What is Post-Traumatic Stress Disorder?

For many people who witness or experience a shocking, scary or dangerous event, flashbacks, nightmares, anxiety or mentally reliving the event are temporary symptoms. When those symptoms don’t go away and become debilitating, a person may be diagnosed with post-traumatic stress syndrome (PTSD).

Signs of PTSD

PTSD in adults may begin shortly after a traumatic event or happen months or years later. PTSD symptoms can be debilitating and keep a person from appropriately managing work, school or social interactions. PTSD behavioral signs will include the following that last for more than a month and which are not attributable to substance abuse or other medical condition:

• Recurrent, involuntary and intrusive distressing memories or dreams of the traumatic event(s)
• Flashbacks that cause the person to act as if the event was recurring
• Intense or prolonged psychological distress when experiencing dreams, thoughts or flashbacks
• Persistent avoidance of memories, thoughts, feelings or reminders of the event
• Two or more of the following negative alterations in mood:
• Inability to remember important aspects of the event
• Persistent and exaggerated negative beliefs or expectations about oneself, others or the world that lead the individual to blame himself/herself or others
• 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 alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s):
• Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects
• Reckless or self-destructive behavior
• Hypervigilance
• Exaggerated startle response
• Problems with concentration 
• Sleep disturbance 
• Persistent or recurring feelings of detachment from one’s self or experiences of unreality of surroundings

Diagnosis

Diagnosing PTSD requires thorough physical and psychological evaluation. Your behavioral health provider will use the criteria for PTSD listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to determine if your symptoms indicate the condition.

How Do Doctors Test for PTSD?

Diagnostic tests include:

Physical examination: Your physician will perform a physical exam and ask questions about your health to determine if your symptoms could be linked to an underlying physical health problem.

Psychiatric evaluation: Your behavioral health provider will ask about your symptoms, thoughts, feelings and behavior patterns as well as the event(s) that led up to the symptoms. You will be asked about your personal and family history of mental illness, anxiety disorders and other mood disorders. 

PTSD Causes

People with PTSD have been exposed to actual or threatened death, serious injury or sexual violence because they have experienced or witnessed a traumatic event; learned about such an event happening to a loved one; or have experienced repeated or extreme exposure to the details of such an event other than through electronic media, television, movies or pictures, unless such exposure was work related.

Risk Factors

People of all ages can experience PTSD. Risk factors that could make it more likely for development of PTSD can include: 

Gender: Women are more likely to experience PTSD than men.

Jobs: People in jobs that increase the risk of being exposed to traumatic events, like military personnel or first responders, have an increased risk of developing PTSD.

Extra stress after an event: Those who experience a shocking, scary or dangerous event and who have additional stress such as injury, loss of a loved one or loss of home or job after the event are more likely to experience PTSD.

Other mental health problems: Anxiety or depression can contribute to developing PTSD.

Substance abuse: Excessive drinking or drug use can increase the risk of PTSD.

Prevention

PTSD cannot be prevented. Seeking treatment at the earliest sign can help prevent the condition from getting worse or interfering with your life.

Prognosis

PTSD will not simply ‘go away’. Fortunately, it is a treatable condition. In recent years, new approaches combined with a better understanding of the psychological mechanisms involved have resulted in improved forms of treatment. Learning to control the impact of PTSD takes time, but many patients have been able to regain their footing as healthy and productive individuals.

Treatment

Most people with PTSD benefit from a combination of medication and psychotherapy delivered by a psychiatrist, psychologist or other behavioral health professional. The primary focus of this treatment is helping the traumatized individual regain a sense of control over his or her life. Also important is learning to recognize PTSD symptoms for what they are, which can act as a first step in diminishing their impact in the patient’s life.

Psychotherapy

Working with a therapist experienced in treating PTSD can reduce the symptoms associated with PTSD, help with family, job or social problems, and provide coping skills to control fear and symptoms. 

PTSD Medication

Medication can help treat the symptoms of PTSD and is typically prescribed along with therapy. You may need to try a few different medications, or medication combinations, before you find the one that’s right for you. Some medications will treat certain symptoms, for example, PTSD anger medication. Some medications take a few weeks before their full effect is obvious. Some cause side effects for certain patients. If you experience any side effects, it’s important to talk to your provider immediately but not to abruptly stop taking the medication, which could cause a worsening of symptoms.

Common medications prescribed for PTSD include:

• Antidepressants: These medications may be prescribed to help manage the sadness, worry, anger or feeling numb inside that is caused by PTSD.
• Sedatives: These medications may be recommended for a short term to help with severe episodes of anxiety or until antidepressants take effect.
• Sleep medications: Certain sleep medications may be prescribed to reduce nightmares associated with PTSD.

How to Improve PTSD

Lifestyle Changes

Lifestyle changes along with therapy and medication can help treat PTSD. Specific lifestyle changes that are recommended include:

• Physical activity: Regular exercise helps reduce stress and improve mood.
• Avoid alcohol and drugs: Self-medicating with alcohol or drugs can interfere with medical treatment and prevent healing.

PTSD Complications

Early and ongoing treatment is key to managing PTSD. Left untreated, complications can arise, including:

• Drug and alcohol abuse
• Depression
• Anxiety
• Suicide
• Social, occupational and physical disability