Posttraumatic Stress Disorder (PTSD): All You Need To Know

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may develop in individuals who have been exposed to (experienced or witnessed) a stressful or traumatic event. PTSD can disrupt an individual's whole life - their health, their job, their relationships, and their enjoyment of everyday activities.

Some of the examples of such distressing and traumatic events that could lead to PTSD may include:

• Child abuse
• Domestic violence
• Stalking
• Bullying and discrimination
• Natural disasters
• Pandemics
• A severe car accident
• A plane crash
• The sudden death of a loved one
• A miscarriage
• A sexual assault
• Being diagnosed with a severe injury or a life-threatening illness
• A terroristic act
• A war combat
• Living in an area affected by conflict/war
• A job where a person repeatedly witnesses distressing things, such as working in the armed forces or emergency services.

Before the term PTSD appeared and was added by the American Psychiatric Association added to its diagnostic manual of mental conditions in the 1980s, some other terms were used to describe the disorder. The British psychologist Charles Samuel Myers coined the term “shell shock” during the years of World War I.

After World War II, the disorder received the names “combat fatigue”, “battle fatigue”, and “battle neurosis”. Later, psychologists came to the conclusion that PTSD does not just happen to war veterans. As a matter of fact, PTSD may even occur in some people who have only been threatened with serious physical injury, sexual violence, and/or death. Some individuals also manifest symptoms of post-traumatic stress disorder after witnessing a trauma-inducing event from a distance.

If a person develops PTSD while supporting a loved one who has gone through a traumatic event, this phenomenon is called “secondary trauma” or “secondary traumatic stress”. Although someone else and not that individual experienced the primary trauma, it does not mean it is less significant or easier to deal with than other kinds of PTSD.

It is worth bearing in mind that most individuals who have been exposed to an event that traumatized them often have symptoms similar to those of PTSD in the first days or even weeks after the incident. Symptoms must last for one month or more, and they must be severe enough to interfere with important aspects of daily life for a person to be diagnosed with PTSD. A significant number of people develop the disorder symptoms within three months after the trauma. In other people, symptoms may appear later and persist for months and sometimes even years.

If you think you or someone you know may have PTSD, we strongly recommend you consult a mental health professional. But if you also want to make a simple and quick assessment, we suggest you take this reliable and free PTSD Test.

Symptoms of post-traumatic stress disorder may vary in severity and intensity. Individuals suffering from PTSD may manifest more symptoms when they are extremely stressed or when they stumble upon reminders of what they have gone through. Usually, PTSD symptoms are grouped into the following four categories: intrusive memories, negative alterations in thinking and mood, avoidance, and alteration in arousal (negative changes in physical and emotional reactions).

The most common symptoms of intrusive memories are the following:

• Repeated involuntary memories of the shocking event;
• Flashbacks (reliving or re-seeing the frightening event as if it were happening again and again);
• Distressing dreams/nightmares about the distressing event;
• Severe emotional pain or physical reactions to things that remind the individual of that event.

The most common symptoms of negative alterations in thinking and mood are as follows:

• Negative thoughts leading to distorted beliefs about oneself, other people, or the world in general (for example, “I am a bad person”, “You cannot trust anyone in today's world”;
• Self-blame (or unjustly blaming someone else) for the disturbing event;
• Hopelessness about the future;
• Inability to remember important aspects of the frightening event the individual experienced;
• Little or no interest in activities loved and enjoyed in the past;
• Feeling estranged from other people, including family, close friends, a romantic partner, and difficulty maintaining close relationships with them;
• Emotional numbness, inability to experience positive emotions.

The most common symptoms of avoidance are the following:

• Constant attempts to avoid remembering, thinking, or talking about the distressing event the individual endured;
• Repeated attempts to avoid places, activities, or people that remind the person of the frightening event.

The most common symptoms of alteration in arousal are as follows:

• Self-destructive behaviors, such as excessive drinking, drug use, or careless and dangerous driving;
• Difficulty sleeping;
• Trouble concentrating;
• Constantly feeling tense or “on the edge”;
• Impulsive outbursts of anger resulting in verbal and/or physical violence;
• Constant fear and suspicion, even when not in danger;
• Being overly watchful of one's surroundings;
• Self-harming or even suicidal thoughts.

According to considerable research, only about 30% of people who have been exposed to terrifying events develop PTSD. Scientists do not know all the answers yet as to why some people develop this mental condition and others do not. However, it is worth noting that people who have experienced interpersonal violence such as stalking, kidnapping, rape, or any other kind of sexual assault, physical abuse by a parent, sibling, or romantic partner, incest, any other form of child sexual abuse, or adult sexual exploitation, are more likely to suffer from PTSD than those who have lived through non-assault based potentially traumatic events.

PTSD has no age preference. As for gender, there is an interesting tendency. While men go through accidents more often, women are typically more likely to develop the condition after having experienced shocking events like domestic violence, sexual assault, etc. There are also many other factors that play a role in whether an individual will develop post-traumatic stress disorder or not. Risk factors make a person much more likely to get PTSD. Resilience factors, on the contrary, may help reduce the risk of developing PTSD.

Here below are listed some risk factors that may increase the likelihood of an individual developing this condition:

• Previous traumatic experiences: individuals who have experienced trauma in the past, such as child abuse, a car accident, a natural disaster, a rape, or any other act of violence, are more susceptible to developing PTSD than people who have never been exposed to traumatic events before since the distress caused by trauma can have a cumulative effect;
• Family history of PTSD and/or depression: a family history of PTSD, depression or other mental health issues may also be a significant risk factor;
• History of substance abuse: individuals with a history of substance abuse, such as alcohol and/or drug use disorder, are more likely to develop PTSD - substances may interfere with one's ability to cope with the stress caused by a shocking event;
• Lack of social support: according to numerous research, supportive social and familial relationships can help people reduce the effects of trauma; on the contrary, individuals who do not have that kind of support, tend to be more vulnerable to PTSD after experiencing scary events;
• Unhealthy coping mechanisms: coping mechanisms (or coping skills) can play a role in an individual's susceptibility to the condition; people who have unhealthy coping mechanisms are more susceptible to post-traumatic stress disorder because they may have little sense of control over their circumstances;
• Having to deal with extra stress after the disturbing event: for example, as a result of a terrorist attack, in addition to the shock, a person has to cope with a severe injury or has lost a family member or a home.

Some individuals suffering from PTSD have also other related conditions, such as depression, memory problems, substance use disorder, and other physical and mental health issues. Here below are some of these conditions.

Acute Stress Disorder

Acute stress disorder (ASD),also known as acute stress reaction or simply shock is a mental health issue that occurs due to an individual’s reaction to a distressing or traumatic life event, such as exposure to serious injury, sexual violence, or threatened death by either witnessing it or living it, just like PTSD does. The symptoms of both disorders are, in fact, similar. However, the symptoms of ASD can appear between three days and one month after the frightening event. Overall, within one month after the event, survivors show rates of ASD ranging from 6% to 33%, depending on their type of trauma. If a person has ASD, they are likely to develop PTSD. According to research, over 50% of individuals suffering from ASD get PTSD within six months. However, just like not everyone with ASD will develop PTSD, some individuals who did not have ASD may still get PTSD later on.

Multiple studies have shown that the symptoms of survivors who get psychotherapy, in particular, trauma-focused cognitive behavior therapy, right after going through a traumatic life event, are less likely to get PTSD. Medication, such as SSRI antidepressants and benzodiazepines, can also help patients with ASD ease the symptoms, such as acute anxiety, agitation, and sleep problems if they start the treatment in the immediate period following the stressful event.

Adjustment Disorder

Another disorder that often occurs in response to an unexpected and/or traumatic event is adjustment disorder, otherwise referred to as stress response syndrome. It is classified as a mental disorder. This short-term condition is, essentially, a maladaptive response to a psychosocial stressor, since the symptoms an individual experiences are more intense than most people would expect. Such stressor might be a single event - for example, an ending of a romantic relationship, or a series of events, like an ongoing severe illness with increasing disability.

Because individuals suffering from adjustment disorder often manifest some of the symptoms of depression - constant tension, tearfulness, hopelessness, sadness, impulsiveness, withdrawal from other people, and loss of interest in work or hobbies, adjustment disorder is sometimes informally referred to as situational depression.

According to a recent study, more than 15% of adults suffering from cancer had adjustment disorder.

The symptoms of this condition usually last no longer than 6 months after the stressor or its consequences have ended.

The most common treatment for adjustment disorder is psychotherapy.

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED),sometimes referred to as disinhibited attachment disorder, is a behavioral disorder. It occurs exclusively in young children who have received inconsistent or insufficient care from their primary caregiver. The most common symptom of this disorder is a child’s unusual interaction with strangers. Such a child may engage in overly familiar verbal or physical behavior with unfamiliar adults, like not checking back with their adult caregiver after venturing away, or even the willingness to go off with an adult stranger without hesitation.

Usually, moving the child with this disorder to an appropriate caregiving environment reduces the symptoms of DSED. Signs of this condition typically disappear after an adolescent has reached twelve years of age.

Reactive Attachment Disorder

Reactive attachment disorder (RAD) is a rare condition occurring in children. In the majority of cases, a child with this disorder does not form healthy emotional bonds with their caregivers because of emotional neglect or abuse at an early age. Spending too much time in orphanages or other similar institutions and frequent parental figures changes (for example, repeated foster parents changes) do not let the child form emotionally stable and healthy attachments. So kids who were adopted, especially more than once, might experience RAD.

Children with reactive attachment disorder often have trouble with emotional regulation. They may be emotionally withdrawn from or feel uncomfortable and anxious around their caregivers, even when the latter are caring and loving.

Children usually manifest symptoms of RAD before age 5. Developmental delays, particularly cognitive and language delays, often occur along with reactive attachment disorder.

Treatment for RAD may include psychotherapy, special education, and/or social skills intervention - that kind of therapy teaches the little one how to interact with other children their age in typical social settings.

Mental health professionals use different research-proven methods to help people recover from post-traumatic stress disorder. These methods may include psychotherapy or medication. Here below are the most common and effective ones:

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is almost always a good choice to treat PTSD. There are several types of therapy under the CBT umbrella: cognitive processing therapy, acceptance and commitment therapy (ACT),group therapy, prolonged exposure therapy, and stress inoculation therapy. There are also other kinds of therapy - interpersonal, supportive, and psychodynamic. These therapies focus on the emotional and interpersonal aspects of post-traumatic stress disorders, which may be helpful for individuals who do not want to expose themselves to reminders of their traumas.

Medication

Medication can help control the symptoms of PTSD. Moreover, the relief provided by medication makes psychotherapy more effective for a large number of individuals. Antidepressants such as SSRIs and SNRIs, are widely used to treat the main PTSD symptoms.

Other Solutions

Other treatments for PTSD, such as acupuncture and animal-assisted therapy, are also increasingly being used to help individuals suffering from the condition. These approaches provide treatment outside the traditional mental health care standards and may require less talk and disclosure than counseling and psychotherapy.

Before starting treatment for PTSD, a detailed assessment of symptoms should be carried out. That way, a mental health professional can ensure the treatment is tailored to the patient's needs.

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