What Is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health disorder caused by experiencing or witnessing a dangerous, frightening, or traumatic event. After the trauma occurs, the person with PTSD may experience many physical, mental, and emotional changes in response to the event.

What Is A Traumatic Event?

According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), a traumatic event includes actual or threatened death or serious injury or seeing such an event firsthand. There are other types of trauma, including secondary trauma, which occurs when someone experiences distress after seeing or hearing about a traumatic event.

Symptoms Of PTSD

There are many signs and symptoms associated with PTSD. Symptoms are categorized into sections, including:

• Intrusive memories
• Avoidance of stimuli associated with the trauma
• Negative alterations in cognition and mood associated with the trauma
• Noticeable alterations in arousal
• Reactivity associated with the trauma

Because there is such a wide variety of symptoms, PTSD can present differently for different people. It is helpful to know more about the symptoms so you or your loved one can get the education and help they need to heal.

Intrusive Memories

Intrusive symptoms may include experiencing:

• Upsetting memories about the trauma
• Nightmares
• Dissociative reactions such as flashbacks
• Psychological distress when exposed to cues, or reminders, associated with the trauma

Other dissociative reactions might include not being aware of one’s surroundings due to the memories seeming so real and experiencing periods where one feels as though they are outside of their body.

Avoidance

Avoidant symptoms include consistent avoidance of stimuli associated with the traumatic events, including:

• Avoiding distressing memories, thoughts, or feelings connected to the trauma
• Avoiding external reminders that bring on thoughts or feelings related to the trauma
• Avoiding places and people connected to the trauma

Negative Changes in Thinking and Mood

Symptoms of changes in thinking and mood include:

• Difficulty remembering important parts of the traumatic event
• Unrealistic thoughts about the cause or consequences of the trauma
• Being in a persistent negative state
• Significantly decreased interest or participation in activities
• Feelings of detachment from others
• Struggling to experience positive emotions
• Consistent and extreme negative beliefs about oneself, others, or the world in general

These symptoms can make it very challenging to enjoy and participate in activities and hobbies a person previously enjoyed and participated in. These symptoms can be similar to and overlap with symptoms of depression.

Changes in Physical and Emotional Reactions

Lastly, physical and emotional PTSD signs may include:

• Irritable behavior
• Angry outbursts
• Reckless or self-destructive behavior
• Sleep disturbances
• Hypervigilance

Hypervigilance can present in many ways, but one example is that someone may feel that when they go out to eat at a restaurant, they need to sit facing the door to feel safe. An exaggerated startle response may look like someone being jumpy for no obvious reason.

Symptoms Of PTSD In Children

Symptoms of PTSD in children are similar to those experienced in adults. However, there are important differences to note:

• What is considered traumatic for a child: A traumatic event for a child can include learning that a traumatic event occurred to a parent or caregiver, so the part about experiencing or witnessing a traumatic event is unnecessary for children to meet the full criteria for a PTSD diagnosis. Just hearing a loved one share about a traumatic event that happened to them is enough to consider a PTSD diagnosis for a child if other symptoms are present as well.
• The type of trauma: Children may be more likely to experience certain types of trauma than adults. For example, children are more likely to experience neglect and have less control of the situation if their caregivers use substances, which could lead to traumatic events. Also, fears of abandonment often stem from one’s childhood, so this is another important example of how trauma that occurs when one is a child can have very long-lasting effects.

Trauma can have a significant impact on one’s life, including when the trauma stems from childhood. It is important to be aware of symptoms and to take them seriously so you or your loved one can get the support needed as soon as possible.

Complications Of PTSD

PTSD and its associated symptoms can last for a long time. Also, symptoms can improve for some time and then flare up again later. Because there is such a variety of symptoms, the effects of PTSD can affect someone in many ways. For example, if someone is struggling to sleep and experiences hypervigilance due to PTSD, they are likely to experience things like significant fatigue and muscle tension as well. These symptoms can affect one’s academic and work performance, social life, relationships with family members, and ability to take care of oneself.

What Are The Risk Factors For PTSD?

Certain groups of people may be more at risk of PTSD. For example:

• Women are more likely than men to develop PTSD.
• Veterans are also more likely than civilians to be diagnosed with PTSD.
• For children, even hearing about a traumatic event that a loved one experienced could put them at a heightened risk of experiencing symptoms of PTSD.
• First responders are also at a higher risk of being diagnosed with PTSD at some point in their lives.

It’s important to remember that anyone can experience a traumatic event and develop PTSD, but various factors like one’s gender, age, and occupation can create elevated risk factors.

How Is PTSD Diagnosed?

PTSD may be diagnosed after meeting with a therapist, psychiatrist, psychologist, or other qualified provider. The provider will likely assess you by asking many questions about the symptoms you experience as well as your background and history. Then, the provider will use the information they have gathered, along with the DSM-5, to make an assessed and well-informed diagnosis.

There are also other measures and more concrete assessments that specifically assess for PTSD, including:

• The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
• The PTSD Symptom Scale Interview (PSS-I and PSS-I-5)
• The Davidson Trauma Scale (DTS)
• The Impact of Event Scale-Revised (IES-R)

These are often used in combination with the information that is gathered during the assessment about one’s symptoms, background, and overall history.

Types Of PTSD

Post-traumatic stress disorder is one of the more well-known trauma and stress-related disorders, but there are several others. Some of these include the following:

• Complex PTSD (C-PTSD) occurs when the trauma occurs repeatedly or is prolonged. The symptoms of PTSD and C-PTSD are very similar, but with C-PTSD, the symptoms may be more noticeable and could potentially last for longer periods.
• Acute stress disorder occurs after someone has experienced trauma. It differs from PTSD because symptoms last for only a short period of time.
• Adjustment disorders are diagnosed when someone experiences a stressor and then experiences symptoms of depression and/or anxiety after the stressor occurs. If the symptoms of depression and/or anxiety continue for longer than six months, then a diagnosis of PTSD is reconsidered.
• Reactive attachment disorder (RAD) is typically diagnosed in children. Children diagnosed with RAD often have a history of significant trauma, including trauma that made it challenging for the child to bond securely with an adult caregiver from a young age.
• Disinhibited social engagement disorder is also typically diagnosed in children and is an attachment disorder as well. Children with this diagnosis often have a history of significant trauma and seem to have limited or no fear of strangers.
• Other specified trauma-and stressor-related disorders, which are diagnosed when one is experiencing symptoms similar to those of PTSD but does not meet the full criteria for such a diagnosis.
• Unspecified trauma-and-stressor-related disorders, which are diagnosed when one is experiencing symptoms similar to those of PTSD but does not meet the full criteria for such a diagnosis.

How Common Is PTSD?

About 6% of the U.S. population will have PTSD at some time in their lives. However, this percentage may be higher as not everyone is aware that they meet the criteria for a diagnosis of PTSD, and others may not report it even if they are aware of their diagnosis.

Because some people are diagnosed with a different mental health diagnosis first, such as adjustment disorder, this could affect the accuracy of these percentages as well.

How Is PTSD Treated?

There are many mental health treatment options available for PTSD. Each individual must find the treatment or combination of treatment options that best fits them. This can take some time and trial-and-error while the individual meets with different providers and tries many techniques until they settle on the one that works for them. It is common for an individual to need to try meeting with several providers before finding someone who compliments their style and personality.

Cognitive Processing Therapy

Cognitive processing therapy (CPT) is a trauma-focused psychotherapy approach that helps people experiencing symptoms of PTSD to challenge and change beliefs related to trauma that are harmful to them. There is a lot of research evidence to support this technique, and this is one of the main therapeutic strategies recommended to treat PTSD.

Cognitive processing therapy usually occurs over 12 sessions and begins with the client learning about PTSD and how thoughts, behaviors, and emotions are connected. The next step is for the client to write an impact statement about their trauma, why they think it occurred, and how it has affected their perspective.

The client then spends the next several sessions reading through their statement to process what happened and learn healthy coping skills they can use while experiencing distress stemming from thinking about and processing the trauma. At the end of the process, clients may review how their beliefs have changed during the CPT process.

Eye Movement Desensitization and Reprocessing (EMDR) Therapy

During the eye movement desensitization and reprocessing (EMDR) process, therapists lead clients through various procedures to stimulate brain activity on both sides of the brain. This is believed to help the brain heal and process trauma naturally. The most common procedure is to guide the client in moving their eyes from side to side. EMDR takes place over several sessions and in eight phases.

It is important for those participating in EMDR therapy to have a solid foundation of healthy coping skills before beginning the process because bringing up traumatic memories and spending a lot of time and energy focusing on those challenging memories can trigger side effects, such as irritability and flashbacks. So, having a variety of coping skills and tools to use while going through that process can be extremely helpful.

Lastly, some people who participate in EMDR therapy engage in regular psychotherapy sessions as well to have enough time and space to process what is happening and how they have been feeling during their EMDR sessions. Some EMDR providers are comfortable with one meeting with a different provider for regular psychotherapy, while others require that they be the provider for both the EMDR sessions and the regular psychotherapy sessions.

It is important to speak with your provider about their requirements so that everyone is on the same page and feels as comfortable as possible throughout the emotionally challenging process.

Group Therapy

Group therapy occurs when multiple people meet with a therapist to listen to one another, share their stories, and give and receive support from others who share common experiences. Sessions are guided by a therapist, but much of the time, clients share and support one another by actively listening, validating one another, and offering feedback and ideas.

Some groups are offered to those experiencing many symptoms with a variety of diagnoses, while other groups are specific. For example, some groups are aimed at those with PTSD, those who are military veterans, and those who are grieving.

Prolonged Exposure Therapy

Prolonged exposure (PE) therapy is a type of talk therapy that can be empowering for those who have experienced trauma. The main focus of this therapy is to encourage clients to think about and share the trauma they have experienced at a pace that is safe for them to help clients face the trauma rather than avoid it.

This is another effective technique that occurs over 8-15 weeks, with one therapy session per week. PE therapy also includes the use of healthy coping skills so clients can feel more comfortable as they share and process the trauma they have experienced.

Trauma-Focused CBT

Trauma-focused cognitive behavioral therapy (CBT) includes several types of therapy techniques, including cognitive therapy for posttraumatic stress disorder (CT-PTSD), prolonged exposure (PE) therapy, and cognitive processing therapy (CPT).

These strategies are beneficial for treating symptoms of PTSD because they focus on processing the trauma by having the client share what happened and how this has affected their perspective on themselves, others, and the world. There are also educational parts to this strategy, as clients learn more about trauma and how thoughts, behaviors, and emotions connect to and impact one another.

Clients also learn various healthy coping strategies and learn more about how to become aware of and identify their triggers so they can prepare and cope better.

Medication For PTSD

Antidepressants are often used in the treatment of PTSD.

• Serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor) have been found to be helpful as well.
• Selective serotonin reuptake inhibitors (SSRIs) like Sertraline (Zoloft) and paroxetine (Paxil) have been found to be effective in treating PTSD.

When considering getting a prescription for PTSD treatment medication, it is important to be aware of any potential side effects or interactions that could occur. It is also very important to speak with your doctor or prescribing physician before changing the medication you are taking, such as changing the dose or timing.

Can PTSD Be Prevented?

Since a traumatic event is what triggers symptoms of PTSD, it is impossible to say that the disorder can be fully prevented. However, prevention techniques like having support, knowing the signs, and accessing further resources and support can help one to manage their symptoms of PTSD better.

For children, since even hearing about a trauma that occurred to a loved one may put them at risk of PTSD, it may help to have a support system in place and have a solid foundation of healthy coping skills built up before sharing information that could potentially be traumatizing for them.

When Should I See My Healthcare Provider?

If you or a loved one are experiencing symptoms of PTSD, you should reach out to your healthcare provider as soon as possible. They will be able to provide you with more information, perform an assessment, and give you access to resources and treatment options that can help you start your healing journey.