Post-traumatic stress disorder (PTSD)

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Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that can be triggered by experiencing or witnessing a terrifying event. Symptoms of PTSD may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts related to the traumatic event.

While most people experience temporary difficulty adjusting and coping after traumatic events, PTSD may develop if symptoms worsen, persist for months or even years, and interfere with daily functioning.

Symptoms

PTSD symptoms can appear within one month of the traumatic event, but they may also surface years later. The symptoms are grouped into four types:

Intrusive memories

  • Recurrent distressing memories of the event
  • Flashbacks, reliving the traumatic event
  • Upsetting dreams or nightmares related to the event
  • Severe emotional distress or physical reactions triggered by reminders of the event

Avoidance

  • Trying to avoid thoughts or discussions about the traumatic event
  • Avoiding places, activities, or people associated with the trauma

Negative changes in thinking and mood

  • Negative thoughts about oneself, others, or the world
  • Feelings of hopelessness about the future
  • Memory problems related to the traumatic event
  • Difficulty maintaining relationships
  • Feeling detached from family and friends
  • Lack of interest in activities once enjoyed
  • Difficulty experiencing positive emotions
  • Feeling emotionally numb

Changes in physical and emotional reactions

  • Easily startled or frightened
  • Constantly on guard for danger
  • Engaging in self-destructive behavior, like excessive drinking or reckless driving
  • Trouble sleeping
  • Difficulty concentrating
  • Irritability, angry outbursts, or aggressive behavior
  • Overwhelming guilt or shame

For children 6 years old and younger, symptoms may include re-enacting the traumatic event through play or having frightening dreams related to the event.

Intensity of Symptoms

PTSD symptoms can vary in intensity over time, often becoming worse when exposed to stress or reminders of the trauma.

When to See a Doctor

If you experience disturbing thoughts and feelings related to a traumatic event for more than a month, if they are severe, or if they disrupt your daily life, seek help from a doctor or a mental health professional. Early treatment can prevent symptoms from worsening.

Causes

PTSD can develop after experiencing, witnessing, or learning about an event involving death, serious injury, or sexual violation. The exact cause of PTSD is not known but is likely influenced by a combination of factors, including stressful experiences, inherited mental health risks, personality traits, and the way the brain regulates chemicals and hormones in response to stress.

Risk Factors

Several factors may increase the likelihood of developing PTSD after a traumatic event, including experiencing intense or prolonged trauma, previous exposure to trauma (such as childhood abuse), certain occupations (e.g., military personnel, first responders), other mental health issues (anxiety, depression), substance misuse, lack of a support system, and a family history of mental health problems.

Kinds of Traumatic Events

Various traumatic events, such as combat exposure, childhood physical abuse, sexual violence, physical assault, accidents, and more, can lead to the development of PTSD.

Complications

Untreated PTSD can significantly disrupt a person’s life, affecting relationships, work, health, and overall well-being. It may also increase the risk of other mental health problems, including depression, anxiety, issues with substance use, eating disorders, and suicidal thoughts or actions.

Prevention

Not everyone exposed to trauma develops long-term PTSD. Seeking timely help and support after a traumatic event, turning to family, friends, or mental health professionals, and avoiding unhealthy coping methods can help prevent PTSD from developing.

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Diagnosis

To diagnose post-traumatic stress disorder (PTSD), your doctor will likely:

  • Perform a physical exam to rule out any medical problems causing the symptoms.
  • Conduct a psychological evaluation, discussing your signs, symptoms, and the traumatic event or events that led to them.
  • Use the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess if you meet the criteria for PTSD.

PTSD diagnosis requires exposure to an event involving actual or possible death, violence, or serious injury, which can occur through direct experience, witnessing the event in person, learning that a close person experienced or was threatened by the event, or repeated exposure to graphic details of the event.

If symptoms persist for more than a month after exposure and significantly affect your social, work, and relationship functioning, a diagnosis of PTSD may be considered.

Treatment

Treatment for post-traumatic stress disorder can help you regain control over your life. The primary treatment is psychotherapy, which can be complemented by medication if needed.

The goals of treatment include:

  • Teaching you skills to address your symptoms.
  • Helping you develop more positive thoughts about yourself, others, and the world.
  • Learning coping strategies for any future symptoms that may arise.
  • Treating other problems often associated with traumatic experiences, such as depression, anxiety, or substance misuse.

Psychotherapy, also known as talk therapy, can be beneficial for both children and adults with PTSD. Some common types of psychotherapy used include cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR).

Medications, such as antidepressants and anti-anxiety drugs, can also be prescribed to alleviate specific symptoms of PTSD.

Remember, you don’t have to handle PTSD on your own. Seeking help and support is essential for recovery.

Coping and Support

If stress and trauma-related problems affect your life, consider seeking help from a doctor or mental health professional. In addition to treatment, here are some coping strategies:

  • Follow your treatment plan and stay in communication with your mental health professional.
  • Learn about PTSD to better understand what you’re feeling and develop effective coping strategies.
  • Take care of yourself through rest, a healthy diet, exercise, and stress reduction.
  • Avoid self-medication with alcohol or drugs, as it can worsen symptoms and hinder healing.
  • Find healthy outlets for stress, such as physical activities or hobbies.
  • Stay connected with supportive and caring people, like family and friends.
  • Consider joining a support group with others who have experienced similar traumas.

When Someone You Love Has PTSD

Supporting a loved one with PTSD can be challenging. Learn about PTSD, recognize avoidance and withdrawal as part of the disorder, offer to attend medical appointments, be willing to listen, encourage participation in positive activities, take care of yourself, and seek help if needed.

Preparing for Your Appointment

If you suspect you have PTSD, prepare for your doctor’s appointment by making a list of your symptoms, personal information, experiences related to intense fear or horror, problems caused by stress, medical history, medications, and questions you want to ask.

During the appointment, be prepared to answer questions about your symptoms, experiences, and any history of trauma or other mental health problems.

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