Post traumatic stress syndrome

Post traumatic stress syndrome more commonly called post-traumatic stress disorder or PTSD, is a treatable anxiety disorder It happens when fear, anxiety and memories of a traumatic event don’t go away. Post traumatic stress syndrome can occur after you have gone through an extreme emotional trauma that involved the threat of injury or death. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. The feelings last for a long time and interfere with how people cope with everyday life. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.

A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose and treat PTSD.

According to the National Center for PTSD, about 7 to 8 percent (about 7 or 8 out of every 100 people) of the United States population will have PTSD at some point in their lives and about 8 million adults have PTSD during a given year ¹. About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%). Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Post traumatic stress syndrome can occur at any age. It can occur after events such as:

• Assault
• Car accidents
• Domestic abuse
• Natural disasters
• Prison stay
• Sexual assault
• Terrorism
• War

Going through trauma is not rare. About 6 of every 10 men (or 60%) and 5 of every 10 women (or 50%) experience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

To be diagnosed with post traumatic stress syndrome, an adult must have all of the following for at least 1 month:

• At least one re-experiencing symptom
• At least one avoidance symptom
• At least two arousal and reactivity symptoms
• At least two cognition and mood symptoms

Health care providers do not know why traumatic events cause PTSD in some people, but not in others. Your genes, emotions, and family setting may all play roles. Past emotional trauma may increase your risk of PTSD after a recent traumatic event. With PTSD, the body’s response to a stressful event is changed. Normally, after the event, the body recovers. The stress hormones and chemicals the body releases due to the stress go back to normal levels. For some reason in a person with PTSD, the body keeps releasing the stress hormones and chemicals. However, getting effective treatment after PTSD symptoms develop can be critical to reduce your symptoms and improve your function.

The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

Treatment for PTSD involves talk therapy (counseling), medicines, or both. Everyone is different, and PTSD affects people differently, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD may need to try different treatments to find what works for their symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.

Talk therapy (psychotherapy)

During talk therapy, you talk with a mental health professional, such as a psychiatrist or therapist, in a calm and accepting setting. They can help you manage your PTSD symptoms. They will also guide you as you work through your feelings about the trauma.

There are many types of talk therapy. One type that is often used for PTSD is called desensitization. During therapy, you are encouraged to remember the traumatic event and express your feelings about it. Over time, memories of the event become less frightening.

During talk therapy, you may also learn ways to relax, such as when you start to have flashbacks.

Medicines

Your mental health provider may suggest that you take medicines. They can help ease your depression or anxiety. They can also help you sleep better. Medicines need time to work. DO NOT stop taking them or change the amount (dosage) you take without talking to your mental health provider. Ask your mental health provider about possible side effects and what to do if you experience them.

Do children react differently than adults?

Children and teens can have extreme reactions to trauma, but some of their symptoms may not be the same as adults. Symptoms sometimes seen in very young children (less than 6 years old), these symptoms can include:

• Wetting the bed after having learned to use the toilet
• Forgetting how to or being unable to talk
• Acting out the scary event during playtime
• Being unusually clingy with a parent or other adult

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

Why do some people develop post traumatic stress syndrome and other people do not?

It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.

Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.

Some factors that increase risk for PTSD include:

• Living through dangerous events and traumas
• Getting hurt
• Seeing another person hurt, or seeing a dead body
• Childhood trauma
• Feeling horror, helplessness, or extreme fear
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
• Having a history of mental illness or substance abuse

Some factors that may promote recovery after trauma include:

• Seeking out support from other people, such as friends and family
• Finding a support group after a traumatic event
• Learning to feel good about one’s own actions in the face of danger
• Having a positive coping strategy, or a way of getting through the bad event and learning from it
• Being able to act and respond effectively despite feeling fear

Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.

Post traumatic stress syndrome causes

Post traumatic stress syndrome is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren’t sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

• Stressful experiences, including the amount and severity of trauma you’ve gone through in your life
• Inherited mental health risks, such as a family history of anxiety and depression
• Inherited features of your personality — often called your temperament
• The way your brain regulates the chemicals and hormones your body releases in response to stress

Risk factors for developing post traumatic syndrome

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

• Experiencing intense or long-lasting trauma
• Having experienced other trauma earlier in life, such as childhood abuse
• Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders
• Having other mental health problems, such as anxiety or depression
• Having problems with substance misuse, such as excess drinking or drug use
• Lacking a good support system of family and friends
• Having blood relatives with mental health problems, including anxiety or depression

Kinds of traumatic events

The most common events leading to the development of PTSD include:

• Combat exposure
• Childhood physical abuse
• Sexual violence
• Physical assault
• Being threatened with a weapon
• An accident

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Post traumatic stress syndrome prevention

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what’s happened. Fear, anxiety, anger, depression, guilt — all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

Post traumatic stress syndrome signs and symptoms

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types:

1. intrusive memories or reliving the event, which disturbs your day-to-day activity,
2. avoidance,
3. negative changes in thinking and mood,
4. changes in physical and emotional reactions (hyperarousal).

Symptoms can vary over time or vary from person to person.

Intensity of symptoms

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you’re stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

Intrusive memories

Symptoms of intrusive memories may include:

• Recurrent, unwanted distressing memories of the traumatic event
• Reliving the traumatic event as if it were happening again (flashback episodes in which the event seems to be happening again and again)
• Repeated upsetting dreams or nightmares about the traumatic event
• Severe emotional distress or uncomfortable physical reactions to something that reminds you of the traumatic event

Avoidance

Symptoms of avoidance may include:

• Trying to avoid thinking or talking about the traumatic event
• Avoiding places, activities or people that remind you of the traumatic event
• Emotional numbing or feeling as though you do not care about anything
• Feeling detached
• Not able to remember important parts of the event
• Not interested in normal activities
• Showing less of your moods
• Feeling like you have no future

Negative changes in thinking and mood or feelings

Symptoms of negative changes in thinking and mood or feelings may include:

• Negative thoughts about yourself, other people or the world
• Constant guilt about the event, including survivor guilt
• Hopelessness about the future
• Memory problems, including not remembering important aspects of the traumatic event
• Difficulty maintaining close relationships
• Feeling detached from family and friends
• Lack of interest in activities or other people you once enjoyed
• Difficulty experiencing positive emotions
• Feeling emotionally numb
• Blaming others for the event
• Not being able to recall important parts of the event

You may also have symptoms of anxiety, stress, and tension:

• Agitation or excitability
• Dizziness
• Fainting
• Feeling your heart beat in your chest
• Headache

Changes in physical and emotional reactions

Symptoms of changes in physical and emotional reactions (also called arousal symptoms or hyperarousal) may include:

• Always scanning your surroundings for signs of danger (hypervigilance)
• Being easily startled or frightened
• Always being on guard for danger
• Self-destructive behavior, such as drinking too much or driving too fast
• Trouble falling or staying asleep
• Trouble concentrating
• Irritability, angry outbursts or aggressive behavior
• Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:

• Re-enacting the traumatic event or aspects of the traumatic event through play
• Frightening dreams that may or may not include aspects of the traumatic event

Post traumatic stress syndrome complications

Post-traumatic stress disorder can disrupt your whole life ― your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD may also increase your risk of other mental health problems, such as:

• Depression and anxiety
• Issues with drugs or alcohol use
• Eating disorders
• Suicidal thoughts and actions

Post traumatic stress syndrome diagnosis

To diagnose post-traumatic stress disorder, your doctor will likely:

• Perform a physical exam to check for medical problems that may be causing your symptoms
• Do a psychological evaluation that includes a discussion of your signs and symptoms and the event or events that led up to them
• Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Diagnosis of PTSD requires exposure to an event that involved the actual or possible threat of death, violence or serious injury. Your exposure can happen in one or more of these ways:

• You directly experienced the traumatic event
• You witnessed, in person, the traumatic event occurring to others
• You learned someone close to you experienced or was threatened by the traumatic event
• You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events)

You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.

Post traumatic stress syndrome treatment

Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but can also include medication. Combining these treatments can help improve your symptoms by:

• Teaching you skills to address your symptoms
• Helping you think better about yourself, others and the world
• Learning ways to cope if any symptoms arise again
• Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs

You don’t have to try to handle the burden of PTSD on your own.

Psychotherapy

Psychotherapy also called “talk therapy” involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.

Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.

Effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms, and skills to manage the symptoms.

Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include:

• Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.
• Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.
• Eye movement desensitization and reprocessing (EMDR). Eye movement desensitization and reprocessing combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.

Your therapist can help you develop stress management skills to help you better handle stressful situations and cope with stress in your life.

All these approaches can help you gain control of lasting fear after a traumatic event. You and your mental health professional can discuss what type of therapy or combination of therapies may best meet your needs.

You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.

How psychotherapy help people overcome post traumatic stress syndrome?

Talk therapies teach people helpful ways to react to the frightening events that trigger their PTSD symptoms. Based on this general goal, different types of therapy may:

• Teach about trauma and its effects
• Use relaxation and anger-control skills
• Provide tips for better sleep, diet, and exercise habits
• Help people identify and deal with guilt, shame, and other feelings about the event
• Focus on changing how people react to their PTSD symptoms. For example, therapy helps people face reminders of the trauma.

Medications

Several types of medications can help improve symptoms of PTSD:

• Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
• Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
• Prazosin. While several studies indicated that prazosin (Minipress) may reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over placebo. But participants in the recent study differed from others in ways that potentially could impact the results. Individuals who are considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.

You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks.

Tell your doctor about any side effects or problems with medications. You may need to try more than one or a combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for you.

Coping and support

If stress and other problems caused by a traumatic event affect your life, see your doctor or mental health professional. You can also take these actions as you continue with treatment for post-traumatic stress disorder:

• Follow your treatment plan. Although it may take a while to feel benefits from therapy or medications, treatment can be effective, and most people do recover. Remind yourself that it takes time. Following your treatment plan and routinely communicating with your mental health professional will help move you forward.
• Learn about PTSD. This knowledge can help you understand what you’re feeling, and then you can develop coping strategies to help you respond effectively.
• Take care of yourself. Get enough rest, eat a healthy diet, exercise and take time to relax. Try to reduce or avoid caffeine and nicotine, which can worsen anxiety.
• Don’t self-medicate. Turning to alcohol or drugs to numb your feelings isn’t healthy, even though it may be a tempting way to cope. It can lead to more problems down the road, interfere with effective treatments and prevent real healing.
• Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus.
• Stay connected. Spend time with supportive and caring people — family, friends, faith leaders or others. You don’t have to talk about what happened if you don’t want to. Just sharing time with loved ones can offer healing and comfort.
• Consider a support group. Ask your mental health professional for help finding a support group, or contact veterans’ organizations or your community’s social services system. Or look for local support groups in an online directory.

When someone you love has PTSD

The person you love may seem like a different person than you knew before the trauma — angry and irritable, for example, or withdrawn and depressed. PTSD can significantly strain the emotional and mental health of loved ones and friends.

Hearing about the trauma that led to your loved one’s PTSD may be painful for you and even cause you to relive difficult events. You may find yourself avoiding his or her attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty that you can’t fix your loved one or hurry up the process of healing.

Remember that you can’t change someone. However, you can:

• Learn about PTSD. This can help you understand what your loved one is going through.
• Recognize that avoidance and withdrawal are part of the disorder. If your loved one resists your help, allow space and let your loved one know that you’re available when he or she is ready to accept your help.
• Offer to attend medical appointments. If your loved one is willing, attending appointments can help you understand and assist with treatment.
• Be willing to listen. Let your loved one know you’re willing to listen, but you understand if he or she doesn’t want to talk. Try not to force your loved one to talk about the trauma until he or she is ready.
• Encourage participation. Plan opportunities for activities with family and friends. Celebrate good events.
• Make your own health a priority. Take care of yourself by eating healthy, being physically active and getting enough rest. Take time alone or with friends, doing activities that help you recharge.
• Seek help if you need it. If you have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your stress.
• Stay safe. Plan a safe place for yourself and your children if your loved one becomes violent or abusive.

Post traumatic stress syndrome prognosis

Post traumatic stress syndrome can be treated. You can increase the chance of a good outcome:

• See a mental health provider right away if you think you have PTSD.
• Take an active part in your treatment and follow your mental health provider’s instructions.
• Accept support from others.
• Take care of your health. Exercise and eat healthy foods.
• DO NOT drink alcohol or use recreational drugs. These can make your PTSD worse.

1. How Common is PTSD in Adults? https://www.ptsd.va.gov/understand/common/common_adults.asp