People with PTSD experience re-living the trauma through unwanted memories, nightmares, or flashbacks. Other symptoms include difficulty sleeping, irritability, poor concentration, and being easily startled. It is normal to be upset after a traumatic event, such as an assault or the death of a loved one. But if you have PTSD, your feelings last longer than a few months and interfere with your daily life.
Symptoms
PTSD symptoms may include upsetting memories or flashbacks, being jumpy or easily startled, having trouble falling or staying asleep, feelings of anger, guilt, shame, or vulnerability, and thoughts about suicide. These feelings may not go away if the person does not receive treatment. People who have PTSD often withdraw from family and friends. They may not be able to work or study as well as they used to. They may feel they do not deserve to be loved or that others do not want them around. This can lead to drug and alcohol abuse.
Most people who experience a life-threatening event or trauma will have some PTSD symptoms. However, if these symptoms last for more than a month and interfere with everyday living, a person should get treatment.
Many people who are treated for PTSD find their symptoms improve or disappear with time. For some, this can take years. There are also things a person can do for themselves that help.
There are 4 types of PTSD symptoms. Some of the most common are: Avoiding people, places, and thoughts that remind you of the trauma, having difficulty with memory, feeling jumpy or easily startled, and having problems concentrating. There are other symptoms, but these are less common.
People with PTSD may have nightmares about the event and feel that it is happening again. They may have physical reactions such as sweating or heart palpitations. They may be very angry and have difficulty relating to people. Some people with PTSD have auditory hallucinations such as ringing in the ears (tinnitus) or hearing voices that are not there. Some people with PTSD have paranoid ideation and believe others are trying to harm or steal their possessions.
There are different types of talking therapy that can help with PTSD. These include Prolonged Exposure, where you talk about the event until it becomes less upsetting; Eye Movement Desensitization and Reprocessing, where you focus on sounds or hand movements while talking; and Cognitive Behavioural Therapy. Medications can be used, but they are usually only used if the PTSD is very severe and psychological treatments do not work.
Diagnosis
A person can get PTSD after experiencing or witnessing a terrifying event. It can happen after a serious accident, sexual assault, an attack from someone with a weapon, physical or emotional abuse, a natural disaster, a car crash, or being in a war zone.
Symptoms can be mild or severe. They can last for months or years and affect work, school, or family life. PTSD can make it hard to sleep and think clearly. People with PTSD may also have self-destructive or suicidal behaviors. Getting help early can stop a person from having these symptoms get worse or keep them from going away.
Health care providers who have special training in evaluating and treating mental illnesses can diagnose PTSD. Doctors and psychologists use specially designed interview and assessment tools to find out if a person has PTSD. They also ask about other problems like depression or anxiety. A physical examination will be done to rule out a medical illness that could cause the symptoms.
The doctor will want to know when the traumatic event happened and how long the symptoms have been happening. The doctor will also want to know if the symptoms have interfered with daily functioning. The doctor will decide if the symptoms meet the criteria for PTSD:
- Intrusion symptoms
- Avoidance symptoms
- Negative changes in cognition and mood
- Alterations in arousal and reactivity
A doctor will explain how a diagnosis of PTSD is made. They might say that you have mild, moderate, or severe PTSD. They might say that you have delayed-onset PTSD if the symptoms started more than six months after the trauma. They might also describe the kind of trauma you experienced, such as complex trauma or childhood trauma.
Talk therapy (sometimes called psychotherapy or counseling) and medicine can help treat PTSD. People who have PTSD should take part in a treatment program right away. It is important to have support from family and friends who understand what you’ve gone through. It’s also important to do things that reduce stress, like exercise and practicing mindfulness.
Treatment
When people experience something traumatic, their sense of safety and trust is shaken. Fear is a natural reaction to an event like this, and it helps us protect ourselves from danger. However, if the fear doesn’t subside over time or causes problems at home and work, it may be a sign of PTSD.
Most people with PTSD have psychotherapy to help them understand and deal with the disorder. It’s important to get treatment early. If you don’t have a mental health professional, the Substance Abuse and Mental Health Services Administration has an online tool to find treatment professionals.
Many different types of therapies are effective for PTSD. These include talking treatments, such as individual therapy or group therapy, which can help you talk about your trauma and learn ways to manage your reactions. Other psychotherapies are more focused on how the traumatic events affect you, your relationships, and your life. Examples are interpersonal therapy, family therapy, and psychodynamic therapy.
Eye movement desensitization and reprocessing (EMDR) is a type of talking therapy that helps you process the memories of your trauma so they’re less upsetting over time. In this therapy, a therapist guides you through questions about your traumatic experiences while you watch the movements of your eyes, similar to those during REM sleep.
Prolonged exposure therapy encourages you to confront thoughts, feelings, and situations you’ve been avoiding. It’s a difficult approach, but it can help you gain control over the lasting fear that comes with PTSD.
Medications can also be helpful for some people with PTSD. Some antidepressants have been shown to reduce PTSD symptoms, especially in people with depression. For example, selective serotonin reuptake inhibitors, such as sertraline (Zoloft) or paroxetine (Paxil), can be useful for some people with PTSD.
It’s also possible to reduce the symptoms of PTSD with lifestyle changes, including exercise, regular sleep, and healthy eating habits. Taking steps to reduce stress, such as practicing mindfulness or using relaxation techniques, can also be beneficial. Finally, it’s a good idea to stay connected to family and friends and find positive activities to participate in.
Prevention
While the cause of PTSD is not fully understood, there are many things that contribute to its development. It is usually triggered by experiencing or witnessing an event that involves actual or threatened death or serious injury, including sexual violation. People who have PTSD often avoid people, places, and activities that remind them of the trauma. They also may have difficulty talking about what happened or how they feel about it.
Several psychological and pharmacological interventions have been studied for the prevention of PTSD in adults. These include psychoeducational and skills-based training in coping and emotion regulation (KQ1 of Figure 1), anxiety reduction and relaxation, traumatic stress reaction recognition and response, choice-making, and emotional expression. The effectiveness of these interventions has varied, depending on factors such as age, gender, psychiatric comorbidities, and level of exposure to traumatic events or their aftermath.
In addition to these preventive measures, researchers are exploring genetic interventions, which have the potential to reduce a person’s vulnerability for developing PTSD after a traumatic event. This includes studying DNA methylation and epigenetic changes in the brain, which can be influenced by exposure to stressors and may lead to lasting risk.
The overall goal is to develop an integrated approach that can provide optimal symptom relief and help people return to work and military duty as soon as possible. PTSD can be a severe burden to individuals, families, communities, and the nation, and it is important that we continue to improve the prevention and treatment of this disorder.
Currently, most PTSD research has focused on returning veterans; this reflects the fact that most traumatic events in recent decades have been military-related, such as wars in Afghanistan and Iraq. However, PTSD can affect all ages, including children. Children and adolescents are particularly vulnerable to the effects of traumatic events, such as abuse and neglect, car accidents, natural disasters, violence, terrorism, life-threatening illness or medical procedures, and witnessing a traumatic event. The incidence of PTSD in children and adolescents is higher than that for adults, and the impact on their lives can be profound.
