POST-TRAUMATIC STRESS DISORDER (PTSD)

Sidran Traumatic Stress Foundation

The destruction of the World Trade Center, the violent attack on the Pentagon, and the crashes of hijacked aircraft have impacted all of our lives. These attacks upset our basic sense of safety. You may now be experiencing feelings of shock, disbelief, anger, and anxiety. You may have trouble concentrating, or feel overwhelmed by your emotions. All of these feelings are normal reactions to traumatic events. With the support of friends, family, faith communities and counselors, most of us will be able to get back into the routines of our lives within a few weeks.

However, some people face situations that are so traumatic that they may become unable to cope and function in their daily lives. They may become so distressed by memories of the trauma -- memories that won't go away -- that they begin to live their lives trying to avoid any reminders of what happened to them.

A person who still feels this way months after a traumatic experience took place may be suffering from Posttraumatic Stress Disorder, or PTSD, a serious and common health condition. For these people, getting beyond the trauma and overcoming PTSD requires the help of a professional. Untreated PTSD is associated with an extremely high rate of medical and mental health service use, and possibly the highest per-capita cost of any psychological condition.

But there is help and there is hope.

PTSD is a long-term problem for many people. Studies show that 33-47 percent of people being treated for PTSD were still experiencing symptoms more than a year after the traumatic event. Without treatment many people continue to have PTSD symptoms up to ten years after the traumatic event.

What are the symptoms of PTSD?

PTSD symptoms are divided into three categories. People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. However, the diagnosis of PTSD means that someone has met very specific criteria. The symptoms for PTSD are listed below.


Intrusive Re-experiencing (re-living the event)

People with PTSD frequently feel as if the trauma is happening again. This is sometimes called a flashback, reliving experience or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.


Avoidance

People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.


Arousal

Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled, irritable and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

 
Who gets PTSD?

PTSD can affect anyone at any age who has been exposed to a traumatic event where he/she experienced terror, threat (or perceived threat) to life, limb or sanity and his/her ability to cope was overwhelmed. Conservative estimates show that 9-10 percent of the general population has PTSD. Among people who were victims of specific traumatic experiences (rape, child abuse, violent assaults, etc.), the rate of PTSD is 60-80 percent.

Diagnosis

Unfortunately, it is common for those with PTSD to avoid treatment. Also, it is common for those who do seek treatment to be misdiagnosed. Because PTSD often occurs at the same time as other physiological and mental health disorders, PTSD symptoms may be masked or difficult to identify. Examples of common co-occurring conditions are depression, substance use/dependence and bipolar disorder. Trauma survivors may also experience headaches, chest pain, digestive or gynecological problems as well. However, there is a growing number of clinicians who are skilled at recognizing PTSD and still others who are specializing in treatment of traumatic stress disorders. If you think you might have PTSD you should seek professional help for a thorough physical and mental health assessment.

 
Can PTSD be treated?

Yes. A person who has survived a traumatic event will probably never feel as if the event didn't happen, but the disruptive, distressing effects of PTSD are completely treatable. Depending on the source of the trauma (manmade vs. natural), the nature of the trauma (accidental vs. purposeful), and the age of the victim at the time of the trauma, treatment strategies may vary. Treatment involves both managing symptoms and working through the traumatic event. Most experts agree that psychotherapy is an important part of recovery. Medications can help reduce some symptoms allowing psychotherapy to be more effective.