Post-traumatic stress disorder (PTSD) is a mental health condition caused by exposure to a terribly frightening experience or traumatic event. This event may involve the threat of death to oneself or a loved one. The precipitating event may be a physical or sexual assault, the unexpected death of a loved one, war, a natural disaster, or an accident. Post-traumatic stress disorder is a lasting consequence of severely stressful events that overwhelm an individual’s ability to cope.
Many individuals who have been exposed to these types of traumatic events develop reactions that include shock, anger, fear, guilt, and anxiety. For most, these reactions are completely normal and dissipate over time, while someone who has developed PTSD has heightened feelings that can become so intense that they prevent a person from living a normal life.
While once considered a condition that only veterans suffered from, it is now known that PTSD can develop in anyone following a traumatic incident. It’s important to note that not every person who is involved in a shocking event develops PTSD.
PTSD can develop at any age beginning in the first year of life and symptoms generally, begin within the first three months following the precipitating event but can be delayed months or years following the experience. Often a person’s reaction to the trauma meets the criteria for acute stress disorder immediately following the trauma. For those experiencing acute stress disorder, the duration of symptoms varies with a complete recovery occurring within three months after the event for half the individuals experiencing this type of stress reaction. Some with the acute stress disorder have symptoms longer than a year and may intensify when there are triggers reminding the individual of the initial trauma.
PTSD occurs when the symptoms don’t diminish or fade as time passes. In fact, most people who have post-traumatic stress disorder experience a worsening of symptoms as time passes. This disorder can prevent someone from functioning properly as the symptoms become too overwhelming.
With prompt treatment and support, PTSD can be managed, allowing you to live a normal and happy life. PTSD does not have to define you.
As is the case with many mental disorders, other disorders are often present in individuals who present with post-traumatic stress disorder. These may include:
- Substance use disorder
- Oppositional defiant disorder
- Separation anxiety disorder
- Panic disorder
- Previous traumas
- Depressive disorders
- Obsessive-compulsive disorder
Post-traumatic stress disorder is far more common than previously believed and can develop at any age – including during childhood. The projected lifetime risk for developing PTSD among adults in the United States is 3.5%, with lower risks for Europeans, Asian, African, and Latin American cultures, at a rate of 0.5%-1.0%. Higher rates of PTSD are seen in individuals who have jobs that increase the risks for traumatic events such as nurses, police, and firefighters. The highest rates of PTSD occur among rape survivors, genocide survivors, and military veterans who have seen combat.
Causes of PTSD
Prognostic indicators for developing PTSD in response to a highly traumatic event are often divided into three categories: pretraumatic, peritraumatic, and post-traumatic factors. These include the following:
- Temperamental – These factors include emotional problems of childhood before age six, such as a prior traumatic event, externalizing, or anxiety events and prior mental health disorders such as panic disorder, depressive disorders, PTSD, or obsessive-compulsive disorder.
- Environmental – Environmental factors that are associated with later development of PTSD can include being of lower socioeconomic status, lower education levels, exposure to prior trauma (in childhood especially), childhood adversity, family dysfunction, parental death or separation, cultural characteristics, such as self-blaming or fatalistic coping mechanisms. Other environmental factors can include lower overall intelligence and a family history of psychiatric disorders.
- Genetic and Physiological – Being a female at a younger (adult) age at the time of the trauma increase the likelihood of the development for PTSD.
- Environmental – Environmental factors that may increase the likelihood of developing PTSD during the traumatic event include the severity of the trauma. The more intense the trauma, the greater the likelihood of developing the disorder. Other environmental factors that can lead to the development of PTSD include the perception of the trauma being life-threatening, personal injury, or trauma perpetrated by a caregiver (especially among children). For military personnel, this trigger can include being a perpetrator of violence, seeing atrocities, or killing an enemy. If there is dissociation during the trauma that persists after the trauma, there is a higher likelihood for the development of PTSD.
- Temperamental – these factors may include inappropriate abilities to cope, development of acute stress disorder, and negative appraisals.
- Environmental – environmental factors following a traumatic event include recurring exposure to upsetting reminders of the trauma, additional adverse life events, financial or other losses related to the trauma. Inappropriate social support post-trauma can also impact someone recovering from a hugely traumatic event.
Symptoms of Post-Traumatic Stress Disorder
As with any mental health condition, the symptoms of PTSD can vary wildly among those who suffer this condition. Common symptoms are grouped by intrusive symptoms, avoidance behaviors, alterations in mood, and alterations in arousal and reactivity.
Intrusive Symptoms – these symptoms are associated with the traumatic event and begin after the occurrence of the traumatic events.
- Persistent, involuntarily, and disturbing memories of the trauma
- Intense and prolonged psychological distress to reminders that bring to mind or signify a part of the traumatic event
- Discernible physiological reactions to reminders that symbolize or represent an aspect of the trauma
- Distressing and repeated dreams in which the affect or subject matter is related to the event
- Dissociative reactions (flashbacks) that lead an individual to feel or behave as though the event is reoccurring.
Avoidance Symptoms – these symptoms aim to reduce the sufferer’s anxiety by avoiding cues and memories of the distressing event and may include:
- Efforts or total avoidance of external forces (people, places, activities, objects, situations, conversations) that may create distressing thoughts, memories, or feelings that are closely connected to the traumatic event.
- Efforts to or avoidance of stressful memories, feelings, or thoughts associated with the event.
Negative Mood Symptoms – these symptoms begin and worsen after the traumatic event and include:
- Being unable to recall a very significant part of the trauma
- Continuous inability to feel positive emotions
- Feeling disconnected and estranged from other people
- Distorted thoughts about the causes for and consequences of the trauma that leads to a person feeling as though blame should be assigned to him or herself or to others.
- Ongoing overstated negative beliefs or expectations about yourself, others, and the world.
- Unending negative emotional states
- Disinterest in activities or participation in previously enjoyed activities
Alterations in Arousal Symptoms: these symptoms tend to begin with the trauma and worsen over time and include:
- Being hypervigilant
- Exaggerated startle reflex
- Challenges with concentration
- Angry outbursts
- Sleep disturbances
- Behaving recklessly
- Engaging in self-destructive behaviors
Effects of PTSD
PTSD is a chronic condition that can be managed with the right treatments and support in place. However, if left untreated PTSD can lead to numerous ill effects. These effects can include:
- Eating disorders
- Chronic pain
- Heart disease
- Drug abuse and addiction
- Autoimmune diseases
- Musculoskeletal conditions
- Suicidal ideations and actions