As a human being, there are always risks that put your life in danger. Most people are lucky enough to avoid these dangers and live a nice and safe life. But in some cases, you may experience a life trauma – either physically or emotionally – and this can cause an anxiety problem known as post-traumatic stress disorder.
As the name implies, PTSD is an anxiety disorder that comes after the traumatic event has occurred. Those living with PTSD often must get outside help, because PTSD can affect people for years after the event occurs – possibly even the rest of their life.
PTSD affects people both psychologically and physically. In most cases, the person with PTSD is the one that experienced the traumatic event, but it’s possible to get PTSD by simply witnessing an event or injury, or even simply discovering that someone close to you dealt with a traumatic event.
Post-Traumatic Stress Disorder (PTSD) Causes
You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.
Doctors aren’t sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:
- Stressful experiences, including the amount and severity of trauma you’ve gone through in your life
- Inherited mental health risks, such as a family history of anxiety and depression
- Inherited features of your personality — often called your temperament
- The way your brain regulates the chemicals and hormones your body releases in response to stress
Post-Traumatic Stress Disorder (PTSD) Symptoms
PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years later. The disorder is characterized by three main types of symptoms:
- Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
- Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
- Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.
Diagnosis criteria that apply to adults, adolescents, and children older than six include those below. Read more details here.
Exposure to actual or threatened death, serious injury, or sexual violation:
- directly experiencing the traumatic events
- witnessing, in person, the traumatic events
- learning that the traumatic events occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental
- experiencing repeated or extreme exposure to aversive details of the traumatic events (Examples are first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless exposure is work-related.
The presence of one or more of the following:
- spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events (Note: In children repetitive play may occur in which themes or aspects of the traumatic events are expressed.)
- recurrent distressing dreams in which the content or affect (i.e. feeling) of the dream is related to the events (Note: In children there may be frightening dreams without recognizable content.)
- flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring (Note: In children trauma-specific reenactment may occur in play.)
- intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
- physiological reactions to reminders of the traumatic events
Persistent avoidance of distressing memories, thoughts, or feelings about or closely associated with the traumatic events or of external reminders (i.e., people, places, conversations, activities, objects, situations)
Two or more of the following:
- inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
- persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”).
- persistent, distorted blame of self or others about the cause or consequences of the traumatic events
- persistent fear, horror, anger, guilt, or shame
- markedly diminished interest or participation in significant activities
- feelings of detachment or estrangement from others
- persistent inability to experience positive emotions
Two or more of the following marked changes in arousal and reactivity:
- irritable or aggressive behavior
- reckless or self-destructive behavior
- exaggerated startle response
- problems with concentration
- difficulty falling or staying asleep or restless sleep
Also, clinically significant distress or impairment in social, occupational, or other important areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition, such as traumatic brain injury.
Post-Traumatic Stress Disorder PTSD Treatment
Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but can also include medication. Combining these treatments can help improve your symptoms by:
- Teaching you skills to address your symptoms
- Helping you think better about yourself, others and the world
- Learning ways to cope if any symptoms arise again
- Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs
You don’t have to try to handle the burden of PTSD on your own.
Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include:
- Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.
- Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.
- Eye movement desensitization and reprocessing (EMDR). EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.
Your therapist can help you develop stress management skills to help you better handle stressful situations and cope with stress in your life.All these approaches can help you gain control of lasting fear after a traumatic event. You and your mental health professional can discuss what type of therapy or combination of therapies may best meet your needs.You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.
Several types of medications can help improve symptoms of PTSD:
- Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
- Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
- Prazosin. If symptoms include insomnia with recurrent nightmares, a drug called prazosin (Minipress) may help. Although not specifically FDA approved for PTSD treatment, prazosin may reduce or suppress nightmares in many people with PTSD.
You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks.Tell your doctor about any side effects or problems with medications. You may need to try more than one or a combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for you.