What is post-traumatic stress disorder?


What is post-traumatic stress dis­or­der, or PTSD?

PTSD is an anx­i­ety dis­or­der that some peo­ple get after see­ing or liv­ing through a dan­ger­ous event.

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Sara L . Henry, MALMFT

When in dan­ger, it’s nat­ural to feel afraid. This fear trig­gers many split-second changes in the body to pre­pare to defend against the dan­ger or to avoid it. This “fight-or-flight” response is a healthy reac­tion meant to pro­tect a per­son from harm. But in PTSD, this reac­tion is changed or dam­aged. Peo­ple who have PTSD may feel stressed or fright­ened even when they’re no longer in danger.

Who gets PTSD?

Any­one can get PTSD at any age. This includes war vet­er­ans and sur­vivors of phys­i­cal and sex­ual assault, abuse, acci­dents, dis­as­ters, and many other seri­ous events.

Not every­one with PTSD has been through a dan­ger­ous event. Some peo­ple get PTSD after a friend or fam­ily mem­ber expe­ri­ences dan­ger or is harmed. The sud­den, unex­pected death of a loved one can also cause PTSD.

What are the symp­toms of PTSD?

PTSD can cause many symp­toms. These symp­toms can be grouped into three categories:

1. Re-experiencing symp­toms:

* Flashbacks—reliving the trauma over and over, includ­ing phys­i­cal symp­toms like a rac­ing heart or sweat­ing
* Bad dreams
* Fright­en­ing thoughts.

Re-experiencing symp­toms may cause prob­lems in a person’s every­day rou­tine. They can start from the person’s own thoughts and feel­ings. Words, objects, or sit­u­a­tions that are reminders of the event can also trig­ger re-experiencing.

2. Avoid­ance symp­toms:

* Stay­ing away from places, events, or objects that are reminders of the expe­ri­ence
* Feel­ing emo­tion­ally numb
* Feel­ing strong guilt, depres­sion, or worry
* Los­ing inter­est in activ­i­ties that were enjoy­able in the past
* Hav­ing trou­ble remem­ber­ing the dan­ger­ous event.

Things that remind a per­son of the trau­matic event can trig­ger avoid­ance symp­toms. These symp­toms may cause a per­son to change his or her per­sonal rou­tine. For exam­ple, after a bad car acci­dent, a per­son who usu­ally dri­ves may avoid dri­ving or rid­ing in a car.

3. Hyper­arousal symp­toms:

* Being eas­ily star­tled
* Feel­ing tense or “on edge”
* Hav­ing dif­fi­culty sleep­ing, and/or hav­ing angry outbursts.

Hyper­arousal symp­toms are usu­ally con­stant, instead of being trig­gered by things that remind one of the trau­matic event. They can make the per­son feel stressed and angry. These symp­toms may make it hard to do daily tasks, such as sleep­ing, eat­ing, or concentrating.

It’s nat­ural to have some of these symp­toms after a dan­ger­ous event. Some­times peo­ple have very seri­ous symp­toms that go away after a few weeks. This is called acute stress dis­or­der, or ASD. When the symp­toms last more than a few weeks and become an ongo­ing prob­lem, they might be PTSD. Some peo­ple with PTSD don’t show any symp­toms for weeks or months.

Do chil­dren react dif­fer­ently than adults?

Chil­dren and teens can have extreme reac­tions to trauma, but their symp­toms may not be the same as adults. In very young chil­dren, these symp­toms can include:

* Bed­wet­ting, when they’d learned how to use the toi­let before
* For­get­ting how or being unable to talk
* Act­ing out the scary event dur­ing play­time
* Being unusu­ally clingy with a par­ent or other adult.

Older chil­dren and teens usu­ally show symp­toms more like those seen in adults. They may also develop dis­rup­tive, dis­re­spect­ful, or destruc­tive behav­iors. Older chil­dren and teens may feel guilty for not pre­vent­ing injury or deaths. They may also have thoughts of revenge. For more infor­ma­tion, see the National Insti­tute of Men­tal Health (“NIMH”) book­lets on help­ing chil­dren cope with vio­lence and dis­as­ters.

Why do some peo­ple get PTSD and other peo­ple do not?

It is impor­tant to remem­ber that not every­one who lives through a dan­ger­ous event gets PTSD. In fact, most will not get the disorder.

Many fac­tors play a part in whether a per­son will get PTSD. Some of these are risk fac­tors that make a per­son more likely to get PTSD. Other fac­tors, called resilience fac­tors, can help reduce the risk of the dis­or­der. Some of these risk and resilience fac­tors are present before the trauma and oth­ers become impor­tant dur­ing and after a trau­matic event.

Risk fac­tors for PTSD include:

* Liv­ing through dan­ger­ous events and trau­mas
* Hav­ing a his­tory of men­tal ill­ness
* Get­ting hurt
* See­ing peo­ple hurt or killed
* Feel­ing hor­ror, help­less­ness, or extreme fear
* Hav­ing lit­tle or no social sup­port after the event
* Deal­ing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.

Resilience fac­tors that may reduce the risk of PTSD include:

* Seek­ing out sup­port from other peo­ple, such as friends and fam­ily
* Find­ing a sup­port group after a trau­matic event
* Feel­ing good about one’s own actions in the face of dan­ger
* Hav­ing a cop­ing strat­egy, or a way of get­ting through the bad event and learn­ing from it
* Being able to act and respond effec­tively despite feel­ing fear.

Researchers are study­ing the impor­tance of var­i­ous risk and resilience fac­tors. With more study, it may be pos­si­ble some­day to pre­dict who is likely to get PTSD and pre­vent it.

How do I treat PTSD?

The main treat­ments I use for peo­ple with PTSD are psy­chother­apy (some peo­ple might say, “talk” ther­apy) and Neu­ro­feed­back. I make refer­rals for psy­chi­atric treat­ment,  i.e. med­ica­tions, when war­ranted. Every­one is dif­fer­ent, so a treat­ment that works for one per­son may not work for another. It is impor­tant for any­one with PTSD to be treated by a men­tal health care 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 treated. Other ongo­ing prob­lems can include panic dis­or­der, depres­sion, sub­stance abuse, and feel­ing suicidal.

How can I help a friend or rel­a­tive who has PTSD?

If you know some­one who has PTSD, it affects you too. The first and most impor­tant thing you can do to help a friend or rel­a­tive is to help him or her get the right diag­no­sis and treat­ment. You may need to make an appoint­ment for your friend or rel­a­tive and go with him or her to see the doc­tor. Encour­age him or her to stay in treat­ment, or to seek dif­fer­ent treat­ment if his or her symp­toms don’t get bet­ter after 6 to 8 weeks.

To help a friend or rel­a­tive, you can:

* Offer emo­tional sup­port, under­stand­ing, patience, and encour­age­ment.
* Learn about PTSD so you can under­stand what your friend or rel­a­tive is expe­ri­enc­ing.
* Talk to your friend or rel­a­tive, and lis­ten care­fully.
* Lis­ten to feel­ings your friend or rel­a­tive expresses and be under­stand­ing of sit­u­a­tions that may trig­ger PTSD symp­toms.
* Invite your friend or rel­a­tive out for pos­i­tive dis­trac­tions such as walks, out­ings, and other activ­i­ties.
* Remind your friend or rel­a­tive that, with time and treat­ment, he or she can get better.

Never ignore com­ments about your friend or rel­a­tive harm­ing him or her­self, and report such com­ments to your friend’s or relative’s ther­a­pist or doctor.

How can I help myself?

It may be very hard to take that first step to help your­self. It is impor­tant to real­ize that although it may take some time, with treat­ment, you can get better.


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