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Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD): Causes, Symptoms, Diagnosis, Treatment, and Prevention

People with post-traumatic stress disorder (PTSD) are those who have been exposed to or witnessed a traumatic event, such as a natural disaster, an accident, a war, or a sexual assault. We will discuss the causes, symptoms, diagnosis, treatment, and prevention of PTSD in this blog post, which can cause severe and persistent symptoms that interfere with daily functioning and quality of life.

Causes of PTSD

The exact cause of PTSD is not known, but it is believed that some factors may increase the risk of developing PTSD after a traumatic event. These factors include:

  • The type, severity, and duration of the trauma

  • The personal and emotional impact of the trauma

  • The lack of social support or coping skills

  • The presence of pre-existing mental health problems, such as depression or anxiety

  • The family history of PTSD or other mental disorders

  • The genetic makeup and biological factors that affect the brain’s response to stress

A traumatic event does not necessarily result in PTSD in every person. Approximately 7-8% of Americans will experience PTSD at some point in their lives1. Some people may recover from the trauma with time and self-care, while others may develop chronic and debilitating symptoms.

Symptoms of PTSD

People with PTSD can experience varying symptoms, but they generally fall into four categories: intrusive memories, avoidance, negative changes to their thinking and mood, and changes in their physical and emotional reactions. The symptoms of PTSD may begin within one month of the traumatic event, or they may appear years later. They may also fluctuate over time or in response to triggers that remind the person of the trauma.

  • An intrusive memory occurs when a person experiences recurrent and distressing memories of a traumatic event. It may manifest itself as flashbacks, nightmares, or hallucinations, making them feel as if they are reliving the trauma on repeat. When they encounter reminders of the trauma, they may also experience intense emotional or physical reactions, such as fear, anger, guilt, shame, sweating, and heart palpitations.

  • People who experience trauma tend to avoid everything that reminds them of the trauma, such as people, places, objects, activities, or situations. Also, they may try to avoid thinking or talking about the trauma or their feelings about it. They may lose interest in things they used to enjoy or isolate themselves from others.

  • The person may experience persistent and distorted beliefs or feelings about themselves, others, or the world, resulting in negative changes in thinking and mood. Traumatized people may feel detached from their own emotions or body or have difficulty recalling important aspects of their trauma. They may also experience negative emotions, such as sadness, anger, guilt, shame, or fear, or may have difficulty experiencing positive emotions, such as happiness, love, or satisfaction. Their trust in others or in themselves may be lost, or they may feel hopeless about the future.

  • People may experience changes in arousal or reactivity that affect their behavior or physiology. A person may be easily startled or frightened, or always on alert for danger, or they may have difficulty sleeping or concentrating, or act impulsively or aggressively. They may also engage in self-destructive or risky behaviors, such as substance abuse, reckless driving, or suicidal attempts.

An individual with PTSD may experience significant impairments in their social, occupational, or personal lives. As well as increasing the risk of depression, anxiety, substance abuse, eating disorders, cardiovascular disease, or chronic pain, they can also increase the risk of developing other mental or physical health problems.

Diagnosis of PTSD

The diagnosis of PTSD is based on a comprehensive evaluation by a mental health professional, such as a psychologist or a psychiatrist. The evaluation may include:

  • A physical examination to rule out any medical conditions that may cause or worsen the symptoms

  • A psychological assessment to evaluate the person’s history, symptoms, coping skills, and functioning

  • A standardized questionnaire or interview to measure the severity and frequency of the symptoms and their impact on the person’s life

  • A diagnostic criteria to confirm the diagnosis of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-11)

According to the DSM-5, the diagnostic criteria for PTSD are:

  • Exposure to actual or threatened death, serious injury, or sexual violence, either directly, as a witness, or indirectly, as a close relative or friend of the victim, or as a professional who repeatedly deals with trauma

  • Presence of at least one intrusive symptom, such as recurrent memories, nightmares, flashbacks, or distressing reactions to reminders of the trauma

  • Presence of at least one avoidance symptom, such as avoiding thoughts, feelings, or reminders of the trauma

  • Presence of at least two negative changes in thinking and mood, such as memory problems, negative beliefs, detachment, or negative emotions

  • Presence of at least two changes in physical and emotional reactions, such as hypervigilance, irritability, sleep problems, or reckless behavior

  • Duration of the symptoms for more than one month

  • Significant distress or impairment in the person’s functioning

  • Symptoms not attributable to another medical condition, substance use, or other mental disorder

According to the ICD-11, the diagnostic criteria for PTSD are:

  • Exposure to an extremely threatening or horrific event or series of events

  • Presence of at least one re-experiencing symptom, such as intrusive memories, nightmares, or flashbacks

  • Presence of at least one avoidance symptom, such as avoiding thoughts, feelings, or reminders of the trauma

  • Presence of at least one sense of threat symptom, such as hypervigilance, exaggerated startle response, or difficulty sleeping

  • Presence of at least one impairment in self-organization symptom, such as negative beliefs, detachment, or emotional dysregulation

  • Duration of the symptoms for more than one month

  • Significant distress or impairment in the person’s functioning

  • Symptoms not attributable to another medical condition, substance use, or other mental disorder

Treatment of PTSD

In treating PTSD, the goal is to reduce the severity and frequency of symptoms, improve the person's functioning and quality of life, and prevent or treat any co-occurring disorders.

  • Medications: Some medications, including antidepressants, anti-anxiety drugs, or sleep aids, might ease some of the symptoms of PTSD. Medication alone is not enough to treat PTSD, and it can interact with other drugs or substances and cause side effects. Therefore, medication must be administered under a physician's supervision and in conjunction with psychotherapy.

  • Therapy is the most common form of treatment for PTSD, and it involves talking to a therapist who can help the patient comprehend, process, and cope with the trauma. Different types of psychotherapy have been proven effective in treating PTSD, including:

    • A cognitive behavioral therapy (CBT) can help the individual identify and challenge the negative thoughts and beliefs that result from a trauma and replace them with more positive and realistic ones. As well as helping the person manage their emotions and behaviors, it helps them learn and practice coping skills.

    • Exposure therapy: It aids the person in confronting and gradually reducing the fear and avoidance of their traumatic memories and images. The person is exposed to trauma-related stimuli in a safe, controlled environment, either in reality or in imagination, until they become less distressing and easier to cope with.

    • EMDR (eye movement desensitization and reprocessing): EMDR stimulates the brain's natural healing mechanism to help the person deal with trauma. The person recalls the trauma while following the therapist's finger movements with their eyes, or by receiving bilateral stimulation such as sounds or taps from the therapist. As a result, the trauma can be reprocessed and the emotional impact reduced.

    • As part of psychodynamic therapy, the individual explores and understands the unconscious conflicts and emotions arising from the trauma as they relate to their current relationships and functioning. A person's sense of self and identity is also better integrated and coherent.

  • People who have experienced similar traumas can meet and share their feelings, stories, and coping strategies in group therapy. A safe and supportive environment can also allow the individual to practice social skills and interpersonal communication and help them feel less alone and isolated.

  • Therapy with family members or partners involves discussing the impact of the trauma on the individual's relationships and functioning. It can help the person and their loved ones communicate better, resolve conflicts, and support each other. It can also help family members and partners understand the symptoms and behaviors of the person.

  • Alternative or complementary therapies: These are therapies that may supplement the conventional treatments for PTSD, such as medication or psychotherapy. They may include:

    • Mediation, yoga, and breathing exercises are some examples of mindfulness-based therapies that help people become more aware of their thoughts, feelings, and sensations without judging or reacting to them.

    • Art or music therapy: These therapies help the person express and process their emotions and experiences through creative activities, such as drawing, painting, writing, or playing music.

    • Animal-assisted therapy: This therapy involves interacting with animals, such as dogs, cats, or horses, that can provide comfort, companionship, and emotional support to the person.

    • Acupuncture: This therapy involves inserting thin needles into specific points on the body that are believed to stimulate the flow of energy and relieve pain and stress.

  • Massage therapy: This therapy involves applying pressure and movement to the muscles and tissues of the body to relax them and improve blood circulation and lymphatic drainage.

Prevention of PTSD

There is no sure way to prevent PTSD, but there are some steps that may reduce the risk or severity of developing PTSD after a traumatic event. These steps include:

  • Seeking immediate medical and psychological help after the trauma

  • Getting adequate rest, nutrition, and exercise

  • Avoiding alcohol, drugs, or other substances that may worsen the symptoms or interfere with the treatment

  • Seeking social support from family, friends, or other trusted people

  • Joining a support group or a community organization that can provide emotional and practical assistance

  • Learning and practicing coping skills, such as relaxation techniques, positive affirmations, or problem-solving strategies

  • Seeking professional help if the symptoms persist or worsen over time

PTSD is a serious and complex mental health condition that can affect anyone who has experienced or witnessed a traumatic event. PTSD can be treated with the right diagnosis and treatment, and it is possible to recover from it and lead a fulfilling and productive life. If you or someone you know is suffering from PTSD, please contact a mental health professional. You are not alone, and you can recover from it.

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