Post-Traumatic Stress Disorder

What Is Post-Traumatic Stress Disorder?

PTSD is a psychiatric disorder that occurs in people who have experienced or witnessed a traumatic event.

Examples of traumatic events include:

• Witnessing or experiencing a severe or fatal car accident
• Surviving a natural disaster
• Assault, including sexual assault or domestic violence
• Abuse (e.g., physical or emotional abuse)
• Exposure to violence (i.e., war, combat, terrorist attack)
• Serious injury

PTSD is listed among anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Other anxiety disorders include:

• Generalized Anxiety Disorder (GAD)
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder
• Social Anxiety Disorder

What Is Complex PTSD?

Complex Post-Traumatic Stress Disorder (C-PTSD) is PTSD that develops as the result of prolonged, repeated traumatic experiences. The “complex” portion of the name indicates how the PTSD developed.

Symptoms between PTSD and C-PTSD are very similar. However, someone with complex PTSD may also exhibit these additional symptoms:

• Difficulty controlling their emotions
• Feeling very angry toward the world
• Feeling alone or feel like nobody can understand what they are going through
• Experiencing suicidal thoughts

Symptoms of PTSD

The severity of PTSD can vary based on the traumatic event that happened. Someone directly involved in a traumatic event might experience more severe symptoms than someone indirectly involved.

PTSD symptoms are typically divided into four different groups, each with its own set of sub-symptoms:

• Intrusive memories
• Avoidance
• Negative changes in thinking and mood
• Changes in physical and emotional reactions

Intrusive Memories

Intrusive memories occur when someone is reliving or re-experiencing the traumatic experience.

Examples of intrusive memories include:

• Flashbacks
• Traumatic memories
• Recurring and unwanted memories of the event
• Dreams and nightmares about the event
• Having extreme emotional and physical reactions to things that remind you of the event

Avoidance

When someone has PTSD, it is not uncommon for them to avoid certain situations or places that might trigger memories of the event.

Examples of avoidance include:

• Actively avoiding thinking or talking about the event
• Avoiding people, places, and activities that remind you of the event

Negative Changes in Thinking and Mood

Experiencing a traumatic event (either directly or indirectly) can affect someone’s entire psyche.

Some examples of these negative changes include:

• Feeling numb emotionally
• Feeling detached from others
• Struggling to maintain relationships
• Feeling hopeless
• Having negative thoughts about yourself, others, or the world
• Memory loss as it pertains to the event
• Struggling to feel positive emotions such as joy or happiness
• Experiencing feelings of shame, horror, anger, or fear
• Angry outbursts

Changes in Physical and Emotional Reactions

PTSD can not only affect someone mentally but can also affect them physically and emotionally.

Examples include:

• Sleep problems
• Having trouble concentrating
• Being easily startled or frightened
• Irritability
• Aggressive behavior
• Self-destructive behavior
• Feeling overwhelming guilt or shame

PTSD symptoms can begin as early as three months after the traumatic event. In some cases, symptoms don’t start popping up until years later.

According to the DSM-5, a true diagnosis of PTSD requires at least one symptom from each of the four categories occurring for at least one month.

PTSD Causes and Risk Factors

According to the American Psychiatric Association, PTSD affects approximately 3.5% of the adult population in the U.S. every year. Nearly one in every 11 people will be diagnosed with PTSD in their lifetime.

Studies have shown that women are nearly twice as likely to develop PTSD than men. Latinos, African Americans, and Native Americans all have PTSD at a higher rate than other ethnicities.

Below are some additional causes and risk factors associated with PTSD:

• Genetics
• Chemical makeup of the brain
• Personality traits
• Stressful experiences
• Other mental health problems, such as anxiety or depression
• Substance abuse or addiction

PTSD in Military Combat Veterans

Combat veterans are among those who experience PTSD in higher numbers than the average person.

Below are some statistics about the prevalence of PTSD in combat veterans:

• Anywhere from 11-20% of all veterans who served in Operation Iraqi Freedom and Enduring Freedom have PTSD.
• Roughly 12% of all Gulf War veterans have PTSD.
• A late 1980s study done by the National Vietnam Veterans Readjustment Study found that, at the time, roughly 15% of all Vietnam vets experienced PTSD.
• Estimates show that close to 30% of all Vietnam vets had PTSD at one point in their lives.

Active military duty isn’t the only contributing factor to veterans experiencing PTSD. For instance, assault can be a cause for PTSD developing.

According to the U.S. Department of Veterans Affairs, approximately 23% of women reported sexual assault while in the military. In addition, 55% of women and 38% of men reported cases of sexual harassment.

Related Conditions

While several disorders do not fall under the category of PTSD, they share many of the same symptoms and characteristics. In some instances, someone with PTSD might have one of these related conditions in addition to post-traumatic stress disorder.

• Disinhibited Social Engagement Disorder occurs primarily in adolescents who have experienced severe neglect or deprivation. It is most common in children who don’t get adequate affection.

Disinhibited social engagement disorder can also occur when an adolescent experiences repeated changes in caregivers and can’t form a bond or attachment.

• Acute Stress Disorder is similar to PTSD because it occurs due to a traumatic event. People with Acute Stress Disorder often show symptoms that are similar to PTSD as well.

The main difference is that PTSD symptoms often won’t occur for months or even years after the traumatic event, while Acute Stress Disorder symptoms can pop up as fast as three days afterward.

• Adjustment Disorder is a response to a stressful event or series of events. The symptoms of Adjustment Disorder are very similar to those of PTSD, including feelings of sadness and hopelessness plus withdrawal from others.

Whereas PTSD is usually triggered by one very serious or traumatic event, Adjustment Disorder can be triggered by any event that can cause stress.

Post Traumatic Stress Disorder and Addiction

The symptoms of PTSD can be troublesome at best; for many, these symptoms are debilitating and can be difficult to cope with. As a result, some individuals may turn to drugs and alcohol to numb the mental pain they are experiencing and self-medicate.

Many may not even realize they have PTSD. They just know that alcohol or drug use helps them deal with their emotions in the short term.

However, self-medicating with substance use for PTSD will often lead to the PTSD symptoms getting worse—specifically anxiety, irritability, and depression. In many cases, ongoing substance abuse as a means of coping also leads to developing substance use disorder (i.e., addiction).

Individuals receiving treatment and support for PTSD are reportedly 14 times more likely to also be diagnosed with substance use disorder.

Post-Traumatic Stress Disorder Treatment Options

Thankfully, there is no shortage of effective treatment options for PTSD. Before beginning a treatment plan, speaking to your healthcare provider or licensed mental health professional is crucial.

Psychotherapy

Psychotherapy, or talk therapy, is a popular treatment option for people with PTSD. Many forms of psychotherapy help patients address and process specific aspects of the traumatic event (especially those that were life-threatening) in a safe environment.

Psychotherapy not only helps identify the causes behind PTSD, but it also teaches individuals helpful ways to manage symptoms and cope with their triggers in a healthier way moving forward.

Typical forms of psychotherapy used for treating PTSD are:

• Cognitive Behavioral Therapy (CBT)
• Exposure Therapy
• Eye Movement Desensitization and Reprocessing (EMDR)
• Prolonged Exposure Therapy
• Psychodynamic Therapy
• Cognitive Processing Therapy
• Stress Inoculation Therapy

Medications for PTSD Treatment

Sometimes, a doctor might prescribe antidepressants to ease PTSD symptoms. More specifically, SSRIs (selective serotonin reuptake Inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are viewed as the most effective medications for treating PTSD.

The most common antidepressants used for PTSD treatment include:

• Sertraline (Zoloft®)
• Paroxetine (Paxil®)
• Venlafaxine (Effexor®)

PTSD Support Groups

Some people with PTSD experience feeling isolated and having nobody to talk to. Finding a support group can be a great way to alleviate these feelings.

Support groups provide safe environments for those with PTSD to share what they are going through with others who understand what they are going through because they also have PTSD.

The U.S. Department of Veterans Affairs is a government organization to help veterans in need, including those with PTSD. They provide resources for support groups both locally and online.

Find Help for PTSD

If you or a family member or loved one is dealing with PTSD, it’s essential to get help immediately before symptoms worsen.

Contact your healthcare provider or a licensed professional to discuss treatment options.

If you don’t have a healthcare provider or want a list of treatment professionals in your area, visit the SAMHSA online Behavioral Health Treatment Services Locator or the National Center for PTSD.