Author: Keeley Joyce
What is PTSD?
Post- Traumatic stress disorder (PTSD) is a disorder that an individual may develop after experiencing or witnessing terrifying, shocking, or dangerous events.
These events could be
- natural disasters
- military combat
- physical or sexual assault
- serious accidents
This is not an exhaustive list and trauma can look different for everyone.
People who have PTSD have a heightened sense of fear. The body has natural stress response called fight-flight-freeze reaction when exposed to danger to help respond to the situation. The body uses these physiological changes to act quickly to avoid harm. In individuals who have PTSD fight-flight-freeze mode is enhanced even in safe situations evoking feelings of stress and anxiety.
Signs and symptoms of PTSD?
Most commonly post-traumatic stress disorder symptoms begin to surface after one month of the event, although in some cases symptoms may not arise until years later. PTSD symptoms can affect daily functioning, they interfere with social and work situations as well as relationships.
PTSD Symptoms are grouped into five categories: Intrusions, avoidance, arousal and reactivity, as well as change in cognition and mood.
These symptoms are intrusive memories that pop up regardless of if the individual is actively trying to recall the event or not. These memories can be experienced during sleep as nightmares or during the day as vivid memories or flashbacks. The thought of these memories can induce feelings of anxiety, fear, or even guilt. Alongside the emotional component, these memories can cause physical symptoms such as chills, shaking, heart palpitations, etc.
An individual with PTSD tries their best to avoid everything that may trigger the memories of the traumatic event. This could be escaping people or situations that evoke the memory.
Avoidance also can manifest into steering clear from other people as a whole.
Arousal and Reactivity
Arousal and reactivity symptoms include
- being easily startled
- constant feelings of being on edge
- difficulties with concentration
- difficulties falling or staying asleep
- feelings of irritability or aggression
- participating in reckless or destructive behavior
Cognition and Mood
People with PTSD often have trouble recalling parts of the traumatic event. They often have distorted or negative views about themselves and/or the world. They experience ongoing negative emotions such as fear, anger, guilt. People who develop PTSD often lose interest in activities they previously enjoyed. They often have feelings of isolation and have trouble attaining happy thoughts.
How is PTSD diagnosed
Many people will most likely go through a dangerous or traumatic event in their lifetime, although not everyone goes on to develop PTSD.
Risk factors that may increase developing PTSD
- exposure to dangerous events or traumas
- childhood trauma
- lack of social support
- additional stress after the event (i.e., lost loved one, injury, loss of home)
- personal or family history of substance abuse
High-risk professions for PTSD
- Police officers
- Healthcare workers
Factors that may reduce developing PTSD
- social support
- coping strategies
- physical exercise
- early detection and treatment
To determine a diagnosis, a psychological evaluation will be done to discuss signs and symptoms and the events that may have caused them. The use of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will be used to compare symptoms and see if the individual meets the criteria.
How is PTSD treated
Different types of psychotherapy may be used to treat PTSD this may include cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing.
This approach is a talk therapy that aims to restructure thinking patterns into a more positive outlook. For individuals with PTSD, it will help alter the negative views of oneself, or the world as well as negative beliefs of the traumatic event reoccurring
This therapy will allow an individual to safely face the memories or experiences that caused the trauma in an attempt to learn effective coping skills for facing the fear.
Eye movement Desensitization and reprocessing (EMDR)
this included a combination of exposure therapy with a series of instructed eye movements that attempts to allow the individuals to actively process the traumatic event that was experienced.
In addition to therapy for severe cases, medication can be provided to decrease symptoms of PTSD.
Selective serotonin reuptake inhibitors are prescribed to help symptoms of anxiety and depression. These medications also can also help with sleeping difficulties and nightmares associated with PTSD.
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
Serotonin-norepinephrine reuptake inhibitors are also an effective treatment for PTSD. SNRIs and SSRIS both increase serotonin although SNRIS prevent the reuptake norepinephrine. Norepinephrine is a hormone and neurotransmitter play crucial role in how the body reacts to stress. SNRI’s can help the intense fight-flight- freeze response individuals with PTSD experience. They also can aid with feelings anxiety, mood, and panic attacks.
- venlafaxine (Effexor)
Acute Stress Disorder
Like PTSD this is a disorder that occurs after a traumatic event. The symptoms are the same as PTSD, such as flashbacks, nightmares, etc.., although these symptoms arise three days to one month after the event. These symptoms can go away while in some cases can go on and develop into PTSD.
This disorder can develop after an individual experience’s stressful life events. Similarly, individuals with PTSD may experience feelings of sadness, hopelessness, feeling tense, detachment from others as well as physical symptoms such as headaches, palpitations. These symptoms usually start in the first three months after an event and last no longer than 6 months after the event has finished.
Complex PTSD, also referred to as c-PTSD is caused by chronic or prolonged trauma, whereas PTSD usually is related to one event or a series of events in a short period of time, complex PTSD is caused from a series of events that occurred time and time again over a long period.
People with c-PTSD often have some symptoms of PTSD but not all of them. Additional symptoms of complex PTSD may include
- Problems with self-esteem
- Emotional dysfunction
- Relationship problems
Adverse childhood experiences
- Abuse, neglect, violence, parental separation, parental substance abuse
- Multiple traumas
- Long term trauma
- Domestic violence
- Witness to repeated acts of violence
Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience. Trauma, Violence, & Abuse, 6(3), 195–216. https://doi.org/10.1177/1524838005277438
Bisson, J. I. (2020). Acute stress disorder, adjustment disorders, and post-traumatic stress disorder. Oxford Textbook of Medicine, 6506–6509. https://doi.org/10.1093/med/9780198746690.003.0635
Contributors, W. M. D. E. (n.d.). What is complex PTSD? the symptoms caused by chronic trauma. WebMD. Retrieved February 5, 2022, from https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms
Donohue, M. (2019, November 12). Post-traumatic stress disorder (PTSD). Healthline. Retrieved January 29, 2022, from https://www.healthline.com/health/post-traumatic-stress-disorder#symptoms
Kobayashi, Patel, M., & Lotito, M. (2015). Pharmacotherapy for posttraumatic stress disorder at a Veterans Affairs facility. American Journal of Health-System Pharmacy, 72(11 Suppl 1), S11–S15. https://doi.org/10.2146/ajhp150095
Mayo Foundation for Medical Education and Research. (2018, July 6). Post-traumatic stress disorder (PTSD). Mayo Clinic. Retrieved January 29, 2022, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973
Romney, D. M. (2003). Risk and resiliency factors in posttraumatic stress disorder. Annals of General Hospital Psychiatry, 2(1), 4. https://doi.org/10.1186/1475-2832-2-4
U.S. Department of Health and Human Services. (n.d.). Post-traumatic stress disorder. National Institute of Mental Health. Retrieved January 29, 2022, from
What is posttraumatic stress disorder?What Is PTSD? (n.d.). Retrieved January 29, 2022, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd