Post-traumatic Stress Disorder: Symptoms, Risk Factors, And Treatment

Post-traumatic stress disorder (PTSD) is a serious psychological health problem caused by experiencing or witnessing some dangerous or terrifying event. Getting shocked or feeling afraid is natural after experiencing some traumatic situation. Fear also stimulates many other changes in the body that can help deal with the situation or avoid danger. This parasympathetic “fight-or-flight” response is a typical reaction of the body that activates to protect the system from any harm. Almost everyone experiences different symptoms after trauma, however, most people recover naturally. Whereas some people who continue to experience the symptoms are diagnosed with post-traumatic stress disorder. People experiencing this situation often feel frightened and stressed due to past trauma.

Signs and Symptoms of PTSD:

Most people suffering from PTSD experience short-term symptoms and do not develop chronic PTSD. 

The underlying cause of PTSD is not always the same i.e. experiencing a dangerous situation. There are also some other causes such as the sudden death of a beloved family member or friend. In most cases, symptoms begin 3 months after the terrifying incident but in some instances, they develop years afterward. Symptoms of PTSD usually last more than 30 days and are severe enough to impair one’s daily functioning and relationship status. However, the course of the disease varies as some people recover within 24 weeks while others have symptoms that last longer. In some patients, the duration of illness gets longer and becomes chronic.

A psychologist or psychiatrist, a specialist who helps people with mental health problems can better diagnose PTSD.

For an accurate diagnosis of PTSD, an individual must have:

• At least one intrusion symptom
• One avoidance symptom
• Negative alteration in thoughts and mood (2 symptoms)
• Changes in arousal and reactivity (2 symptoms)

One should experience all these symptoms for at least one month.

Intrusion Symptoms include:

• Flashback — feeling as if the event is happening again, also making physical changes such as increased heartbeat and sweating
• Nightmares
• Frightening and upsetting thoughts

Re-experiencing symptoms of PTSD can interfere with one’s daily routine. The symptoms can start with one’s thoughts, feelings, words of other people, objects, and situations leading to re-experiencing symptoms.

Symptoms of avoidance are:

• Avoiding places, events, people, and objects that remind of the past terrifying experience
• Avoiding memories, feelings, and conversations about the traumatic event

Objects that remind of past shocking experiences can trigger avoidance symptoms. These symptoms of avoidance can make a person change their personal and social routine. For instance, after a serious bike accident, a person who loves riding a bike may avoid it.

Changes in arousal and reactivity symptoms are:

• Over conscious about protecting themselves from danger
• Become scared or afraid easily
• Trouble sleeping at night
• Feeling tensed most of the times
• Easily become aggressive or angry outbursts

These symptoms are constant and are not triggered by any other thing. Arousal and reactivity symptoms make a person disturbed, angry, and stressed. These symptoms also interfere with the daily activities of their life.

Symptoms of negative alteration in thoughts and mood include:

• Negative thoughts and feelings about oneself or other people around the world
• Memory problems such as trouble remembering important aspects of the traumatic event
• Feeling guilt and detached from family members and friends
• Loss of interest in all activities and feeling emotionally blunt

 Symptoms of negative alteration in thoughts and mood begin and worsen after the traumatic event but are not caused due to any injury or use of drugs. These symptoms make it difficult for a person to maintain close relationships.

Most people experience these symptoms only for a few weeks after the traumatic event. However, in some cases symptoms last more than a month and interfere with one’s ability to perform different life activities and are not due to drug abuse, medical disease, or anything except the terrifying event itself. Some people with PTSD do not report any symptoms. In many cases, PTSD is accompanied by drug abuse, depression, and other psychological disorders.

Does the reaction of children differ from adults?

Children and adolescents show extreme reactions to the traumatic event, but their responses may differ from adults. Symptoms that are seen in children of very young age i.e. 6 years of age can include:

• Unconsciously wetting the bed after getting trained to use a toilet
• Forgetting how to react normally or talk to others
• Perform the scary part of the event while playing
• Getting unusually attached to a parent, sibling, or any other adult

Children older than 6 years and teenagers show symptoms almost similar to adults. However, they also develop destructive and disrespectful behaviors. Teenagers have the guilt of not being able to prevent the condition so they develop feelings of revenge.

Risk Factors of PTSD:

There is no age and time limit for developing PTSD, so anyone can develop this problem at any age. Mostly children, war veterans, and people who experienced sexual, emotional, physical abuse, accident, or other serious events develop PTSD. According to the experts of the National Center for PTSD, 7 or 8 people out of 100 are likely to develop PTSD at some point in their lives. Genetics and gender make a person vulnerable to PTSD as women are more at risk of getting affected.

Not every patient with PTSD reports experiencing any traumatic event. Some people develop this problem after their friend or any family member faces danger. The unexpected death of a loved one can also be the cause of PTSD.

Why are some people more vulnerable to develop PTSD than others?

As mentioned earlier, it is not necessary that everyone who lives through a dangerous event eventually develops PTSD. In fact, most people do not report any signs and symptoms of PTSD. This is because many factors contribute to developing PTSD. Risk factors make a person vulnerable to developing post-traumatic stress disorder. On the other hand, resilience factors help reduce the risk of developing a disorder.

Some factors that play a part in developing PTSD are:

• Living through intense events and traumas
• Experiencing physical damage
• Experiencing some childhood trauma
• Feeling helplessness, horror, or intense fear
• Having no social support after the traumatic event
• Dealing with physical or emotional stress after the trauma, such as loss of a job, pain, and injury, or loss of a loved one
• Having psychological illness or problems with substance abuse

Factors promoting recovery after a traumatic event are:

• Joining a support group after the trauma
• Seeking out emotional, financial, and social support from friends and family members
• Learning how to feel good about your actions in the face of danger
• Practicing ways to get out of the dangerous situations
• Being able to respond actively despite feeling fear during the situation

Researchers are now studying the importance of the above-mentioned and other risk and resilience factors such as neurobiology and genetics. After more research, it may be possible to conclude which factors are responsible to develop PTSD and which play a part in prevention.

Treatments and Therapies of PTSD:

Just like other psychological disorders, the treatment options for PTSD are medications and psychotherapy (talk therapy) or a combination of both. Everyone in this world is different and the symptoms of PTSD developed in every person are also different. That’s why the treatment options for PTSD can vary from person to person.

A patient with PTSD needs to consult a mental health expert experienced in PTSD. Some people experiencing PTSD have to try different treatment options to find out the best one for themselves.

If a person with PTSD is also experiencing ongoing trauma, for example, an abusive relationship, then both problems should be treated together. Other health problems associated with PTSD include depression, feeling suicidal, anxiety, panic disorder, and substance misuse.

Medications:

The most common and most studied medications for treating PTSD are antidepressants. These medications help control symptoms such as loneliness, worry, anger, numbness, and sadness. Some other medications can also be used for treating PTSD symptoms including nightmares and sleep problems.

Doctors and patients can work together to find out the most effective medication and its right dose.

Psychotherapy:

Psychotherapy (also called talk therapy) is a collaborative treatment that involves talking to a mental health provider for treating a particular mental health problem. A session of psychotherapy can occur either one-on-one or in a group. It usually takes 6 to 12 weeks for treatment of PTSD through psychotherapy but sometimes it lasts longer. According to research, social support from friends and family members plays an important part in recovery.

Different types of talk therapy can help treat PTSD. Some types target the PTSD symptoms while others help treat family, social or job-related problems. Therapists combine different types of psychotherapy depending upon needs.

Some psychotherapies also focus on key components such as education about illness and its symptoms, teaching skills to manage symptoms, and identifying the triggers. One effective form of therapy for treating PTSD is cognitive-behavioral therapy (CBT).

CBT further can include:

Exposure Therapy: This form of therapy helps face and control the fear. In this therapy, a person is gradually exposed to trauma. It involves imagining, writing, or visiting the terrifying place. The therapist utilizes these tools to help people with PTSD deal with their fear.

Cognitive restructuring: In this technique, people are trained to change their way of thinking. This is because sometimes people remember the traumatic event differently from what actually happened. They may have feelings of guilt and shame about something they are not responsible for. In cognitive restructuring, therapists help people logistically look at things.

There are other treatment options for PTSD as well. These treatments should help people understand the skills to deal with symptoms and participate in the activities that they used to enjoy before developing PTSD.

Effectiveness of Talk Therapy For Overcoming PTSD Symptoms:

Talk therapies teach people some effective ways to respond to dangerous events that trigger symptoms of PTSD. Based on this common goal, different types of talk therapies may:

• Help use anger controlling and relaxation skills
• Educate about the traumatic event and their effects
• Provide effective tips for improving sleep, diet, and exercise habits
• Help people deal with feelings of guilt and shame about the event
• Focus on changing the reaction of people to the event

Other techniques to deal with PTSD Symptoms:

No doubt it is hard to take the first step to help yourself in this emotional crisis. But it is very important to realize that self-help can accelerate the results of treatment. If you cannot decide where you should go first for help, talk to your family doctor. For initial help, you can talk to an emergency room doctor. They will further guide you.

To help yourself during the treatment:

• Talk to a healthcare provider about treatment options
• Engage in some physical activity daily to reduce stress
• Set your priorities and perform easy tasks first
• Try to be more social and share things that trigger your symptoms
• Set realistic goals and expect your symptoms to improve slowly

Finding Professional Help:

If you are experiencing any symptoms of PTSD, it is time to seek professional help. Mental health clinics offer online counseling sessions and virtual counseling that can help you manage the situation. In virtual counseling, your counselor monitors your activities regularly and helps you through an online virtual system. This is an easily accessible service for everyone that ensures fast recovery.

The bottom line:

PTSD is a mental health problem developed after experiencing a traumatic event or after the death of a loved one. Symptoms of PTSD are nightmares, flashbacks, avoiding places that remind of trauma, and insomnia. Risk factors associated with PTSD are under research. Medications and psychotherapy are effective treatment options for improving the symptoms of PTSD. Fortunately, mental health clinics offer counseling sessions that can help improve the condition.

All information in this article is written based on the publication of The National Institute of Mental Health, a U.S based federal agency that researches mental disorders. The experts of NIMH provide information on mental health problems and the latest mental health research.

https://www.nimh.nih.gov/