What is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) is severe anxiety disorder that may develop as a result of exposure to a terribly frightening, life-threatening, or otherwise highly unsafe experience (i.e. trauma). This event may involve the threat of death to oneself or someone else. It could be a sexual or physical assault, unexpected death of a loved one, an accident, war or a natural disaster. Post-traumatic stress disorder is a lasting consequence of such stressful ordeals.
Many people who have experienced such traumatic events will have reactions that include anger, shock, fear, guilt, and nervousness. These reactions are common and dissipate over time. However, for someone suffering from PTSD, these feelings increase and often become so strong that they prevent the person from living a normal life.
Who Gets Post-Traumatic Stress Disorder?
Everyone handles traumatic events differently – just as each person handles fears, threats and stresses in a unique way. That means that not every person who witnesses or experiences a traumatic event will develop post-traumatic stress syndrome. Also, the support and help a person receives following the traumatic event influences the development of PTSD and the severity of symptoms of the disorder.
While PTSD was once known as something that happened to war veterans, it is now known that post-traumatic stress disorder can occur in anyone following a stressful event. The likelihood for developing PTSD depends upon many things, including:
- The intensity of the trauma and how long it lasted
- If you lost someone close to you
- How close you were to the event
- The strength of your reaction
- How in control you felt about the traumatic event
- The amount of help and support you got after the traumatic event
What Are The Risk Factors For Developing PTSD?
There are risk factors for developing PTSD, though. They include:
- Those who have had previously traumatic experiences – especially in early life.
- Those who have a history of physical, sexual or substance abuse.
- Those who have a history of mental illness, including depression and anxiety.
- Those who have a lack of support after trauma.
- Traumatic events are more likely to cause PTSD if they involve a severe threat to one’s life or personal safety – the more prolonged and extreme, the greater the risk for development of PTSD.
- Those who have suffered childhood abuse are at greater risk for development of post-traumatic stress disorder.
- Victims of physical and/or sexual trauma face the greatest risk for development of PTSD.
What Are The Symptoms of PTSD?
Symptoms of PTSD often begin within three months of the traumatic event, although they can take years to surface. The severity and duration of post-traumatic stress disorder varies from person to person – some recover within six months while others suffer many years.
PTSD can negatively impact everyday functioning at work and at home, as it often disrupts the normal course of a person’s day and makes it difficult to sleep, eat, or focus on a task.
The symptoms of PTSD are grouped into four categories:
Reliving: PTSD sufferers re-experience the stressful or traumatic event in some way. These can include thoughts and memories of the trauma, nightmares, intrusive thoughts, and flashbacks. Someone with PTSD may also feel distress when they are reminded of the trauma, such as an anniversary of the event.
Avoidance: People who have PTSD may avoid places, people, or other things that remind them of the event or trauma. This may lead to feelings of detachment and isolation from loved ones and friends, as well as a general loss of interest in once-pleasurable activities.
Increased Arousal: People who have post-traumatic stress disorder may become exquisitely sensitive to normal life experiences. This is also known as hyper-arousal. Symptoms of hyper-arousal may include being easily startled, emotional outbursts, difficulty concentrating, increased blood pressure, muscle tension, and/or nausea and vomiting.
Feeling Emotionally Numb: It may be very hard for someone who experiences PTSD to express and feel their emotions. This is a way to cope with memories, but can feel very discomfiting for both the person with PTSD and their loved ones.
Other symptoms of post-traumatic stress disorder include:
- Drug or alcohol abuse
- Problems holding a job
- Relationship troubles, including divorce and domestic violence
- Feelings of hopelessness, shame or despair.
Can Kids Have Post-Traumatic Stress Disorder?
Anyone at any age can develop post-traumatic stress disorder. Their symptoms may be similar to those listed above or can be different. Older children experience symptoms similar to adults. Here are some other symptoms children with PTSD may have:
- Young children may have trouble being separated from parents or caregivers
- Children may have trouble sleeping
- Previously toilet-trained children may suddenly start having accidents or have difficulty using the bathroom.
- Children ages 6-9 may act out the traumatic event through drawings, stories and play. They may also develop anxieties or fears that do not seem to be related to the traumatic event.
Is Post-Traumatic Stress Disorder Common?
PTSD is more common than once believed. It’s estimated that about 5.2 American adults suffer from PTSD each year, and 7.8 Americans will suffer it at some point in their lifetime.
PTSD can develop at any age – including childhood.
Women are more likely to develop PTSD than men, although that may be due to the fact that women are more likely to be the victims of domestic violence, sexual assault and rape than men.
How is Post-Traumatic Stress Disorder Diagnosed?
If the symptoms of post-traumatic stress disorder are present, a complete medical history and physical exam will be performed. If no physical illness is found, a general family practitioner will refer the patient to a mental health professional for a more thorough examination.
A mental health professional will perform a specially designed interview to ascertain whether PTSD is present and how severe the symptoms may be. From there, the therapist and person with PTSD can work together to develop a treatment plan to work on managing the symptoms of the disorder.
How is Post-Traumatic Stress Disorder Treated?
The goal of treatment for PTSD is to reduce the physical and emotional symptoms, improve daily functioning and help the person better cope with the event that triggered the disorder. Treatment for PTSD often involves therapy, medication or both.
Medication – Often, those who have PTSD are prescribed antidepressants to control the feelings of anxiety associated with the disorder. Other medications that may be prescribed are mood stabilizers and tranquilizers.
Therapy – Therapy teaches a person who has PTSD to learn skills to manage symptoms of the disorder and learn to cope with the event and fears that triggered the disorder.
Coping With Specific Post-Traumatic Stress Disorder Symptoms:
PTSD has very specific and very debilitating symptoms. Here are some ways to cope with these symptoms:
Intrusive memories, thoughts or images:
- Remind yourself that they’re just memories.
- Remember that while these can be overwhelming, the reminders often dissipate over time.
- Remind yourself that it’s normal to have memories of the traumatic event.
- Talk about these things with someone that you trust.
Sudden feelings of panic or anxiety:
PTSD often leaves us with our hearts pounding, feeling light-headed or spacey (often called by quick breathing.) If this is something that happens, remember:
- These reactions aren’t dangerous – you wouldn’t notice if you had them while exercising.
- These feelings may come with scary thoughts, which is what may make them so upsetting. These scary thoughts are not true.
- Try to slow down your breathing.
- These awful sensations will pass.
Difficulty concentrating or focusing:
- Slow down – give yourself time to focus upon what it is you need to do.
- Make “to-do” lists every day.
- Break big tasks into smaller doable chunks.
- Plan a realistic amount of tasks to do in a day.
- You may be suffering depression – if so, talk to your doctor about your symptoms.
Trouble feeling or expressing positive emotions.
- Remind yourself that this is a common reaction to trauma, not something you’re doing on purpose.
- Don’t feel guilty for something you can’t control.
- Continue engaging in activities you like or used to like. Even if you don’t think you’ll enjoy it now, once you get into it, you may find yourself feeling pleasurable feelings.
- Take really small steps to tell your loved ones you care – write a card, leave a gift, send an email, call them to say hi.
- Keep your eyes open – look around and see, really see where you are.
- Talk to yourself. Remind yourself that you’re here, that you’re safe. The trauma is long-since over and you are in the present.
- Get up and move around. Take a drink of water or wash your hands. Interrupt the flashbacks with movements.
- Call someone you trust and tell them that you’re experiencing a flashback.
Irritability, anger and rage:
- Before reacting, take a time out to cool off and think.
- Walk away from the situation.
- Exercise every day – exercise reduces tension and relieves stress.
- Talk to your doctor about your anger.
- Take anger management classes.
- If you blow up at family or friends, find time to talk to them and explain what happened and what you are doing to cope with it.
Nightmares about the trauma:
- If you wake from a nightmare in a panic, remind yourself you’re reacting to a dream. The DREAM is responsible for the panic, not any current danger.
- Get out of bed, regroup, and orient yourself to the present.
- Try a pleasant and calming activity like taking a bath or listening to soothing music.
- If someone is awake, talk to them.
- Tell your doctor that you’re having nightmares.
Difficulty falling or staying asleep:
- Keep a regular bedtime schedule and routine.
- Avoid heavy exercise for a few hours before bed.
- Use your bed only for sex and sleeping.
- Don’t use alcohol, tobacco, and caffeine – these hurt your ability to sleep.
- Don’t lie there in bed thinking or worrying. If you can’t sleep, get up and do something quiet like drinking herbal tea, or warm milk. Read a book or do something else quietly.
How Do I Manage PTSD At Home?
Recovering from PTSD is a gradual, ongoing process that can take many months or years. The memories of the trauma will never disappear completely, although in time they will become manageable. Here are some ways to cope with residual complications from PTSD:
Recovery – Remember that recovery is a process, not an event, that happens gradually. Having an ongoing response to stress is normal. Healing doesn’t mean forgetting the event or removing all pain while thinking about the event – healing means learning to cope with the symptoms.
Learn – learning about trauma and PTSD in response to a traumatic event as well as some common signs and symptoms may help you to realize you’re not alone, weak or crazy. It helps to know your problem is something shared by many, many others.
Relax – sometimes, relaxation techniques can be helpful for people with PTSD. These activities include: muscle relaxation exercises, breathing exercises, meditation, prayer, spending time in nature, yoga, listening to quiet music. In others, however, these may increase distress at first. If that happens, simply try relaxation techniques for smaller periods of time, or mix them with other activities like listening to music or walking.
Don’t Isolate – The urge to pull back and isolate is very strong in those who have PTSD. It’s easy to feel disconnected to everyone around you, withdrawing from loved ones and social activities. It’s very important to have support from others while you recover, so resist the urge to isolate.
Join a Support Group – find a support group for people who have experienced similar types of trauma in your area. Being around people who understand what you are going through is priceless when it comes to recovery. It can remind you that you are not alone and provide you with invaluable information and tools for making a recovery from PTSD. If there are no local support groups, try online.
Don’t Self-Medicate – While you’re struggling with traumatic memories and painful emotions, the urge to use alcohol and drugs can be overwhelming. It’s a temporary fix. And unfortunately, these substances worsen PTSD in the long run, as they worsen symptoms like emotional numbing, social isolation, anger and depression.
Overcome Helplessness – trauma leaves you feeling vulnerable and powerless. It’s easy to forget that you do, in fact, have both coping skills and strengths. One of the best ways to overcome these feelings is to help other people. Donate time, money, help friends, or take other positive action. Taking positive action directly refutes the feelings of helplessness common in PTSD.
How Do I Help A Loved One With PTSD?
Be Patient and Understanding – Recovery from PTSD takes time – even if a person is actively trying to get better. Be patient with the pace (slow as it may be) and offer a kind ear. Someone with PTSD may need to talk about their trauma over and over – this is part of the healing, and while it can be frustrating to hear, don’t tell your loved one to “move on,” or “stop talking about it.”
Don’t Pressure – Sometimes, it can be very hard for someone with PTSD to talk about their trauma. For some people, it may make the situation worse. So never, ever force someone into discussing their trauma. Simply let them know that you are there if they’d like to talk.
Try to Prepare for PTSD Triggers – many people who have PTSD will have triggers around the anniversary of the trauma, certain sights, sounds, or smells. If you’re aware of what these triggers are, you can offer support and help to calm your loved one.
Don’t Take It Personally – Some of the more common PTSD symptoms can hurt your feelings. These may include anger, withdrawal, and isolation. If your loved one seems distant or irritable, remember this probably has nothing to do with you.
Be There – sometimes the biggest help for someone who is suffering from PTSD is to have a partner, friend, or other loved one simply be there for them. Do simple favors. Offer unconditional love. Don’t push. Simply be there for them.
It’s Not “In Their Head” – being the partner of someone with an invisible illness can be very stressful. You may wonder why they don’t just “get over it.” The thing is – PTSD is a real illness, and your loved one may already feel as though they’re going crazy. Don’t add to it by making your partner feel badly for having these emotions or guilt them for “not getting over it.” It’s not as simple as that.
Help Yourself – if handling the flashbacks, the anxiety, the numbing, and the rest of the PTSD symptoms are becoming too stressful for you, seek help for yourself. No one ever said you had to go through this alone. Seeing a therapist or attending a support group yourself can ease the burden tremendously.
What is Complex Post-Traumatic Stress Disorder?
Repeated traumatic events (such as long-term abuse) can result in what is known as Complex Post-Traumatic Stress Disorder (it may also be called Disorders of Extreme Stress Not Otherwise Specified or DES-NOS).
The current PTSD diagnosis doesn’t quite capture the severe psychological harm that occurs with prolonged, repeated trauma. Complex PTSD is somewhat different from typical PTSD as repeated traumas can cause the individual to question their own self-concept and alter adaptive abilities; in other words, the individual’s ability to distinguish between safety and danger is compromised. There is talk of adding Complex PTSD, with new criteria, to the DSM-IV.
According to the National Center for PTSD, symptoms of Complex PTSD may include:
Changes in emotions and the ability to regulate them. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
Changes in consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body.
Changes in how one thinks of themselves. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
Changes in how the victim sees the perpetrator of the trauma. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
Changes in interpersonal relationships. Examples include isolation, distrust, or a repeated search for a rescuer.
Changes in one’s system of values and meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.
Post-Traumatic Stress Disorder During The Holidays:
People suffering from Post Traumatic Stress Disorder (PTSD) may have a more difficult time during the holidays for any number of reasons:
PTSD sufferers can suffer setbacks at the anniversary or during the season the anniversary of the traumatic event occurred. For example, if someone has PTSD because of being molested by a family member during the holidays, the holiday season may bring back the memories and make it difficult to relax and enjoy the holiday. If a veteran remembers spending a horrible holiday seeing other members of their unit killed, the holiday season may be difficult to make it through. Sometimes, those suffering from PTSD do not understand why or cannot explain why they are irritable or cannot enjoy the holidays.
Family members try to make the holiday special and may end up feeling angry instead when the person with PTSD is not willing or able to participate in holiday events.
Holidays and family functions can make the PTSD sufferer feel like an outsider. They may feel uncomfortable joining in the celebration and, as a result, end up feeling alone and isolated. Although family members may try to include the person with PTSD, if the event brings back memories or makes him or her uncomfortable, being pushed into participating can make the feelings of isolation even more uncomfortable.
PTSD sufferers may have survivor’s guilt. The traumatic event that caused the PTSD may be one in which other people perished. This may create guilt and cause them to wonder why he or she survived and others did not. Holidays may increase these feelings. Family members, with good intentions, can create even more guilt by either ignoring the situation or calling attention to it. The survivor must be able to grieve in his or her own way and family members must be respectful of that grief.
Large crowds or events with alcohol can be problems for people with PTSD. He or she may feel unsafe in places with many people or large crowds. Trips to the mall or large family gatherings may bring about such uncomfortable feelings the sufferer may instead avoid all situations that involve crowds.
People with PTSD have a larger chance than the general public of having problems with alcohol. Holiday parties often include alcoholic beverages and this may be a big problem, especially if triggers are around.
No matter what the reason, the holiday season is often difficult for people with PTSD, but there are a number of things they can do to help manage their PTSD during this holiday season:
Understand Your Triggers – Knowing what your triggers are and having techniques to cope with triggers can help you to make it through family gatherings or shopping trips.
Develop Coping Strategies– Anxiety coping techniques, such as deep breathing or removing yourself from the situation for a few minutes can help.
Prepare Yourself – Be prepared for situations that may come up. You may want to write down some of your coping strategies. When a stressful situation arises, you can take out your notes and use the strategies. Sometimes during a stressful situation, you can forget what helps. Having it written down can help calm you down.
Accept You may Need to Leave – If your anxiety becomes difficult or impossible to handle, excuse yourself and leave, even if just for a few minutes. Sometimes leaving for a few minutes may enable you to relax and return for the rest of the event. Other times, your anxiety may require you to leave the event. Whichever it may be, leaving is an option and those people that care about you will understand.
Prepare First – When accepting a social invitation, ask the host or hostess questions to help you be more prepared. How many people will be attending? Who will be attending? By knowing about the event, you can prepare yourself for possible triggers and knowing in advance can help you cope with the triggers.
Create a Support Network – Finding someone that understands and is willing to provide you with support is a wonderful feeling. Bring a friend with you to events you find to be scary or may contain triggers for PTSD. Knowing there is someone that understands what you are feeling and will be watching for signs of anxiety can help and make coping with the situation easier.
The holidays are a time of spirituality. No matter whether you celebrate Christmas, Hanukah or Kwanzaa, the meaning behind the holiday is love and peace. Family celebrations are meant to accentuate these feelings. However, holidays do not need to be celebrated only with family gatherings. Finding your own way to celebrate can make the holidays meaningful. Take time to volunteer at a local hospital or by providing food baskets to those that need them. Sometimes, reaching out to others that are in pain can help to relieve your own pain.
Additional Post-Traumatic Stress Disorder Resources:
Anxiety Disorders Association of America – promotes the prevention, treatment, and cure of anxiety and stress-related disorders through advocacy, education, training, and research.
Sidran Institute Traumatic Stress Education and Advocacy – non-profit organization that helps people understand, recover from and treat those who have PTSD, dissociative disorder, and disorders that coexist with those disorders.
International Society for Traumatic Stress Studies – an international, interdisciplinary professional organization that promotes advancement and exchange of knowledge about traumatic stress. This knowledge includes understanding the scope and consequences of traumatic exposure, preventing traumatic events and ameliorating their consequences, and advocating for the field of traumatic stress.
The National Center for Post Traumatic Stress Disorder – US Department of Veterans Affairs website. A wealth of information for families of veterans as well as anyone else who suffers from PTSD and/or related anxiety disorders.
Make The Connection – A support community run by the US Department of Veterans Affairs, geared towards helping connect military personnel with others who can help and resources to get them help with issues that arise upon coming home from a deployment.
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