Post-Traumatic Stress Disorder

Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that occurs in individuals who have experienced or witnessed a traumatic event. Trauma can include exposure to combat, physical or sexual assault, natural disasters, accidents, or other extreme or life-threatening events. PTSD can cause a range of symptoms, such as flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the traumatic event. These symptoms can significantly impact an individual's daily functioning and may persist for months or even years if left untreated. Effective treatment can help reduce symptoms and improve overall well-being.

Understanding the disease

Symptoms

The symptoms of post-traumatic stress disorder (PTSD) include:

1. Recurrent, unwanted distressing memories of the traumatic event
2. Reliving the traumatic event as if it were happening again (flashbacks)
3. Upsetting dreams or nightmares about the traumatic event
4. Severe emotional distress or physical reactions to something that reminds you of the traumatic event
5. Avoidance:
   • Trying to avoid thinking or talking about the traumatic event
   • Avoiding places, activities, or people that remind you of the traumatic event
6. Negative changes in thinking and mood:
   • Negative thoughts about yourself, other people, or the world
   • 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 you once enjoyed
   • Difficulty experiencing positive emotions
   • Feeling emotionally numb
7. Changes in physical and emotional reactions (also called arousal symptoms):
   • Being easily startled or frightened
   • Always being on guard for danger
   • Self-destructive behavior, such as drinking too much or driving too fast
   • Trouble sleeping
   • Trouble concentrating
   • Irritability, angry outbursts, or aggressive behavior
   • Overwhelming guilt or shame For children 6 years old and younger, additional signs and symptoms may 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

Risk Factors

The risk factors for developing post-traumatic stress disorder (PTSD) include: 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, and having blood relatives with mental health problems, including anxiety or depression.

Development

Post-traumatic stress disorder (PTSD) develops as a result of experiencing or witnessing a traumatic event that causes intense fear, helplessness, or horror. 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, accidents, and many other extreme or life-threatening events. The exact cause of PTSD is not entirely understood, but it is believed to be a complex interaction of factors such as stressful experiences, inherited mental health risks, inherited personality traits, how the brain regulates chemicals and hormones in response to stress, and other variables. Risk factors for developing PTSD include experiencing intense or long-lasting trauma, having a history of other trauma, having a job that increases exposure to traumatic events, having other mental health problems, having substance misuse issues, lacking a good support system, and having blood relatives with mental health problems.

Assessment and Diagnosis

Triage

If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, you should talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.

Diagnosis

To diagnose post-traumatic stress disorder (PTSD), your doctor will likely perform a physical exam to check for any underlying medical issues that might be causing your symptoms. They will also conduct a psychological evaluation, discussing your signs and symptoms and the events that led to them. The diagnosis of PTSD requires exposure to an event involving the actual or possible threat of death, violence, or serious injury. Exposure can occur through direct experience, witnessing the event, learning about it happening to someone close, or repeatedly being exposed to graphic details of traumatic events. If you've experienced these issues for more than a month and they significantly impact your ability to function in social and work settings, negatively impacting relationships, you may have PTSD.

Management and Treatment

Complications

Potential complications of post-traumatic stress disorder (PTSD) include:

1. Increased risk of other mental health problems: PTSD can lead to the development of depression, anxiety, substance misuse, and eating disorders.
2. Suicidal thoughts and actions: People with PTSD are at a higher risk of having suicidal thoughts and taking actions to harm themselves.
3. Impact on daily life: PTSD can disrupt an individual's job, relationships, health, and enjoyment of everyday activities.
4. Worsening of symptoms: If left untreated, PTSD symptoms can worsen over time, leading to a more severe and persistent condition. It is important to seek professional help if you or someone you know is experiencing PTSD symptoms to prevent these complications and improve overall well-being.

Treatment

The treatments for post-traumatic stress disorder (PTSD) are critical to reducing symptoms and improving function. Effective treatments for PTSD include:

1. Psychotherapy: Trauma-focused psychotherapies, such as cognitive-behavioral therapy (CBT), prolonged exposure therapy, or eye movement desensitization and reprocessing (EMDR), are effective in treating PTSD. These therapies help individuals process traumatic memories and reduce distressing symptoms.
2. Medications: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), can help reduce PTSD symptoms, especially anxiety and depression.
3. Group therapy: Joining a support group with others who have experienced trauma can help individuals feel understood and less alone. Group therapy can also provide coping strategies and social support.
4. Mindfulness-based interventions: Mindfulness practices, such as meditation and deep breathing exercises, can help individuals manage stress and anxiety related to PTSD.
5. Holistic approaches: Engaging in activities that promote relaxation, such as yoga or tai chi, can help individuals manage stress and improve overall well-being. It is essential to work with a mental health professional to determine the most appropriate treatment plan based on individual needs and circumstances.

Preparing for medical consultation

To prepare for an appointment for post-traumatic stress disorder (PTSD), you should:

1. Make a list of any symptoms you've been experiencing and for how long.
2. Gather information about key personal events or experiences that have caused you fear, helplessness, or horror.
3. Note down things you have stopped doing or are avoiding due to stress.
4. Gather your medical information, including any other physical or mental health conditions, medications, and supplements you're taking.
5. Prepare a list of questions to ask your doctor or mental health professional during the appointment. Some basic questions to ask may include:

• What do you believe is causing my symptoms?
• Are there any other possible causes?
• How will you determine my diagnosis?
• Is my condition likely temporary or long term?
• What treatments do you recommend for this disorder?
• How can I manage my PTSD along with other health problems?
• How soon do you expect my symptoms to improve?
• Does PTSD increase my risk of other mental health problems?
• Are there any printed materials on PTSD that I can have? What websites do you recommend? Remember to bring a trusted family member or friend along if possible, as they can help remember information and support you during the appointment.