Postraumatic stress disorder or PTSD is a mental health condition that happens to people who have gone through a traumatic experience such as war, a terrorist act, rape, natural disasters, accidents and violent assaults.
In the past, this condition was mostly associated with soldiers and combat veterans who have experienced shell shock and combat fatigue during times of war. In recent years, researchers have found out that PTSD is not only experienced by soldiers. It can affect anyone who has gone through trauma.
According to the National Alliance on Mental Illness, 3.6% of the adult population in the U.S. have been affected by PTSD. That’s about 9 million people and more than 30% of those suffer from severe symptoms.
Research indicates that experiencing trauma can significantly alter the brain. While this mental health problem is not preventable (because we can’t control when trauma happens), it is definitely treatable. The first step is to recognize the symptoms and get a diagnosis from a trained professional.
Symptoms typically start within 1-3 months after the traumatic event. Although, in some cases it will take years before symptoms begin surfacing. Other disorders like anxiety, depression, OCD and personality disorder can also appear alongside PTSD.
The symptoms may differ depending on the individual’s specific case but symptoms are generally grouped in four different categories:
One of the most common signs of PTSD is the re-experiencing of the traumatic event. This is typically one of the first symptoms that can appear. The trauma is so deeply embedded in the brain that the individual feels like they are re-living it again when triggered by certain things, people or environments.
Re-experiencing can be in the form of:
- Intrusive thoughts
- upsetting thoughts and memories
- recurrent nightmares
- feelings of emotional distress
- physical reactions when confronted with things that are related to the trauma
This can happen out of nowhere, even when it is least expected. In most cases, this symptom is set off by triggers. For example: a soldier may be triggered by the sound of fireworks because they sound like bombs going off, bringing them back to the warzone.
Distressing dreams and recurring nightmares can also happen. Typically, these dreams will also be about the traumatic incident or in forms that are a reminder of the event.
It is not uncommon to also experience severe emotional distress while this is happening. The intrusive memories can be so intense that the person may start experiencing physical reactions including chills, heart palpitations, headaches and panic attacks.
While it is normal for anyone to avoid a potentially stressful situation, someone with PTSD will go to extremes just so they will not be reminded of the terrifying experience.
Avoidance examples include:
- Staying away from places and objects that can be a reminder of the trauma
- Not wanting to be around people who are reminders of the trauma
- Avoiding thoughts and feelings about the traumatic incident
Individuals who have posttraumatic stress disorder feel like they need to avoid these reminders to alleviate unpleasant emotions and the distressing anxiety that comes with it.
Avoidance can also come in other forms including projection, denial and distorting their trauma-related experiences. While this coping mechanism may work initially, it will do more harm than good in the long run because the real issue will not be addressed.
In some cases, a traumatized person can even completely disassociate from the traumatic event, completely blocking it from their memories.
These symptoms may make it hard for the individual to carry on with their day-to-day activities. It is not uncommon that people with PTSD become reclusive from society, preferring to stay at home than face the world outside.
During trauma recovery, one of the key ingredients to healing is managing triggers without avoidance. It is impossible to get over the trauma without dealing with these emotions. So, therapists use desensitizing techniques to help PTSD patients face their triggers in a healthier way.
3. Changes in mood
Trauma can greatly affect the mental health. It can cause changes in mood and completely alter one’s feelings and beliefs. Some of the changes can include:
- feelings of isolation
- feelings of guilt and shame
- having difficulties being positive
- feeling hopeless about the future
- loss of interest in hobbies
- emotional numbness
- a general sense of negativity over life
Someone who is suffering from undiagnosed PTSD may feel anxious and depressed but will not understand why they are feeling down. It is normal to experience bouts of sadness from time to time but someone who has trauma has persistent feelings of loneliness, anxiety and fear, which does not go away without proper treatment.
Aside from mood changes, this can also cause physiological problems, like high blood pressure, increased heart rate and rapid breathing.
A lot of these symptoms result from the body’s natural response to stressors. When the body detects danger, it activates the “fight or flight” response for survival. This creates a series of physiological changes and releasing of stress hormones.
However, when stress becomes chronic – as it is in posttraumatic stress disorder – the body is constantly on survival mode. Over time, this can take a toll on the body. The stress response is on overdrive and hormones become imbalanced, which is why the mood shifts significantly.
As the body is on survival mode, the person becomes hypervigilant. Someone who has PTSD will be anxious and jumpy, always feeling on edge and defensive. This state of mind is also known as hyperarousal.
It is believed that this is caused by the chronic increase of dopaminergic and noradrenergic levels in the system. In the hypersarousal state, a person is on high alert even when danger is not present. Because the trauma is too deeply embedded into the brain and the hormone imbalance, the body acts in defensive mode. This can cause problems such as:
- sleeping problems
- difficulty in concentrating
- anger outbursts
- being easily startled
- a sense of guilt or shame
- aggressive behavior
- self-destructive behaviour
The symptoms may worsen when the person is exposed to triggers, causing the body to remember the trauma again. Sometimes, the hypervigilance seems like it is not present until the individual is triggered by a certain event, thing or person.
PTSD in Children
Children and teenagers can also suffer from this disorder. Because children are not as perceptive as adults, it is important to be vigilant for them. Children may exhibit different symptoms aside from the four core symptoms. Watch out for the signs below:
- difficulty in sleeping
- feeling grouchy
- feeling depressed
- seeming detached and numb
- no interest in activities
- trouble with affection
- aggressive and violent acts
- have problems in school
- trouble in focusing
Changes in mood and behaviour can be a telling sign of unprocessed trauma. As a parent, you play an important role in helping your child get through this difficult situation. Be supportive and take things seriously. If you notice these behavioural changes, it is best to consult a healthcare provider or a family physician to help you with the diagnosis.
While not every child who exhibits these symptoms have PTSD, it is still best to err on the safe side and have them assessed by a professional. When trauma is left untreated, it can lead into other mental health problems.
How PTSD is Treated
While this is a complicated mental health disorder, it is definitely treatable. The first step, of course, is to seek the help of a professional. In the diagnosis, the doctors will check for the symptoms present. Symptoms from the four core above should be present for at least one month.
The specific treatment and treatment time can vary from person to person. Some may be able to successfully recover in just a few months of therapy, while others may need years and years to get better.
The therapist’s approach will depend on different factors including: the severity of the case, the age of the patient and the specific symptoms. The three most important goals in therapy are:
- improving symptoms
- teach the patient healthy coping skills
- restore the patient’s self-esteem
Here are some of the most common treatments applied to PTSD patients:
Cognitive Behavioral Therapy
This method is a short-term treatment (typically lasting from 3 – 8 months) that focuses on changing negative patterns of thinking. With a practical and goal-oriented approach, this method has been proven to positively enhance cognitive control activity in patients’ depression and PTSD.
Aside from PTSD, Cognitive Behavioral Therapy is also used to treat a wide range of problems including anxiety, depression and drug abuse. It is usually done in a one-on-one setting but can also work in groups.
One of the most common forms of CBT is talk therapy. In this method, the patient will be asked to share the details of the trauma, for the purpose of understanding and assessing the pain and fear. Over time, the individual will have a higher level of self-awareness and will also develop stronger coping mechanisms.
This is done to address the avoidance problem in PTSD. While it may seem like an easy way out, it is very unhealthy to avoid stressors because this doesn’t help in building healthy coping strategies.
Exposure therapy focuses on desensitizing the individual to their trauma so that they can work on controlling their fear. The therapist can use different methods including writing, imagining or actually visiting the place where the trauma happened. Gradual exposure, guided by a trained therapist, will significantly improve symptoms over time.
In one study where PTSD patients did written exposure therapy, it was concluded that this is just as effective in treating symptoms as the widely practiced CBT.
Proper medication is critical to the success of PTSD treatment. In this disorder, the brain of the patient works differently than someone who does not have trauma. Their neurotransmitters may be impaired, causing an unbalance of chemicals into their system. Additionally, their hormones can also be irregular, which is why the individual is prone to fits of anxiety, depression and anger.
Because of this, it is necessary to take drugs that help regulate brain function again. Some of the most common medicines used to treat PTSD include:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
- Paroxetine (Paxil)
Typically, patients are given a combination of different medicines to help treat their specific issues. It might take some time to find the right cocktail mix of medications to make the symptoms more manageable because it can be trial-and-error at first.
It is advised that medication treatment should still be done with psychotherapy treatment to get optimal results. It should also be noted that these strong drugs can have negative side effects, which is why it is essential to get proper dosage. Also, depending too much on medications for the symptoms, without treating the actual cause of trauma can be even more detrimental to one’s mental health.
Posttraumatic stress order is a very treatable mental health condition despite its complexities. However, when this disorder is not treated, someone with PTSD can be crippled by their fear, which can lead to other mental illnesses such as anxiety and depression.
With proper guidance from a trained therapist, a PTSD patient will have to go through treatments such as Cognitive Behavioral Treatment or Exposure Therapy. The main focus is not only to understand the root cause of the trauma but also to develop healthier coping mechanisms to manage the symptoms.
It is not advisable to self-medicate and self-diagnose when dealing with this kind of problem. Because there are a lot of emotional, hormonal and neurological factors at play, it is best to be left at the hands of a skilled professional.
Keep in mind that not everyone who experiences trauma develops PTSD. Some can naturally get over traumatic events by themselves, while others will need years of therapy and medications to heal their wounds.