Post-traumatic stress disorder, is it anxiety or something else? Years ago, it was categorized as an anxiety disorder. The newest version of the diagnostic and statistical manual (DSM-5) files this under trauma- and stress-related disorders.
What is very clear is that this disorder is not easy to live with. Whether you are a veteran, first responder, or police officer, you can learn more about PTSD below. We will discuss the causes, symptoms, and treatment of this mental health disorder.
What is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is defined as a mental illness because it significantly impairs your daily life.
Which traumatic event can cause PTSD
People with PTSD show symptoms after exposure to a traumatic situation.
These traumatic situations cause your PTSD. The DSM-5 defines that these situations must be
- actual or threatened death,
- Serious injury
- or sexual violation.
Your exposure follows from
- Experiencing the trauma directly
- Being a witness of the trauma in person
- Learning that a close friend or family member was in a traumatic event. This trauma resulted in actual or threatened death (in a violent or accidental way).
- Experiencing direct extreme or repeated exposure to the horrendous details of the trauma. This should not be through media, television, movies, or pictures).
That last one isn’t easy to understand. Imagine a first responder. One day at the job, they witnessed physical assault at the scene. When they return to their job, they might be exposed to similar situations that resurface the details of the first traumatic event.
Not everyone who experiences a trauma will develop the condition. We are not sure why that is.
When someone feels like they experienced trauma after a medical contact, they might refer to it as “medical PTSD.” While medical professionals are trying to protect and heal you, some also traumatize you. Think of the child going to chemotherapy and being all alone in radiation.
It is not something that is referred to as an official diagnosis in the DSM. Research mainly focuses on this phenomenon after providing someone with a chronic diagnosis.
A visit to the ICU environment can also be traumatic to some. This avenue might be interesting to research regarding treatment plans for those with PTSD as it is easier to monitor these patients.
We can all agree that it must be traumatic to get in touch with a cancer diagnosis and the consequences.
Some women could experience a very traumatic birth. That might be because their wishes weren’t accepted or because there was an emergency.
While postpartum depression is well known, postpartum PTSD is also a possible result of giving birth. People feel like their bodily integrity is threatened.
This form of PTSD is not formalized in the DSM and can happen to every woman. Women with previous PTSD show a prevalence of 6.3%, while women without any PTSD showed a prevalence of 4.6%.
Complex PTSD is a form of PTSD in which the person experiences prolonged or repeated trauma. It is proposed as a separate construct.
Researchers find it relatively common with children who went through neglect or sexual assault. Complex trauma might be expected in other situations are war, refugee, or forced prostitution.
Symptoms would be broader than just those subscribed as PTSD. Including the symptoms described, those with C-PTSD also could experience a change from previous personality and loss of previously sustaining beliefs. They also might show:
- impaired interpersonal functioning,
- impaired sense of self,
- dissociative symptoms,
- and self-harm.
More research might open up other avenues for borderline personality disorder or mood disorder people. It looks like there is an overlap in symptoms there. More research is needed on this topic.
PTSD Symptoms and Signs
More above, we can already read some signs and symptoms of PTSD. As mentioned, the person needs to go through or witness a severe or violent trauma.
To have PTSD, you should at least show one of the following symptoms. They are also referred to as “intrusion symptoms”.
- The memories of the traumatic event are recurrent, involuntary, and intrusive.
- The content or effect of the traumatic event gets replayed in recurrent distressing dreams.
- You might feel like the trauma is recurring through dissociative reactions. Dissociative reactions occur on a continuum. Such a reaction can feel like a short flashback or a complete loss of awareness of present surroundings. This last example is more of an extreme dissociative reaction.
- You might experience intense or prolonged psychological distress as a result of exposure to a trigger. These triggers might be internal or external cues that resemble or symbolize the traumatic event (or an aspect of it).
You might persistently avoid stimuli related to the trauma. This avoidance starts after the trauma occurs.
The following symptoms might happen:
- Avoid or try to avoid painful memories, thoughts, or feelings related to the traumatic events.
- Avoid or try to avoid external cues that remind you of the traumatic events.
Arousal and Reactivity Symptoms
To be diagnosed with post-traumatic stress disorder, you should at least show two of the following symptoms. These symptoms are considerable differences in arousal or reactivity to situations after experiencing the trauma.
- Easily irritable or angry (by little provocation), accompanied by verbal or physical aggression toward the subject.
- Self-destructive/reckless behavior
- Abnormally or extremely alert to danger or threats ( hypervigilance)
- Excessive Startle response
- Concentration issues
- Difficulty falling or staying asleep, restless sleep (sleep disturbances)
Negative Cognition and Mood Symptoms
The person with trauma should show two or more of the following symptoms concerning negative cognitions or mood:
- You forget essential aspects of the traumatic event(s). This might be due to dissociative amnesia. Typically it is not due to alcohol, drugs, or head injury.
- Exaggerated and persistent negative expectations or beliefs about the world, others, or yourself. Some examples of thoughts could be:
- “I am bad.”
- “The world is dangerous.”
- “My brain is broken.”
- “My body doesn’t work how it should.”
- Constant, distorted cognitions on why the trauma happened or the consequences of the trauma. These cognitions lead to self-blaming or blaming others.
- They persistently feel negative emotions, like horror, anger, fear, guilt, or shame.
- Less interest or participation in meaningful activities.
- You might feel detached or estranged from others.
- You can’t consistently feel positive emotions. You don’t feel happiness, satisfaction, or loving feelings.
Do children react differently than adults?
Children can also experience PTSD after a traumatic event. They might react differently than adults. The above symptoms are set up for adults and children older than six years old. The signs of intrusion, or re-experiencing of the trauma, would look like the below examples.
The child might use repetitive play in which specific themes or aspects of the trauma are expressed or reenacted. The common nightmares for adults might look like frightening dreams without recognizable content.
The CDC warns that signs of restlessness or fidgety behavior might confuse clinicians in diagnosing children with ADHD.
Some researchers would like more attention to complex trauma in the developmental ages. At this point, “Developmental Trauma Disorder” is not yet a recognized category in the DSM-5. More research is needed and welcomed in the scientific community on these subjects.
The National Institute for Mental Health declares that younger children might show some temporary regression in their behavior.
Some children might wet the bed while already potty trained. Others might show extreme clinginess to their parents or other adults. Like the older children, these might also reenact the trauma in plays.
PTSD Risk Factors
People can develop PTSD, physical or sexual assault, serious injury, or a traumatic experience revolving around death.
Still, not everyone who experiences such traumatic stress will develop PTSD. Women do have about twice more risk of getting PTSD after trauma.
The below risk factors make it more likely that you will:
- Experiencing a dangerous or traumatic situation
- Getting hurt
- Seeing someone else dead or hurt
- Childhood trauma
- Helpless, horrendous feeling or extreme fear
- No or little social support after the trauma
- Exposure to extra stress after the trauma, like a loss, pain, injury, or the loss of a job or home
- History of mental illness or substance abuse
Preventing PTSD is almost impossible. An option could be to prevent people from experiencing trauma.
In military zones, civilians could be evacuated early enough. Other situations are challenging to avoid. We are not sure yet how to prevent PTSD.
A PTSD diagnosis can only occur at least one month after the incident. You will need to consult an expert in mental health to know more. Usually, only a psychiatrist, psychologist, or specialized physician can help you.
They will use the DSM for diagnosing and might ask about your symptoms and what happened.
PTSD Treatments and Therapies
Post-traumatic stress disorder (PTSD) is a severe mental health condition. Treatment can involve different therapies, medications, and self-care techniques.
It’s essential to work with a doctor or therapist who can help you find the best treatment plan for you. Explore your options below and see what works best for you.
Usually, a combination between therapy and medication is recommended, depending on your situation.
The first step should be observation. If the traumatic event happened recently, giving the victim four weeks to readapt would be necessary. Two out of three victims usually improve after some weeks without treatment. A follow-up is required after.
Psychotherapy is usually needed for those with trauma. The NHS recommends cognitive-behavioral therapy, peer support, or EMDR.
CBT or cognitive-behavioral therapy can help you reframe the beliefs and thoughts after the trauma.
Your therapist will guide you through your experience, distress, and fear. They might also help you with exposure if your experience was related to activities or situations you are avoiding.
This could look like learning how to drive a car again, in contact with certain animals, or exposure to their own place of work.
EMDR or “Eye movement desensitization and reprocessing” is a form of psychotherapy that seems to help those with trauma.
The patient is asked to recall the traumatic event in sequences while focussing on external stimuli. You might be asked to track the moving hand of your therapist while recalling the situation.
The goal is to make new associations with the memory that are not debilitating fear and to move forward by their own social and emotional insights. The client sees themselves as vital and survivors after EMDR instead of the victim.
The FDA approves only two forms of medication. Only the selective serotonin reuptake inhibitors(SSRIs), sertraline (Zoloft), and paroxetine (Paxil) are approved by them at this point.
Although others SSRIs and selective serotonin-norepinephrine reuptake inhibitors (SNRI – venlafaxine) show proof, using these would be considered “off label.”
Beyond Treatment: How can I help myself?
Sometimes treatment is not enough. If you need more help, you (and your family) can reach out to support groups. In these groups, survivors can support others and hear how others deal with the trauma.
If you are in an emergency or need urgent support, you can call 911. You can also text CONNECT to 741741 to talk to someone while in crisis.
If you have suicidal thoughts, call the National Suicide Prevention Lifeline. You can reach them at 1-800-273-TALK (1-800-273-8255).
When to Seek Professional Help
If you experienced trauma, you should look for help when you can and feel comfortable. You will most likely feel these symptoms the first weeks after the experience.
It would be good to make first contact with a professional at that time. After the first month, if you still show symptoms, then therapy can start.
When you are experiencing PTSD, it is not your fault. It can happen to anyone. Not everyone who goes through a traumatic event ends up with PTSD. Treatment options are available. You are not alone. You should seek help if you need it. That can be through therapy or medication.
There are professional people out there who specialize in this area just for you. If it goes on for a long time, you should seek professional help as soon as possible.
If you want to know about PTSD or mental health in general, check out our plethora of resources. Do you want to join the conversation and our self-help community? Click here to join.