Posttraumatic Stress Disorder (PTSD)

Traumatic events—such as an accident, assault, military combat or natural disaster—can have lasting effects on a person’s mental health. Posttraumatic Stress Disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. While many people will have short-term responses to life-threatening events, some will develop longer-term symptoms that can lead to a Posttraumatic Stress Disorder diagnosis. 

It is natural to feel afraid during and after a traumatic 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.

Posttraumatic Stress Disorder affects 3.5% of the U.S. adult population—about 8 million Americans. About 37% of those diagnosed with PTSD are classified as having severe symptoms. And women have higher rates than men.  

PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety. A comprehensive medical evaluation resulting in an individualized treatment plan is optimal.

A diagnosis of PTSD requires a discussion with a trained professional. Symptoms of PTSD generally fall into these broad categories:

  • Re-experiencing type symptoms – recurring, involuntary and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams and intrusive thoughts.
  • Avoidance – staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
  • Cognitive and mood symptoms – trouble recalling the event, negative thoughts about one’s self. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can in some instances extend to include out-of-body experiences or feeling that the world is “not real” (derealization).
  • Arousal symptoms – exaggerated startle response, hyper-vigilance. Examples might include being intensely startled by stimuli that resembles the trauma, trouble sleeping or outbursts of anger. Hyper-vigilance is being on constant high alert for danger or trauma.

Symptoms of PTSD usually begin within three (3) months after experiencing or being exposed to a traumatic event. Occasionally, symptoms may emerge years afterward. For a diagnosis of PTSD, symptoms must last more than one month. Symptoms of depression, anxiety or substance abuse often accompany PTSD.

While PTSD has a treatment history of being difficult to cure, new treatments are proving to be very effective in treating and clearing trauma as well as managing symptoms in the ways listed below.

  • Lifespan Integration Therapy (LI) – gentle body-based, right brain therapy that has shown to be effective in clearing out past trauma. Individuals completing LI report feeling relief from the trauma and realization that it is in the past. As the body-mind system is convinced the trauma is over, emotional reaction to triggers is reduced and often eliminated and individuals are better able to return to living a more normal life.  
  • Psychotherapy – cognitive processing therapy or group therapy
  • Medications – anti-anxiety, sleep and nightmare/dream medications 
  • Self-management strategies – self-soothing and mindfulness are helpful to ground a person and bring him/her back to reality after a flashback
  • Service animals – especially dogs, can help soothe some of the symptoms of PTSD

It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD.  Some people with PTSD 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 and co-occurring diagnoses can include panic disorder, depression, substance abuse, and feeling suicidal.

Sources:

  • National Alliance on Mental Illness (nami.org)
  • National Institute of Mental Health (nimh.nih.gov)
  • Diagnostic Statistic Manual of Mental Disorders: DSM-IV-TR and DSM-4

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