Post-traumatic stress disorder is often confused with the effects of any traumatic event. Yet not everyone who experiences trauma develops symptoms of PTSD. After a traumatic experience such as assault, abuse, natural disaster, accident, rape, or combat exposure, it is common to undergo a period of crisis and readjustment. However, up to one third of traumatized people experience lasting, chronic symptoms that interfere with work, family, and social functioning.
WHAT IS PTSD?
In order to receive a PTSD diagnosis, one must (1) experience or be exposed to an event that causes intense fear, helplessness, horror, or the threat of injury or death, (2) display multiple symptoms from each of the categories outlined below, and (3) demonstrate clinically significant impairment in life functioning (at work, home, or school) for at least one month. The traumatic event can range from witnessing a violent event to being a target of violence or terrorism. Sometimes the traumatic event is limited to a single encounter; other times it involves repeated exposure to a threatening situation.
According to diagnostic manual of mental disorders (DSM-IV-R, 2000), symptoms fall into three primary categories:
1. Intrusive Recollection: Flashbacks, intrusive memories, and nightmares are common forms of reliving the trauma. Flashbacks can be dangerous when they happen while driving or performing risky tasks, while nightmares can cause chronic insomnia.
2. Avoidance and Numbing: Avoidance refers to avoiding situations, settings, or activities that resemble the traumatic event (such as TV shows or movies depicting similar situations) or immersion in work or other activities that distract from uncomfortable feelings. Although a protective form of denial, avoidance can prevent people from getting help for PTSD. Numbing could include blocking out or forgetting aspects of the event, withdrawal from social relationships and hobbies, general emotional detachment, and an inability to discuss the event. For many people with PTSD, numbing involves “self-medication” in the form of drug and alcohol abuse.
3. Hyper-arousal: Continuing to feel afraid, anxious, or threatened in everyday situations; exaggerated startle response; hyper-vigilance (i.e., vigilant against an expected attack); problems sleeping; sudden bursts of anger, rage, and hostility; and feeling “on edge” or “on guard.” In addition to the personal discomfort of constant watchfulness, hyperarousal causes harm when it leads to arguments, fights, and even arrests.
WHO GETS PTSD?
Susceptibility to PTSD is associated with the severity of the initial trauma and one’s degree of closeness to or involvement in the event. There is evidence that people with PTSD continue to undergo symptoms like those felt during the traumatic event (e.g., panic, fear, dissociation) because of permanent changes in brain structure and chemistry set in motion by the original experience.
Symptoms can emerge immediately after the event, but sometimes they don’t surface until weeks, months, or years after the event. This form of "delayed onset" PTSD often occurs in response to a “trigger” that revives the traumatic feelings of fear and helplessness, such as watching a similar encounter in a movie or visiting an environment that resembles the setting of the traumatic event.
HOPE FOR RECOVERY
It’s not uncommon for people to tell someone with PTSD to “just get over it.” They think that the symptoms are an overreaction or a plea for attention and sympathy. But PTSD is a real psychological condition that is unlikely to disappear on its own—and it can’t be willed away. Don't let stigma or fear prevent you from getting help. You can find ways to cope with PTSD symptoms through counseling, education, and support. Recovery is a complex process that takes time, but it’s never too late to face your fears and begin your healing journey.
If you or someone you know has PTSD, I highly recommend that you visit the National Center for PTSD website for links to education and services.
Note: Always seek the advice of a qualified mental health or medical professional with any questions or concerns regarding a mental health or medical condition. The material presented on this website is for educational and informational purposes only and is not intended as clinical, psychological, or medical advice. If you are in crisis or have a mental health emergency, call your doctor, 1-800-273-TALK (8255), 911, or go to your local emergency room.