type of cognitive behavioral therapy in which patients relive traumatic experiences in a controlled and supportive environment.  This technique allows patients to confront their fears and become more comfortable in anxiety-provoking situations. EMDR helps patients deal with traumatic memories by teaching a group of guided eye movements that assist in processing these memories.

A word about prevention: there is evidence that seeking treatment as soon as possible after a traumatic event can be highly beneficial.  Immediate support can often help an individual recover from trauma without developing full-blown PTSD. Whether a mental health counselor, minister, or other helping professional, a trained, caring individual can provide invaluable support at a critical time.

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