POST TRAUMATIC STRESS DISORDER (PTSD)

Post Traumatic Stress Disorder (PTSD) is a mental health condition that can develop in individuals who have experienced or witnessed a traumatic event. PTSD, formerly known as shell shock or battle fatigue syndrome, is a serious condition stemming from experiencing or witnessing a traumatic event involving significant physical harm or threat. It’s a lasting repercussion of such ordeals, causing intense fear, helplessness, or horror. Instances triggering PTSD range from sexual or physical assault to sudden loss of a loved one, accidents, war, or natural disasters. Even families of victims and emergency personnel can be affected.

After a traumatic event, many people may experience reactions like shock, anger, nervousness, fear, or guilt, which usually fade over time. However, for individuals with PTSD, these feelings persist and worsen, hindering their normal functioning. PTSD symptoms persist for over a month, significantly impairing the person’s ability to live as they did before the triggering event.

Causes of Post Traumatic Stress Disorder (PTSD)

PTSD can be caused by experiencing or witnessing a traumatic event such as combat, a natural disaster, a serious accident, childhood abuse, physical or sexual assault, or any other life-threatening event.
Trauma can overwhelm a person’s ability to cope, leading to changes in brain function and the development of PTSD symptoms.

Prevalence

According to the National Institute of Mental Health (NIMH), approximately 7-8% of the population will experience PTSD at some point in their lives. Approximately 3.6% of adult Americans—equivalent to about 5.2 million individuals—experience PTSD within a year. Throughout their lives, an estimated 7.8 million Americans will develop PTSD. It can occur at any age, even in childhood. Notably, women are more susceptible to PTSD, possibly due to higher rates of domestic violence, abuse, and sexual assault experienced by women compared to men, with a prevalence rate of about 10%, compared to 4% in men.

Post Traumatic Stress Disorder (PTSD) triggers

Triggers for PTSD can come in all shapes and sizes, but they all have one thing in common: they remind you of the trauma you experienced. They’re like little whispers from the past, stirring up emotions and reactions that you thought you’d left behind.

Here’s a breakdown of the different types of triggers:

People: Seeing someone who reminds you of the person involved in the trauma can set off a reaction. It could be their appearance, like a beard or a certain physical trait, that acts as a painful reminder.
Thoughts and Emotions: Remembering how you felt during the traumatic event—whether it was fear, helplessness, or stress—can trigger symptoms all over again.
Objects: Sometimes, just seeing an object that was present during the trauma can bring back the memories and symptoms of PTSD.
Scents: Smells have a powerful connection to memories. Something as simple as the aroma of smoke from a barbecue could transport a fire survivor back to the traumatic experience.
Places: Returning to the scene of the trauma or encountering a similar environment—like a dark hallway—can act as a trigger, reigniting feelings of fear and distress.
Media: Watching TV shows, news reports, or movies that depict similar traumas can stir up symptoms of PTSD, reminding you of what you went through.
Feelings: Certain sensations, like pain or touch, can trigger flashbacks. For example, survivors of assault may find that a touch on a specific body part brings back painful memories.
Sounds: Hearing specific noises, songs, or voices can evoke memories of the trauma. For instance, the sound of a car backfiring might trigger memories of gunfire for a veteran.
Tastes: Even the taste of something, like alcohol, can serve as a reminder of a traumatic event.
Situations: Certain scenarios or situations may become associated with the trauma. For instance, being stuck in an elevator might remind someone of feeling trapped after a car accident.
Anniversaries: Dates marked by traumatic events, like the anniversary of a terrorist attack, can bring back vivid memories and emotions.
Words: Reading or hearing certain words associated with the trauma can also trigger symptoms of PTSD, reopening old wounds.

How do these triggers even develop?

Well, when your brain senses danger, it’s like flipping a switch. Your body gears up to fight, flee, or freeze. Your heart races, your senses go into overdrive, and your brain prioritizes survival over everything else, even short-term memory.

But with PTSD, something goes haywire in your brain’s processing. It doesn’t file away the traumatic memory like it should, as something in the past. Instead, it keeps it front and center, like an ongoing threat. This leaves you feeling on edge, even when you logically know you’re safe.

The brain latches onto certain details—like specific sights, sounds, or smells—associated with the trauma. These become your triggers, like buttons that set off your body’s alarm system. When one gets pushed, it’s like your brain hits the panic button. You might feel scared, your heart racing, and the whole trauma might rush back like a tidal wave. It’s what we call a flashback, and it’s intense.

Recognizing Triggers for PTSD

Identifying what triggers your PTSD symptoms can be a mix of the obvious and the subtle. Sometimes, you might not even realize something is a trigger until you find yourself reacting to it. It’s like those moments when your PTSD symptoms seem to appear out of nowhere. But usually, there’s an underlying trigger causing them.

One key indicator that you’ve encountered a trigger is the sensation of being in danger. This feeling often accompanies the activation of PTSD symptoms. Consulting with a therapist can be invaluable in pinpointing your specific triggers. They possess the expertise to assist you in recognizing these triggers and provide guidance on effective coping strategies.

Symptoms of Post Traumatic Stress Disorder (PTSD)

Symptoms of PTSD typically emerge within three months of the traumatic event, although in some cases, they may not surface until years later. The severity and duration of these symptoms vary greatly, with some individuals recovering within six months while others experience them for much longer.

PTSD symptoms commonly fall into four main categories:

Reliving: Individuals with PTSD often find themselves repeatedly reliving the traumatic event through intrusive thoughts, memories, or flashbacks. These can also manifest as hallucinations or nightmares. Certain triggers, like the anniversary date of the event, may evoke intense distress.
Avoidance: Those affected may go to great lengths to avoid people, places, thoughts, or situations reminiscent of the trauma. This avoidance behavior can lead to feelings of detachment from loved ones and social isolation, as well as a loss of interest in activities once enjoyed.
Increased arousal: This category encompasses heightened emotional responses, difficulties in relating to others, including expressing or receiving affection, sleep disturbances, irritability, anger outbursts, concentration problems, and being easily startled or “jumpy.” Physical symptoms such as elevated blood pressure, rapid heartbeat, tense muscles, nausea, and diarrhea may also occur.
Negative cognitions and mood: Individuals may experience negative thoughts and emotions related to self-blame, estrangement from others, and persistent memories of the traumatic event.

In children with PTSD, developmental delays may manifest in areas like toilet training, motor skills, and language.

The intensity of PTSD symptoms can fluctuate, often correlating with general stress levels or exposure to specific triggers related to the traumatic event.

Risk Factors

Certain factors may increase the risk of developing PTSD, including a history of trauma or adverse childhood experiences, lack of social support, ongoing stressors, and a family history of mental health disorders.
Additionally, the severity and duration of the traumatic event can impact the likelihood of developing PTSD.

Diagnosis for Post Traumatic Stress Disorder (PTSD)

Diagnosing PTSD typically occurs after at least one month has passed since the traumatic event. Upon identifying symptoms, a doctor initiates an evaluation by taking a comprehensive medical history and conducting a physical examination of symptoms, medical history, and exposure to traumatic events. Criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are used to guide diagnosis. Although no specific lab tests diagnose PTSD, various tests may be utilized to rule out physical illnesses as the underlying cause of symptoms.

In the absence of physical illness, the individual may be referred to a psychiatrist, psychologist, or another mental health professional with expertise in diagnosing and treating mental disorders. These professionals employ specialized interview techniques and assessment tools to evaluate the presence of PTSD or other psychiatric conditions. Diagnosis hinges on reported symptoms and any resulting functional impairments. The doctor determines whether the symptoms and level of dysfunction meet the criteria for PTSD, typically requiring symptoms to persist for more than one month.

Treatments for Post Traumatic Stress Disorder (PTSD)

Treatment for PTSD aims to alleviate both the emotional and physical symptoms, improve daily functioning, and aid in coping with the triggering event. It typically involves a combination of psychotherapy and medication.

Medication:

Doctors may prescribe certain antidepressants to manage feelings of anxiety and associated symptoms, including:

Selective serotonin reuptake inhibitors (SSRIs) like citalopram, fluvoxamine, fluoxetine, paroxetine, and sertraline.
Tricyclic antidepressants such as amitriptyline and isocarboxazid.
Mood stabilizers like divalproex and lamotrigine.
Atypical antipsychotics including aripiprazole and quetiapine. Additionally, specific blood pressure medications may be used to address particular symptoms:
Prazosin for nightmares.
Clonidine for sleep disturbances.
Propranolol to mitigate the formation of traumatic memories. It’s important to note that tranquilizers like lorazepam or clonazepam are generally discouraged due to limited effectiveness and the risk of physical dependence or addiction.

Psychotherapy:

Psychotherapy aims to equip individuals with skills to manage symptoms and develop coping strategies. Various approaches may be employed, such as:

Cognitive behavioral therapy (CBT): Helps recognize and modify thought patterns contributing to troublesome emotions and behavior.
Prolonged exposure therapy: Involves gradual exposure to traumatic memories or anxiety-inducing stimuli in a controlled environment to diminish fear responses.
Psychodynamic therapy: Focuses on exploring personal values and emotional conflicts stemming from the traumatic event.
Family therapy: Addresses how the individual’s behavior impacts family members and fosters understanding and support.
Group therapy: Provides a supportive environment for individuals to share experiences and emotions with others who have undergone similar traumas.
Eye Movement Desensitization and Reprocessing (EMDR): Originally developed to alleviate distress linked to traumatic memories, EMDR is now utilized for treating phobias as well.

These treatments are tailored to individual needs and may be used alone or in combination to effectively manage PTSD symptoms and facilitate recovery.

Home Care Tips

Engage in activities that promote relaxation and stress reduction, such as deep breathing exercises or meditation.
Maintain a healthy lifestyle with regular exercise, balanced nutrition, and adequate sleep.
Establish a support network of friends, family, or support groups to connect with during difficult times.
Limit exposure to triggers or reminders of the traumatic event, when possible.

Prevention

While it may not be possible to prevent all instances of PTSD, early intervention and support following a traumatic event can reduce the risk of developing symptoms. Seeking professional help and participating in trauma-focused therapies can also mitigate the long-term impact of trauma.

Complications of PTSD

PTSD can profoundly impact various facets of life, ranging from employment and relationships to overall health and daily functioning. Additionally, it can increase the risk of developing other mental health issues, including:

Depression and Anxiety: PTSD often coexists with depression and anxiety disorders, amplifying symptoms and impairing overall well-being.
Substance Abuse: Individuals with PTSD may turn to drugs or alcohol as a means of coping with distressing symptoms, leading to substance abuse or dependence.
Eating Disorders: Disordered eating patterns, such as binge eating or restrictive behaviors, may develop as individuals attempt to manage overwhelming emotions associated with PTSD.
Suicidal Thoughts and Actions: The emotional turmoil and sense of hopelessness experienced with PTSD can elevate the risk of suicidal ideation and behaviors, necessitating prompt intervention and support.

When to See a Doctor

If you or someone you know is experiencing symptoms of PTSD that interfere with daily functioning or quality of life, it’s essential to seek help from a mental health professional.
Prompt diagnosis and treatment can improve outcomes and enhance overall well-being.

Outlook/Prognosis

With proper treatment and support, many individuals with PTSD can experience significant improvement in symptoms and quality of life.
However, the course of PTSD can vary, and some individuals may experience ongoing challenges or relapse.
Continued access to treatment and support services is crucial for long-term recovery.

Sources:

National Institute of Mental Health (NIMH)
American Psychiatric Association
National Alliance on Mental Illness.
Mayo Clinic

POST TRAUMATIC STRESS DISORDER PTSD