Posttraumatic stress (PTSD) is a common reaction to traumatic or stressful events. Studies indicate 3.5% of the United States (U.S.) population will experience PTSD in any given year. Almost 37% of these cases can be classified as “severe.”

Someone with PTSD may relive a traumatic experience through memories and dreams. They may avoid reminders of the trauma to prevent emotional distress. PTSD can also involve memory issues and a heightened reactivity to one’s surroundings.

PTSD takes many forms. It may happen due to a natural disaster or a personal tragedy. It may arise immediately after an experience or years later. People of any gender, ethnicity, and background can experience it.

Posttraumatic stress is a treatable condition. People with PTSD may wish to contact a therapist. Therapy can help people process distressing emotions and memories. Understanding one’s symptoms is often the first step to reducing them.

WHAT CAUSES PTSD?

PTSD can occur after any type of physically or psychologically stressful event. Situations that may bring about PTSD include:

• Transportation accidents

• Military combat

• Domestic violence

• Sexual abuse or assault

• Vicarious trauma, such as learning of the death of a loved one or experiencing an attack as a bystander

During a shocking or scary event, it is natural to experience a “fight or flight” response. Increased adrenaline and stress can be necessary for survival in emergencies. Strong emotions like anger and fear are also common.

Yet some people will continue responding to trauma long after the danger has passed. Their mind’s immediate reaction to the emergency becomes a default pattern. Mental health professionals look for behaviors that have a lasting and detrimental impact. When someone’s response to trauma interferes with their daily life, a diagnosis of PTSD may be appropriate.

SYMPTOMS OF PTSD

The Diagnostic and Statistical Manual (DSM) outlines four categories of PTSD symptoms: re-experiencing, avoidance, arousal/reactivity, and cognition/mood. To qualify for a PTSD diagnosis, an individual should have symptoms from each category. All the symptoms must have been present for at least one month.

1. Re-experiencing symptoms (need at least one):

• Recurring and intrusive memories of the trauma

• Flashbacks where the person feels or acts as if the trauma is recurring

• Disturbing or scary thoughts when faced with reminders of trauma

• Nightmares

• Intense physiological reactions to reminders of trauma, such as rapid heartbeat and sweating

2. Avoidance symptoms (need at least one):

• Avoiding reminders of the traumatic experience, including people, situations, places, or objects

• Repressing or ignoring emotions or thoughts related to the event

3. Arousal and reactivity symptoms (need at least two):

• Outbursts of anger with little provocation

• Reckless or self-destructive behavior

• Startling easily

• Tension or a feeling of being “on edge”

• Insomnia

• Difficulty concentrating

4. Cognition or mood symptoms (need at least two):

• Inability to remember an important detail of the event

• Exaggerated negative beliefs such as “I am bad” or “nobody can be trusted”

• Feeling constant negative emotions like shame or horror

• Unfairly blaming oneself or others for the event

• Inability to feel positive emotions like happiness and satisfaction

• Lack of passion for previously enjoyed activities

• Feeling detached from other people

Most cases of PTSD begin within the first three months after the trauma, but some individuals may not develop symptoms until six months or later.

HISTORY OF PTSD

Before modern medicine, doctors thought posttraumatic stress was a physical condition. American Civil War records speak of a condition called “Da Costa’s Syndrome.” Soldiers diagnosed with the syndrome would have anxiety, a rapid pulse, and trouble breathing. Medics assumed the soldiers had overstimulated their hearts. Soldiers received medicine to control their symptoms and returned to war soon after.

In World War I, posttraumatic stress was called “shell shock.” Common symptoms of shell shock included headaches, flashbacks, and sensitivity to loud noises. Physicians thought soldiers’ symptoms were due to brain damage from artillery shells. But many soldiers who hadn’t been near explosions showed shell shock as well. Scientists dismissed this second group as having “a weakness of nerves.”

Modern research shows no connection between PTSD and resilience. There is no evidence that individuals with PTSD are emotionally weaker than anyone else. But in the early twentieth century, soldiers with posttraumatic stress often faced extreme stigma. During WWI and WWII, the military’s priority was usually returning soldiers to the battlefield rather than promoting mental health.

The DSM did not list posttraumatic stress as a diagnosis until 1980. By then, scientists had data from Vietnam veterans, Holocaust survivors, and more. Experts agreed PTSD was a mental health condition rather than a physical injury or character flaw.

PTSD AND CO-OCCURRING MENTAL HEALTH CONDITIONS

People with PTSD are 80% more likely to have a comorbid mental health concern than those without the condition. Depression, substance abuse, and anxiety often co-occur with PTSD. Children with PTSD are likely to have comorbid oppositional defiant behavior and separation anxiety. Veterans with PTSD are 48% likely to also have a mild traumatic brain injury.

Other mental health issues can exacerbate PTSD symptoms. They may lower mood, disrupt concentration, or bring out aggressive tendencies. These complicating issues can prevent individuals from seeking help. They may isolate themselves from loved ones or avoid treatment resources. If someone with PTSD has a comorbid condition, it can be quite difficult for them to get necessary care.

A therapist can identify if co-occurring conditions are contributing to PTSD. Therapy can help someone reduce symptoms from PTSD and any other diagnoses. There is no shame in seeking help.

SOURCE: https://www.goodtherapy.org/learn-about-therapy/issues/ptsd