| Post-Traumatic
Stress Disorder (PTSD) is a debilitating condition
that follows a terrifying event. Often, people
with PTSD have persistent frightening thoughts
and memories of their ordeal and feel emotionally
numb, especially with people they were once
close to. PTSD, once referred to as shell shock
or battle fatigue, was first brought to public
attention by war veterans, but it can result
from any number of traumatic incidents. These
include kidnapping, serious accidents such as
car or train wrecks, natural disasters such
as floods or earthquakes, violent attacks such
as a mugging, rape, or torture, or being held
captive. The event that triggers it may be something
that threatened the person's life or the life
of someone close to him or her. Or it could
be something witnessed, such as mass destruction
after a plane crash.
Whatever the source of the problem, some people
with PTSD repeatedly relive the trauma in the
form of nightmares and disturbing recollections
during the day. They may also experience sleep
problems, depression, feeling detached or numb,
or being easily startled. They may lose interest
in things they used to enjoy and have trouble
feeling affectionate. They may feel irritable,
more aggressive than before, or even violent.
Seeing things that remind them of the incident
may be very distressing, which could lead them
to avoid certain places or situations that bring
back those memories. Anniversaries of the event
are often very difficult.
PTSD can occur at any age, including childhood.
The disorder can be accompanied by depression,
substance abuse, or anxiety. Symptoms may be
mild or severe—people may become easily
irritated or have violent outbursts. In severe
cases they may have trouble working or socializing.
In general, the symptoms seem to be worse if
the event that triggered them was initiated
by a person—such as a rape, as opposed
to a flood.
Ordinary events can serve as reminders of the
trauma and trigger flashbacks or intrusive images.
A flashback may make the person lose touch with
reality and reenact the event for a period of
seconds or hours or, very rarely, days. A person
having a flashback, which can come in the form
of images, sounds, smells, or feelings, usually
believes that the traumatic event is happening
all over again.
Not every traumatized person gets full-blown
PTSD, or experiences PTSD at all. PTSD is diagnosed
only if the symptoms last more than a month.
In those who do have PTSD, symptoms usually
begin within 3 months of the trauma, and the
course of the illness varies. Some people recover
within 6 months, others have symptoms that last
much longer. In some cases, the condition may
be chronic. Occasionally, the illness doesn't
show up until years after the traumatic event.
Quick Facts
Post-traumatic stress disorder (PTSD) is an
extremely debilitating condition that can occur
after exposure to a terrifying event or ordeal
in which grave physical harm was threatened
or occurred. Traumatic events that can trigger
PTSD include violent personal assaults such
as rape or mugging, natural or manmade disasters,
car accidents, or military combat.
Most people with PTSD try to avoid any reminders
or thoughts of the ordeal. Despite this avoidant
behavior, many people with PTSD repeatedly re-experience
the ordeal in the form of flashback episodes,
memories, nightmares, or frightening thoughts,
especially when they are exposed to events or
objects reminiscent of the trauma. Symptoms
of PTSD also include emotional numbness and
sleep disturbances (including insomnia), depression,
and irritability or outbursts of anger. Feelings
of intense guilt are also common. PTSD is diagnosed
only if these symptoms last more than one month.
Fortunately, through research supported by
the National Institute of Mental Health (NIMH),
effective treatments have been developed to
help people with PTSD.
How Common Is PTSD?
About 4% of the population will experience
symptoms of PTSD in a given year.
When Does PTSD Strike?
PTSD can develop at any age, including childhood.
Symptoms of PTSD typically begin within 3 months
following a traumatic event, although occasionally
symptoms do not begin until years later. Once
PTSD develops, the duration of the illness varies.
Some people recover within 6 months while others
may suffer much longer.
What Treatments Are Available for PTSD?
Treatment for PTSD includes cognitive-behavioral
therapy, group psychotherapy, and medications
(including antidepressants). Various forms of
exposure therapy (such as systemic desensitization
and imaginal flooding) have all been used with
PTSD patients. Exposure treatment for PTSD involves
repeated reliving of the trauma, under controlled
conditions, with the aim of facilitating the
processing of the trauma.
Can People with PTSD Also Have Other Physical
or Emotional Illnesses?
People with PTSD can also have other psychological
difficulties, particularly depression, substance
abuse, or another anxiety disorder. The likelihood
of treatment success is increased when these
other conditions are appropriately diagnosed
and treated, as well.
Treatment
Many people with anxiety disorders can be helped
with treatment. Therapy for anxiety disorders
often involves medication or specific forms
of psychotherapy.
Medications, although not cures, can be very
effective at relieving anxiety symptoms. Today,
thanks to research by scientists at NIMH and
other research institutions, there are more
medications available than ever before to treat
anxiety disorders. So if one drug is not successful,
there are usually others to try. In addition,
new medications to treat anxiety symptoms are
under development.
For most of the medications that are prescribed
to treat anxiety disorders, the doctor usually
starts the patient on a low dose and gradually
increases it to the full dose. Every medication
has side effects, but they usually become tolerated
or diminish with time. If side effects become
a problem, the doctor may advise the patient
to stop taking the medication and to wait a
week—or longer for certain drugs—before
trying another one. When treatment is near an
end, the doctor will taper the dosage gradually.
Research has also shown that behavioral therapy
and cognitive-behavioral therapy can be effective
for treating several of the anxiety disorders.
Behavioral therapy focuses on changing specific
actions and uses several techniques to decreases
or stop unwanted behavior. For example, one
technique trains patients in diaphragmatic breathing,
a special breathing exercise involving slow,
deep breaths to reduce anxiety. This is necessary
because people who are anxious often hyperventilate,
taking rapid shallow breaths that can trigger
rapid heartbeat, lightheadedness, and other
symptoms. Another technique—exposure therapy—gradually
exposes patients to what frightens them and
helps them cope with their fears.
Like behavioral therapy, cognitive-behavioral
therapy teaches patients to react differently
to the situations and bodily sensations that
trigger panic attacks and other anxiety symptoms.
However, patients also learn to understand how
their thinking patterns contribute to their
symptoms and how to change their thoughts so
that symptoms are less likely to occur. This
awareness of thinking patterns is combined with
exposure and other behavioral techniques to
help people confront their feared situations.
For example, someone who becomes lightheaded
during a panic attack and fears he is going
to die can be helped with the following approach
used in cognitive-behavioral therapy. The therapist
asks him to spin in a circle until he becomes
dizzy. When he becomes alarmed and starts thinking,
"I'm going to die," he learns to replace
that thought with a more appropriate one, such
as "It's just a little dizziness—I
can handle it."
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Stress Homepage
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