| 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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