Print
Authors
What is post-traumatic stress disorder (PTSD)?
One Woman’s Story of PTSD
Three months ago, Wendy was in a major car accident. She was driving a friend home one night when, out of nowhere, a drunk driver sped through a red light and smashed into the passenger’s side of her vehicle. Wendy’s friend was killed instantly, while Wendy sustained only minor injuries.
At first, the accident seemed like just a bad dream. Then Wendy started having nightmares about it: waking up in a cold sweat to the sound of squealing tiles, crunching metal, and breaking glass. Now, the sights and sounds of the accident haunt her all the time. She has trouble sleeping at night, and during the day she feels foggy and on edge. Wendy avoids TV, because she never knows when a terrifying scene might occur. She also avoids driving whenever possible, and refuses to go anywhere near the site of the crash.
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after you’ve gone through a traumatic experience, usually one that has caused or threatened death or severe injury. Most people associate PTSD with battle-scarred soldiers, and indeed, military combat is the most common cause of PTSD in men. But any catastrophic life experience—a hurricane, a mugging, a horrific accident—can trigger the disorder, especially if the event is perceived as unpredictable and uncontrollable.
Traumatic events that can lead to PTSD include:
- War
- Natural disaster
- Car or plane crash
- Terrorist attack
- Rape
- Kidnapping
- Violent assault
- Sexual or physical abuse
PTSD can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma.
Symptoms of post-traumatic stress disorder (PTSD)
PTSD develops differently from person to person. If you’ve lived through a traumatic incident, your symptoms may appear within hours or days of the event, or they may take weeks, months, or even years to develop. Symptoms can arise suddenly, gradually, or come and go over time.
There are three main types of PTSD symptoms: re-experiencing the traumatic event, avoiding reminders of the trauma, and symptoms of hyperarousal or heightened anxiety. In the days or months following a traumatic event, you may find yourself alternating between re-experiencing the event and avoiding reminders of it, with symptoms of increased arousal as the common backdrop.
Re-experiencing the traumatic event
The most disruptive symptoms of PTSD involve the flashbacks, nightmares, and intrusive memories of the traumatic event. You may be flooded with horrifying images, sounds, and recollections of what happened. You may even feel like it’s happening again. These symptoms are sometimes referred to as intrusions, since they involve memories of the past that intrude on the present.
If you have PTSD, you may re-experience the traumatic event or intrusion in several ways:
- Intrusive memories of the traumatic event
- Bad dreams about the traumatic event
- Flashbacks or a sense of reliving the event
- Feelings of intense distress when reminded of the trauma
- Physiological stress response to reminders of the event (pounding heart, rapid breathing, nausea, muscle tension, sweating)
These distressing symptoms can appear at any time, sometimes seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event: a noise, an image, certain words, a smell.
Examples of PTSD Triggers
- For an auto accident survivor: The smell of gasoline
- For a combat veteran: The sound of a helicopter or firecrackers
- For a rape victim: The sight of a person suddenly appearing around the corner
- For a carjacking victim: The song that was playing on the radio at the time of the assault
The intrusions or flashbacks that result from these PTSD triggers are terrifying, disorienting, and unpleasant. The natural response is to protect yourself by avoiding them. This leads to the second major cluster of PTSD symptoms.
Symptoms of avoidance
Symptoms of avoidance are prominent in PTSD. You may persistently avoid situations that remind you of the traumatic event you experienced, minimize the event’s significance, or push all thoughts of it out of your mind. Avoidance can also take the form of detachment and apathy.
Symptoms of avoidance include:
- Avoiding thoughts, feelings, or conversations associated with the trauma
- Avoiding activities, places, or people that remind you of the trauma
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Feeling detached or estranged from other people
- Feeling emotionally numb, especially toward loved ones
- Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)
Symptoms of increased arousal
PTSD can cause you to feel and react as if you’re constantly in danger. In this state of chronic hyperarousal, your mind and body is on constant red alert, making it impossible to fully relax, be productive, or enjoy life.
The PTSD symptoms of increased arousal and anxiety include:
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance, or being constantly “on guard”
- An exaggerated startle response, or jumpiness
Other common symptoms of PTSD
In addition to the PTSD symptoms of intrusion, avoidance, and hyperarousal, you may also experience a number of other distressing symptoms. If you survived an event that killed others, you may feel guilt that you lived while others died. You may also blame yourself for what happened or suffer from feelings of shame and hopelessness. You may also experience an array of physical symptoms linked to PTSD, including headaches, stomach problems, and chest pain.
Over the long-term, PTSD can also lead to many complicating problems, including depression, panic attacks, and other psychological issues. Substance abuse is another common complication, especially if you’re turning to alcohol and drugs in an attempt to handle the symptoms of PTSD.
Symptoms of PTSD in children and adolescents
In children—especially those who are very young—the symptoms of PTSD can be different than the symptoms in adults. Symptoms in children include:
- Fear of being separated from parent
- Losing previously-acquired skills (such as toilet training)
- Sleep problems and nightmares without recognizable content
- Somber, compulsive play in which themes or aspects of the trauma are repeated
- New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters).
- Acting out the trauma through play, stories, or drawings.
- Aches and pains with no apparent cause
- Irritability and aggression
Post-traumatic stress disorder (PTSD) causes and risk factors
Most people who live through a traumatic or life-threatening event experience some symptoms at first, such as anger, shock, and anxiety. However, not everyone goes on to develop PTSD. While it’s impossible to predict who will develop PTSD in response to trauma, there are certain risk factors that appear to increase a person’s vulnerability to it.
Many risk factors revolve around the nature of the traumatic event itself. Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.
Other risk factors for PTSD include:
|
|
Getting help for post-traumatic stress disorder (PTSD)
If you think that you or a loved one has PTSD, it’s important to seek help right away. This is particularly important if your symptoms are interfering with your work or home life. The faster PTSD is diagnosed and treated, the better the long-term outlook. There are many places you can turn for help, including your family doctor or a mental health professional such as a psychiatrist or counselor.
Unfortunately, many people with PTSD don’t seek out the treatment they need. Some resist treatment because they’re worried what others will think or believe that they should be able to get over the problem on their own. Others aren’t ready to face the trauma and the strong emotions associated with it.
| Why Should I Seek Help for PTSD? | |
Early treatment is better |
Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes. |
PTSD symptoms can change family life |
PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life. |
PTSD can be related to other health problems |
PTSD symptoms can worsen physical health problems. For example, a few studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD you could also improve your physical health. |
Source: National Center for PTSD |
|
If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.
Finding a therapist for PTSD
When looking for a therapist for PTSD, seek out mental health professionals who specialize in the treatment of trauma and PTSD. Beyond credentials and experience, it’s important to find a therapist who makes you feel comfortable and safe, so there is no additional fear or anxiety about the treatment itself. Finding the right treatment provider can take time, but a good place to start is with your doctor. You may also want to ask trusted friends or family members for recommendations. You can also call a local mental health clinic, psychiatric hospital, or counseling center.
Help for U.S. Veterans with PTSD
If you’re a veteran suffering from PTSD or trauma, you can turn to your local VA hospital or Vet Center for help. Vet Centers offer free counseling to combat veterans and their families. To find out more about the resources and benefits available to you, you can also call the VA Health Benefits Service Center at 1-877-222-VETS.
Click here for a nationwide directory of facilities for veterans, including VA hospitals and Vet Centers.
Source: U.S. Department of Veterans Affairs
Treatments for post-traumatic stress disorder (PTSD)
Treatments for PTSD relieve symptoms by helping you deal with the trauma you’ve experienced. Rather than avoiding the trauma and any reminder of it, you’ll be encouraged in treatment to recall and process the event that caused your PTSD. In treatment for PTSD, you’ll also:
- Explore your thoughts and feelings about the trauma
- Work through feelings of guilt, self-blame, and mistrust
- Learn how to cope with and control intrusive memories
- Address problems PTSD has caused in your life and relationships
In addition to offering an outlet for emotions you may have been bottling up, treatment for PTSD will also help restore your sense of control and reduce the powerful hold the memory of the trauma has on your life.
Cognitive-behavioral therapy for post-traumatic stress disorder (PTSD)
Cognitive-behavioral therapy is believed to be the most beneficial treatment for PTSD. There are several types of cognitive-behavioral therapies.
- Exposure therapy - According to a October 2007 report issued by the Institute of Medicine, there is strong evidence for the effectiveness of exposure therapy in PTSD treatment. Exposure therapy for PTSD involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Often, you’ll start by focusing on a memory that is upsetting but still manageable, then slowly work your way up to more upsetting memories in a process known as systematic desensitization. As you think about and re-experience these memories in a safe, controlled environment, they will start to feel less intense and overwhelming.
- Cognitive restructuring – In cognitive restructuring, the focus of treatment is to identity upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replace them with more accurate, balanced views. For example, you may blame yourself for failing to save a fallen comrade, even if you did everything you could. Cognitive restructuring would help you challenge this troubling thought and learn to look at what happened in a healthier way.
- EMDR (Eye Movement Desensitization and Reprocessing) – EMDR incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. For example, in EMDR therapy you might talk about the traumatic event while following your therapist’s finger back and forth with your eyes. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress, leaving only frozen emotional fragments which retain their original intensity. Once EMDR frees these fragments of the trauma, they can be integrated into a cohesive memory and processed.
To learn more, see EMDR Therapy: A Guide to Making An Informed Choice.
Finding a Cognitive-Behavioral Therapist for PTSD
Click here to find a therapist who specializes in cognitive-behavioral therapy. You can narrow your search to therapists who specialize in the treatment of PTSD.
Other therapies for post-traumatic stress disorder (PTSD)
In addition to cognitive-behavioral therapy, you may also benefit from other PTSD treatments, including individual psychotherapy, family therapy, or group therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems.
Medication treatment for post-traumatic stress disorder (PTSD)
Medication is sometimes prescribed to people with PTSD, usually to relieve symptoms of depression or anxiety. The SSRIs, a type of antidepressant that includes drugs such as Prozac and Zoloft, are the medications most commonly used for PTSD. The SSRIs do not cure PTSD, but they may help you feel less sad, worried, and on edge.
Coping with post-traumatic stress disorder (PTSD)
Recovery from PTSD is a gradual, ongoing processing. Healing doesn’t happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many things you can do to cope with residual symptoms or reduce your anxiety level.
Positive ways of coping with PTSD include:
- Learning about trauma and PTSD.
- Joining a PTSD support group
- Practicing relaxation techniques
- Confiding in a person you trust
- Spending time with positive, supportive people
- Avoiding alcohol and drugs
To Learn More: Related Helpguide Articles
|
|
Related links for post-traumatic stress disorder (PTSD)
General information about post-traumatic stress disorder (PTSD)
Post-Traumatic Stress Disorder Research Fact Sheet – Overview of the latest research on PTSD, including its causes, risk factors, and promising new treatments. (National Institute of Mental Health)
Myths and Facts About PTSD – Learn the truth behind common misconceptions about PTSD. (Post-traumatic Stress Disorder Alliance)
How Common is PTSD? – Fact sheet on the prevalence of PTSD in the U.S., including its occurrence in the military. Also includes information on PTSD causes and risk factors. (National Center for PTSD)
Symptoms of post-traumatic stress disorder (PTSD)
Post-Traumatic Stress Disorder Self-Test – Online self-test for PTSD to help you evaluate your symptoms. (Anxiety Disorders Association of America)
The Symptoms of Post-Traumatic Stress Disorder: Chronic and/or Delayed – Description of PTSD’s many symptoms, including withdrawal, avoidance, isolation, and flashbacks. (PTSD Support Services)
Treatment and help for post-traumatic stress disorder (PTSD)
Treatment of PTSD – Guide to the treatments for PTSD, including cognitive therapy, exposure therapy, and EMDR. (National Center for PTSD)
Finding a Therapist – Advice on how to find a therapist for PTSD treatment. Includes questions to ask a potential therapist. (National Center for PTSD)
Therapy for Post-Traumatic Stress and Dissociative Conditions: What to Look for and How to Choose a Therapist – Tips on choosing a therapist and treatments for PTSD. Includes a phone number for referrals. (Sidran)
VVA's Guide on PTSD – Advice for combat veterans on how to get help and claim military benefits. (Vietnam Veterans of America)
Coping with post-traumatic stress disorder (PTSD)
Coping with PTSD and Recommended Lifestyle Changes for PTSD Patients – Tips on how to cope with PTSD in healthy ways that promote healing and recovery. (National Center for PTSD)
Managing Stress and Recovering from Trauma: Facts and Resources for Veterans and Families – Learn how to manage traumatic stress and cope with the symptoms of PTSD. (National Center for PTSD)
Helping a loved one with post-traumatic stress disorder (PTSD)
Returning from the War Zone: A Guide for Families (PDF) – Advice for service members and their families on what to expect and how to adapt after returning home from war. (National Center for PTSD)
Partners with PTSD – Article for the friends and family members of people with PTSD. Includes an explanation of symptoms and what you can do to help. (Gift from Within)
Partners of Veterans with PTSD: Caregiver Burden and Related Problems – Learn how to help a loved one with PTSD while still taking care of yourself. Includes tips for dealing with caregiver burnout. (National Center for PTSD)
Bookmark
Email