PTSD: Definition, Psychology, Symptoms and Treatment Options
By: Nadia Khan
Updated August 28, 2020
At some point or another most people go through a stressful or nerve-wracking situation, which may leave them feeling anxious and nervous for a period of time. In most cases, people deal with the situation, move on and in a worse case scenario they are left with a handful of bad memories and a lesson learned for the future. But in some cases, especially when the individual suffered a traumatic event, they have a hard time moving on from the event and eventually go on to develop PTSD or Post Traumatic Stress Disorder.
PTSD is defined as a "trauma and stress-related disorder that may develop after exposure to an event or ordeal in which death or severe physical harm occurred or was threatened."
In the United States, approximately eight million adults have been affected and / or have been diagnosed with PTSD. At first PTSD was thought to only affect war veterans and decades ago it was commonly referred to as 'shell shock'. It was only in later years that doctors began to diagnose it as Post Traumatic Stress Disorder as they realized it was a condition which went beyond war veterans. PTSD can develop in men and women, can strike at any age and take years for symptoms to first pop up. Even though the disorder is not gender specific, women are usually at a higher risk for developing PTSD since they are the usual targets for physical and sexual abuse and assault.
Research has shown that people with PTSD also go on to develop additional illnesses and anxiety disorders. It is also not uncommon for someone with PTSD to have an addiction to alcohol or drugs.
Causes of PTSD:
There is no known medical cause of PTSD but researchers believe that biology, genetics and social factors can influence whether one individual is more at risk of developing PTSD than another. For instance, if someone already suffers from an anxiety disorder or depression or there is a family history of mental disorders, the chances of them developing PTSD after a trauma are higher than someone with no history at all.
As explained above, PTSD is a disorder which is generally caused by witnessing or living through trauma or abuse. What one person finds traumatic or stressful can be very different from what someone else considers to be traumatic. Therefore there is a wide range of issues, events and situations (some much more serious than others) that can lead to someone developing PTSD. Some examples include but are not limited to:
- Being the victim of a kidnapping or hostage situation;
- Being the victim of human trafficking;
- Being abused sexually or physically;
- Going through a traumatic labour and childbirth experience - this can be a traumatizing experience for the mother or the father or both;
- Being the victim of domestic abuse (physical or emotional) or living through a bad marriage;
- Spending a prolonged period of time in a job where they frequently witness or are exposed to violent or traumatic images and events, for example, a police officer, a homicide detective or a soldier etc.
- Being in a car accident;
- Witnessing the death of someone (a stranger or a loved one) through violence or as a result of an illness or distressing circumstance;
- Living through or witnessing war, a terrorist attack, a natural disaster like an earthquake or tsunami etc.
In some situations, some individuals develop what is referred to as secondary trauma where they experience symptoms of PTSD even though the traumatic event did not actually happen to them but rather to someone they were supporting. The impact of the trauma can have an affect on the individual after the fact and is commonly referred to as secondary traumatic stress. Because the trauma did not happen to the individual directly does not mean the effects are any less severe and any symptoms of PTSD should be taken seriously.
It is generally accepted that the worse the trauma, the higher the chances of developing PTSD. A lack of a proper support system, whether it's from family, friends or a therapist, can also increase the risks of PTSD and if PTSD is already there, it can make the symptoms worse. Often, the best thing to do after going through a trauma is to be proactive and take preventative action by seeking help right away before any symptoms crop up, even if you're feeling completely fine and think you are past the trauma. Symptoms don't always show up immediately after the trauma has occurred. It often takes some time. Symptoms can crop up as early as a few weeks or as late as a few years. There is really no set timeline for when PTSD might develop and so it can often take people by surprise.
Symptoms of PTSD:
Post Traumatic Stress Disorder is a mental disorder affecting the way the brain processes and responds to certain situations. The initial symptoms are mainly mental and emotional and as the severity increases, the symptoms may become more physical.
If you think you may have developed PTSD or suspect someone else may be developing it, here are some of the signs and symptoms to watch out for:
- Being depressed and / or anxious;
- Lack of joy or interest in things that were previously enjoyed;
- Feeling negative and down all the time;
- Use of drugs or alcohol either to numb the pain or as a way of dealing with the trauma;
- Having flashbacks to the traumatic event and feeling like it was taking place again - this can result in a physical reaction. For example, if a rape victim is suffering from PTSD, the simple act of being hugged by her father or husband or friend can bring her back to the rape and make her physically fight back against the physical affection because that's how she reacted with her attacker;
- Nightmares and night terrors. This is similar to flashbacks but occur in sleep;
- Avoiding places, events or situations that might bring back memories of what happened;
- Having insomnia;
- Having a hard time focusing on things or thinking clearly;
- Having panic attacks or other physical symptoms like sweating or trouble breathing;
It is entirely possible for the symptoms to vary between men and women as biologically the two sexes often handle things differently. The symptoms of PTSD in men are more likely to be aggressive and irritable and violent whereas a woman's symptoms may involve more emotional reactions such as feeling depressed and sad. They may also exhibit more anxiety than men and isolate themselves from the people around them.
It can take time to diagnose or even recognize PTSD for what it is, especially since so much time can pass between the trauma and the symptoms. Any human being who goes through any of the traumatic examples mentioned above will likely go through a short period of time where they may feel preoccupied by what happened. They might experience fear and anxiety and will need some time to recover from and shake off the experience and that is only normal. But for some people those feelings persist and don't go away or they come back months and years later.
If the symptoms mentioned above seem familiar to you and you are wondering whether you might have PTSD, a good resource to check out is PTSD Checklist. It can be found online, takes under five minutes to complete and can help you pinpoint and understand your symptoms before you go to the doctor or at the very least give you an idea of what you might be going through. Keep in mind this checklist should not be used as a medical or self-diagnosis and before beginning any kind of treatment, you should see a doctor.
If you suspect you may have PTSD, the first step to getting help is acknowledging there may be a problem (this is something the checklist can help with) and then finding the appropriate mental health professional to provide an accurate diagnosis and lay out a treatment plan. Your family doctor or clinic is usually the best place to start.
The doctor will ask you to explain your symptoms and will likely conduct some medical tests including a physical evaluation and blood tests etc. in order to rule out any illnesses which could be impacting your behaviour or emotions, such as a tumour. Once anything medical has been ruled out they will likely refer you to a medical professional who specializes in mental disorders so they can do a psychological evaluation, have a discussion with you about your life, family history, your symptoms etc. Based on the information accumulated, a diagnosis will be made.
The criteria for diagnosing PTSD is outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), usually the symptoms have to be persistent and have lasted for a month or longer.
After the diagnosis, the doctor will map out a treatment plan with your input that is customised to your specific needs. PTSD is mainly treated using talk therapy or medication or a combination of both.
Talk therapy, especially Cognitive Behavioural Therapy (CBT) is particularly useful for PTSD. CBT encourages you to explore your emotions, thoughts and feelings. It gets you to analyse your behaviours and through simple exercises and activities it provides you with the tools you need to manage your symptoms and move past your trauma.
Some doctors may also use exposure therapy as a way to help you deal with and come face to face with what happened to you. Most treatment plans will strongly encourage family and couples counselling as well as group therapy or support groups. Involving your family in your treatment helps them to better understand what you are going through, it provides them with an outlet to share their own pain, struggles and frustrations and helps them cope with the reality and challenges of the disorder.
Group therapy and support groups help you to feel less alone because it allows you to share your experiences with people who are going through the same thing.
Medication provided to treat PTSD come in the form of anti-depressants and patients are prescribed either Zoloft or Paxil. These are selective serotonin reuptake inhibitors (SSRIs) which help to control and manage symptoms like anger, numbness, feelings of sadness or depression etc. It usually takes a few weeks to start seeing proper results with the medication and there may also be a period of trial and error as the doctor finds the right combination and dosage of medication for you. Even though medication provides relief from your symptoms, in order to manage the illness long term, it's a good idea to also do therapy.
It cannot be stressed enough that in order for treatment to be effective and successful in the long run, you need to participate and be involved in your treatment. If you are simultaneously going through other mental issues such as anxiety, depression or addiction issues, your doctor will also discuss how best to treat them with you.
You might think that everyone goes through periods of ups and downs in their life. Bad things happen to people everyday. You'll just deal with it and move on, right? Is it really that important to get help?
Yes it is, because left untreated your trauma may fester and worsen and lead to PTSD.
PTSD a mental illness which is debilitating for the individual. It reduces their quality of life and not only does it significantly impact their social, professional and personal life but PTSD in its most severe form can also have a seriously negative impact on their families and friends. It is not uncommon for the individual to exhibit violent and aggressive behaviours towards others consciously or unconsciously.
For instance, a war veteran may have nightmares where they think they are back on the battlefield fighting an enemy. This nightmare may make them react physically and lead them to unconsciously attack their spouse or partner while they sleep. The sudden sound of a car backfiring might have them reaching for imaginary weapons or running for cover.
In it's worse form, PTSD can lead to self-harm and suicide.
PTSD is easily treatable so if you are going through a rough time or have some symptoms of PTSD, you are strongly encouraged to get help. Getting better will help you get your life back and will help your loved ones as well. Don't wait for your symptoms to worsen, if you're unsure of where to turn at this very moment, help from licensed professionals can always be found online. They can be a stepping stone on your path to recovery.
If you are having suicidal thoughts or thinking of hurting someone or yourself, call a crisis line, 911 or get yourself to a hospital or clinic right away. If you are living with someone who has PTSD and feel worried for your safety, step out of the house and get help immediately.
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