Post-traumatic stress disorder (PTSD) is a condition that is caused by a reaction to extreme stressors that posed the threat of death or extreme injury. Post-traumatic stressors can include military combat, war, sexual assault, car accidents, natural disasters, terrorism, or domestic violence. Those who suffer from PTSD can be survivors or witnesses to these stressors and have a belief that they were going to die or their life was in danger.
While it is normal to have a fearful or distressing reaction to these types of events, those with PTSD experience the aftermath of chronic anxiety, flashbacks, and/or nightmares that can last months or years after the traumatic event.
According to the National Institute of Mental Health, nearly 8 million Americans 18 years and older suffer from post-traumatic disorder symptoms; children can also suffer from PTSD.
People with post-traumatic stress disorder are at a greater risk of co-occurring illnesses such as depression, substance abuse, or other anxiety disorders.
What is Posttraumatic Stress Disorder?
Posttraumatic Stress Disorder is a mental disorder that can develop in people who have experienced or witnessed extremely stressful events, including military combat, sexual assault, war crimes, natural disasters, car accidents, and terrorist attacks, among others.
Those with PTSD continue to reexperience the traumatic event in the form of nightmares, flashbacks, or rumination long after the event has ended, usually months or years. The persistent thoughts of the event can cause sadness, anger, and depression, as well as hypervigilance and anxiety. Those struggling with symptoms may avoid certain places or people who remind them of the event and may have extreme reactions to sounds or other sensory experiences that trigger symptoms, such as a loud noise, certain smells associated with the traumatic event, or fear of crowded spaces.
Additional symptoms may include survivor’s guilt, shame, isolation, feelings of emptiness, disconnection with others whom they believe don’t understand their distress, anger, mistrust of others, and difficulty expressing emotions. Those struggling with PTSD may also go through a cyclical process of reexperiencing, avoiding, and numbing, which may include substance abuse.
The diagnosis of PTSD requires that a person be exposed to a traumatic event, although people struggling with posttraumatic stress can indirectly be exposed to extreme stressors – such as close family members who died violently and meet the criteria for PTSD.
Posttraumatic Stress Disorder in Combat Veterans and Military
Posttraumatic stress disorder was first attributed to combat veterans, originally described as “shell shock” or “battle fatigue.” However, research has since proven that PTSD has been seen in individuals who have experienced traumatic events, other than war. However, research has suggested that there may be differences in treatment for veterans versus civilians. Veterans have been trained to go into dangerous situations to fight and may have a different degree of hypervigilance than civilians who experienced trauma outside of war. Their treatment may be different for veterans, focusing more on reentry into society and reducing their “fight” impulse.
While there is uncertainty regarding the causes of post-traumatic stress disorder, there are several factors that can trigger PTSD symptoms. Those include:
Trigger of “Fight or Flight” Response
One theory on the trigger of PTSD involves our “flight or fight” response system that triggers “survival” mode. Flashbacks or ruminations about the traumatic event may trigger our survival mechanism and we begin to believe we need to relive or re-experience the event so we can better prepare for it in the future. However, reliving the experience doesn’t allow healing or processing of the event itself.
Recent studies have shown that those who suffer from PTSD may have an abnormal level of stress hormones.
Those who were sexually abused or experienced other severe childhood trauma may be at a greater risk of post-traumatic stress disorder should they experience another traumatic event in the future.
These factors may increase your risk of developing PTSD:
- Having a history of other mental disorders such as anxiety, depression, or substance abuse
- Having experienced a multitude of previous traumas, including childhood trauma of sexual abuse or emotional neglect.
- Having a job that increases your risk of traumatic events, such as first responders and medical personnel.
- Lacking an empathetic support system
Signs and Symptoms
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a reference manual used by healthcare professionals as the authoritative guide to the diagnosis of mental disorders – the criteria for a post-traumatic disorder diagnosis are listed below, although a formal diagnosis must come from a licensed and experienced clinician.
For an individual — an adult, adolescent, or child older than 6 — to be diagnosed with PTSD they must meet each of the criteria.
Have had exposure to actual or threatened death, serious injury, or sexual assault either through directly experiencing the event, witnessing the event, learning that the traumatic event occurred to a loved one, or experiencing repeated exposure to traumatic event vicariously through others (i.e., first responders or DCS workers exposure to child neglect or abuse).
Criterion B (one required)
Presence of one or more of the following intrusive symptoms:
- Recurrent and involuntary memories of the event that causes distress
- Recurrent distressing dreams connected to the traumatic event
- Flashbacks that make people feel as if the event is recurring
- Intense or prolonged psychological distress at exposure to cues that remind or resemble the event
- Intense physiological reactions to reminders of the event.
Criterion C (one required)
Avoidance of trauma-related stimuli in the form of the following:
- Avoidance of external reminders
- Avoidance of thoughts or feelings
Criterion D (two required)
Negative thoughts or emotions that began and worsened after the trauma as evidenced by the following:
- Struggle to recall specifics of the trauma
- Low self-worth and negative perspective of one’s self
- Flat or negative emotional effect
- Disinterest in activities
- Isolation and emptiness
- Self-blame or blaming of others for the event
- Difficulty showing emotion
Criterion E (two required)
- Hyperarousal and negative reactivity connected to the trauma with the following symptoms:
- Irritability or anger with little or no provocation
- Exaggerated emotional response
- Struggles with focus and concentration
- Sleep disturbance
The symptoms have lasted at least one month.
The symptoms cause marked impairment and functioning in work and social settings.
Assessment for Posttraumatic Stress Disorder
A diagnosis of post-traumatic stress disorder requires an evaluation and diagnosis by a licensed clinician such as a psychiatrist or psychologist who specializes in bipolar disorders. Because the assessment process for PTSD can be painful, at Clarity Clinic, we are sensitive to the symptoms that may arise because of the trauma and ensure a safe environment to talk about the trauma experience. Additionally, our clinicians will assess for co-occurring disorders, such as substance abuse, anger issues, or suicidal ideation, which may need to be treated before developing the treatment plan for PTSD.
Treatment for Posttraumatic Stress Disorder
Both medication and psychotherapy in conjunction are effective in helping reduce symptoms of PTSD. At Clarity Clinic our experienced clinicians guide clients toward the proper treatments, including pharmacological and non-pharmacological interventions.
Our psychiatrists ensure a proper diagnosis and take care of specialized medication management for clients treating depressive disorders through pharmacological treatment.
Our psychiatrists ensure a proper diagnosis and take care of specialized medication management for clients treating PTSD through pharmacological treatment.
Our psychotherapists work in conjunction with the treatment team to individually tailor the treatments and therapies, which may include exposure therapy — a type of therapy that exposes patients gradually to feared objects or situations in a safe environment to help overcome their distress. Other types of therapies used for PTSD may include cognitive therapies to change distorted thoughts and behaviors, as well as anxiety management training.
For more information on PTSD, below are several additional resources to help learn more:
Posttraumatic Stress Disorder Alliance