The is a mental health problem triggered by a frightening situation, whether you have experienced it or witnessed it. Some examples are natural disasters, serious accidents, terrorist acts, a combat deployment during war, life-threatening situations, sexual violence, a serious injury.
While anyone can suffer from it, it is reported that women are twice as likely to be diagnosed with PTSD as men. Latinos, African Americans, and Native Americans also have disproportionately higher rates of PTSD.
Symptoms may include flashbacks, nightmares, and severe distress, as well as uncontrollable thoughts about the situation. If symptoms worsen, last for months or even years, and interfere with your daily activities, you may have PTSD.
Getting effective treatment can be essential to reducing symptoms and improving your quality of life.
How does PTSD manifest?
PTSD can be different for each person. You may feel panic, fear, or have palpable reactions in the present moment to something traumatic from your past.
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While many people experience trauma, not everyone develops PTSD.
The signs and symptoms of PTSD may be frequent, intermittent, or rare, but they may feel as strong now as they did during the traumatic event.
The symptoms fall into four categories:
- Intrusion: Symptoms of intrusion may include flashbacks, nightmares, or distressing memories of events. These are unwanted and involuntary symptoms that can cause physical effects such as rapid heartbeat or sweating.
- Avoidance: You can avoid places, people, and situations that may trigger panic or memories of the traumatic event. You can also stay away from anything related that reminds you of the trauma, such as certain types of movies.
- Arousal and reactivity: Arousal symptoms are constant, rather than caused by a trigger. This may include persistent stress or anger. Reactivity involves changes in the way you react to certain situations. You may start easily or feel nervous. Both arousal and reactivity can lead to sleep problems and harmful coping behaviors.
- Changes in thoughts and mood: This could manifest as confidence issues, new and negative self-perceptions, or continually feeling “on guard.”
I heard a new term: PTSD. What is the difference?
Experts have recognized for some time that some types of trauma can present with additional symptoms. Complex PTSD is a longer-lasting form of PTSD that usually develops from ongoing trauma (such as experiencing childhood abuse).
There is some debate as to whether it is a formal subtype of PTSD or whether it should be considered a completely separate condition.
CPTSD is not found in the US-based Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but is listed in the .
If you are experiencing complex PTSD, you are more likely to have memory lapses or feel detached from your own body (dissociation), along with the other symptoms of PTSD.
You are more likely to develop complex PTSD if you:
- you experienced trauma at a young age
- the trauma lasted a long time
- escape or rescue was unlikely or impossible
- you have experienced multiple traumas
- you were hurt by someone close to you
How is PTSD diagnosed?
PTSD is diagnosed using very specific criteria because it is often overlapped or misdiagnosed for similar conditions.
To receive a diagnosis of PTSD, a mental health professional will look for at least:
- 1 recurring symptom
- 1 avoidance symptom
- 2 symptoms of excitement and reactivity
- 2 cognition and mood symptoms
The above must be present for at least 1 month and be severe enough to interfere with things in your life, such as relationships or work.
Over the years, research has begun to investigate blood tests to more accurately diagnose PTSD (Aspesi & Pinna, 2018).
How long does PTSD last?
A: According to the National Institute of Mental Health, some people recover in , while others have symptoms that last much longer.
Previous research states that the amount of time someone has PTSD symptoms may depend on proximity to the trauma, the duration and intensity of the trauma, and the subjective interpretation of that trauma (Grinage, 2003).
Research also suggests that for people receiving regular treatment, the average duration of symptoms was around 3 years. In people who were living without a diagnosis or who were not actively seeking treatment, symptoms persisted for about five and a half years.
What is it about these life or death events that cause PTSD in some and not others?
Of people who survive trauma, 25 to 30% develop PTSD (Grinage, 2003).
PTSD can occur for several reasons, including:
- Changes in the brain: The brain areas involved in PTSD are the amygdala, hippocampus, and prefrontal cortex. PTSD can cause lasting changes in these areas of the brain.
In people with PTSD, the hippocampus appears smaller, which may not leave adequate space for flashbacks and nightmares to be fully processed (Akiki et al., 2017). Unprocessed memories can mean that anxiety stays fresh over time. People with PTSD may also have elevated levels of cortisol (the stress hormone).
- Coping mechanism: PTSD symptoms may be the result of an innate survival mechanism that aims to help you survive possible trauma in the future.
Your brain may dwell on a past traumatic event in detail, so it’s better prepared if it happens again, or something similar. Especially when it comes to symptoms of excitement, nervousness is the body’s way of creating preparedness, helping it react in another crisis.
Your body’s survival mechanism activates the sympathetic nervous system. It’s like a fire hydrant. You do your job to help put out the fire, but you need a firefighter to provide the tools to put it out. The same can be said for PTSD therapy and treatments that help your body transition into its relaxation response by activating the parasympathetic nervous system.
- Anxiety or depression: If you have had depression or anxiety in the past, you are more likely to develop PTSD after a traumatic event. According to research, there may also be a genetic factor involved (“Traumatic stress: effects on the brain”, 2006). If your mother or father has a mental health condition, this may increase your chances of developing PTSD.
Is it helpful for people with PTSD to talk about trauma? Should I offer them a venting session?
Talking therapies are helpful for people with PTSD to talk about the trauma, their symptoms, and work through it, but this is done with a professional. It is not recommended that you try to get the story out of someone you know or love. Allow them to open up in whatever way they feel comfortable.
There may be times when someone you know lets you into their lived experience.
Perhaps they are explaining some seemingly out-of-character behavior of yours recently. Or maybe they’re being transparent about what’s on their mind when you ask them what they were thinking about when they seemed lost in thought.
Just remember: Unsolicited insistence can violate a person’s boundaries, increase PTSD symptoms, and ruin your sincere intentions to support them.
What is the treatment for PTSD?
Trauma-focused therapies, which typically last between 8 and 16 sessions, include:
- trauma-focused cognitive behavioral therapy (TF-CBT)
- eye movement desensitization and reprocessing (EMDR)
- prolonged exposure therapy
- cognitive restructuring.
Your doctor may also recommend antidepressants to relieve some of your symptoms. Common types include:
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- selective serotonin reuptake inhibitors (SSRIs)
Anyone can develop PTSD: it begins with a single or ongoing traumatic event in which someone was in real danger, perceived a threat to their life, or witnessed danger or violence.
Historical injustices, along with economic and healthcare inequalities, can lead to higher rates of PTSD in some people. Pre-existing mental health conditions and genetic components may also play a role in the development of this condition.
Receiving a PTSD diagnosis is a first step to healing. Psychotherapy, medications to treat related symptoms, and a support system can help reduce the severity and duration of your condition.
Bibliographic references:
- Akiki, TJ, Averill, CL, Wrocklage, KM, Schweinsburg, B., Scott, JC, Martini, B., Averill, LA, Southwick, SM, Krystal, JH, & Abdallah, CG (2017). The Association of PTSD Symptom Severity with Localized Hippocampus and Amygdala Abnormalities. Chronic Stress (Thousand Oaks, Calif.), 1. https://doi.org/
- Aspesi, D., & Pinna, G. (2018). Could a blood test for PTSD and depression be on the horizon? Expert Review of Proteomics, fifteen(12), 983-1006. https://doi.org/
- Grinage, B. D. (2003). Diagnosis and management of post-traumatic stress disorder. American Family Physician, 68(12), 2401-2408.
- Traumatic stress: effects on the brain. (2006). In Dialogues in Clinical Neuroscience (Vol. 8, Number 4, pp. 445-461). https://doi.org/
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