Post-traumatic stress disorder (PTSD): What you need to know?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in a person who has experienced or seen a traumatic event that caused them fear or helplessness. Signs that are indicative of PTSD may appear between a month and several years after the terrifying event has taken place. 

The symptoms of post-traumatic stress disorder can be grouped into four categories, namely intrusion, avoidance, negative changes in cognition and mood, as well as increased arousal and reactivity. Symptoms of PTSD  may include recurrent nightmares about the traumatic experience, staying away from situations that can trigger memories of the terrifying event, difficulty remembering important details about what happened, and increased startle response. 

The effects of post-traumatic stress disorder include anxiety, depression, impaired occupational functioning, chronic pain, as well as social isolation and withdrawal. 

The causes of PTSD include traumatic events, structural brain changes, a lack of social support from family and friends, as well as genetic susceptibility to PTSD. 

Treatment options for post-traumatic stress disorder mainly involve psychotherapy, medications, or a combination of both. PTSD treatment focuses on improving symptoms and helping individuals learn healthy coping skills.

What is Post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in some people after going through or seeing a life-threatening event. This can include an accident, a natural disaster, military combat, sexual assault, or sudden loss of a loved one. 

Otherwise known as shell shock or battle fatigue syndrome, PTSD can cause intense and lasting thoughts or feelings related to the traumatic experience that can even get worse over time. 

What are the signs of Post-traumatic stress disorder (PTSD)?

Signs of post-traumatic stress disorder can vary from person to person or change over time. The signs of post-traumatic stress disorder (PTSD) are listed below. 

• Re-experiencing the traumatic event: This principal symptom of post-traumatic stress disorder is also called intrusive memories. According to a 2015 research article by Chris R. Brewin published in the European Journal of Psychotraumatology, these are unwanted vivid flashbacks of the traumatic experience where an individual can lose touch with the present and feel as if the trauma is happening at present time.
• Having trauma-related nightmares: PTSD-induced nightmares are emotionally disruptive dreams that are marked by negative emotions such as anger or fear. These vivid dreams can cause significant distress to PTSD sufferers, as they often contain replays of the terrifying event.
• Avoiding any reminders of the event: Individuals with post-traumatic stress disorder often attempt to cope with the trauma by avoiding reminders of the traumatic event. An article on posttraumatic stress disorder (pp. 148-152) from the book Encyclopedia of Human Behavior published in 2012 by the Academic Press states that these may include avoiding distressing thoughts, feelings, memories, people, or even activities that can trigger unpleasant memories from the past.
• Struggling with memory loss: A traumatic incident can cause extreme stress, which can affect different regions of the brain. This can have adverse effects on memory, making it difficult for people with post-traumatic stress disorder to recall important details about what happened.
• Having overly negative thoughts about oneself or the world: Post-traumatic stress disorder can cause negative thinking patterns. Some examples of negative thinking experienced in the condition include not being good enough, feeling that the world is unsafe, and that no one can be trusted.
• Excessive startle reflex: The nervous system of someone with PTSD may become overwhelmed with trauma and can cause them to constantly be on-guard due to an intense fear of the traumatic event happening again.
• Sleep disturbances: Individuals with PTSD often experience sleep problems, such as difficulty falling asleep and being awakened easily. These issues lead to nonrestorative sleep and daytime fatigue.
• Difficulty maintaining personal relationships: The traumatic event that a person had can affect the way they act towards others. People with post-traumatic stress disorder often have trust and communication issues, resulting in difficulty to maintain relationships with family members or friends.
• Emotional numbness: Emotional numbing is a coping mechanism that can be a form of response to trauma. People with the condition tend to emotionally shut down and detach themselves from painful emotions because of the need to protect themselves emotionally.
• Reckless self-destructive behavior: PTSD symptoms can cause people to engage in self-destructive behaviors, such as drug or alcohol abuse and self-harm, according to a 2017 study by Lusk et al., published in the Journal of Traumatic Stress. These behaviors are unhealthy coping strategies to deal with unpleasant emotions. 

Other signs of post-traumatic stress disorder (PTSD) include:

1. Explosions of rage
2. Feelings of hopelessness
3. Difficulty concentrating
4. Reduced interest in activities once enjoyed
5. Deeply rooted feelings of guilt and shame

What are the symptoms of Post-traumatic stress disorder (PTSD)?

The symptoms of post-traumatic stress disorder generally fall into four categories: intrusion, avoidance, negative changes in cognition and mood, and increased arousal and reactivity. However, manifestations of symptoms may slightly differ according to assigned sex at birth and gender.

For instance, women may experience PTSD differently than men. Women tend to be more sensitive to any reminder of their trauma, have an increased risk of being emotionally numb, are more likely to develop a heightened startle response, and tend to feel more depressed and anxious, according to a 2021 article on post-traumatic stress disorder from the U.S. Department of Health & Human Services. 

Furthermore, a 2023 article written by Amy Novotney for the American Psychological Association states that women are twice as likely as men to develop post-traumatic stress disorder in their lifetimes. They also tend to experience a longer duration of PTSD symptoms before diagnosis and treatment occur.  

Women also tend to wait for an average of four years before seeking treatment and in some cases, some never seek treatment at all. Untreated PTSD in women can cause physical symptoms such as headaches, stomach issues, and sexual dysfunction. 

On the other hand, men are more prone to post-traumatic stress disorder symptoms such as anger, irritability, hypervigilance, and difficulty controlling their anger. As a result of trauma, men are more likely to engage in alcohol abuse, according to a 2003 case report by Ben Green published in Current Medical Research and Opinion. They also ask for help for PTSD within only one year following the onset of symptoms. 

Lastly, post-traumatic stress disorder appears to be especially common among individuals in the lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) community. This is because they are more likely to go through traumatizing events that are related to discrimination due to their perceived sexual identity, according to a study by Livingston et al., published in the March 2020 issue of Current Treatment Options in Psychiatry.  

Symptoms of PTSD in LGBTQI individuals include overwhelming shame, increased startle response in anticipation of discrimination, anxiety, depression, as well as negative thoughts of self and others. 

It is worth noting, however, that everyone experiences PTSD differently. That said, each person’s specific symptoms may vary according to their biology and the unique circumstances of their trauma.

What are the causes of Post-traumatic stress disorder (PTSD)?

The causes of post-traumatic stress disorder (PTSD) include traumatic events, structural brain changes, a lack of social support from family and friends, as well as genetic susceptibility to PTSD. 

Exposure to a plethora of traumatic events, such as military combat, domestic violence, sexual assault, and being diagnosed with a chronic or life-threatening illness can cause someone to develop post-traumatic stress disorder. Certain factors may also influence the development of the condition in a person and the severity of their symptoms. 

 A 2017 study by Logue et al., published in Biological Psychiatry also suggests that having a smaller hippocampus, which is the part of the brain that affects memory and emotion, increases a person’s risk of developing PTSD following a traumatic experience. Limited social support is another contributing factor to post-traumatic stress disorder. 

In fact, according to a 2016 study on the relations between social support, PTSD symptoms, and substance use in veterans published in the Psychology of Addictive Behaviors, a lack of a strong social support network is linked to more severe PTSD symptoms and suicidal ideation. 
Finally, a 2015 research article by Jordan W. Smoller published in Neuropsychopharmacology states that having blood relatives with mental health risks or having a history of other mental health issues can also put someone at a heightened risk of developing PTSD after a traumatic event.

What are the risk factors for Post-traumatic stress disorder (PTSD)?

The risk factors for post-traumatic stress disorder (PTSD) involve a complex interplay of factors that may influence the development of the condition. The risk factors for post-traumatic stress disorder (PTSD) are listed below. 

• Previous traumatic experiences: Individuals who previously experienced trauma from events such as a natural disaster, accident, unexpected death of a loved one, and sexual violence are more susceptible to post-traumatic stress disorder. A new traumatic experience can also worsen the negative effects of prior trauma, especially in people who lived through childhood trauma.
• Past abuse: People with a history of physical, emotional, or any other form of abuse as well as children who experienced abuse, maltreatment, and neglect earlier in life are more likely to develop long-lasting psychological disorders, such as PTSD.
• A family history of depression and anxiety: Having blood relatives with depression and/or anxiety can increase a person’s risk of developing post-traumatic stress disorder. A family history of other psychological disorders is also a genetic contributor to the condition.
• High-risk professions: Professions with a high risk of PTSD and trauma include military service, police officers, firefighters, first responders, and other healthcare professionals. Due to the nature of their jobs, these workers are at a higher risk of developing PTSD, as they encounter traumatic events often, if not daily.
• A history of substance abuse: Substance use disorders and post-traumatic stress disorder frequently co-occur. Individuals with a history of substance abuse have an elevated risk of developing PTSD, as drug use and alcohol use disorder can negatively affect one’s ability to handle the stress caused by a traumatic event. 
  

Other risk factors for post-traumatic stress disorder (PTSD) include:

1. Poor coping skills
2. Lack of social support 
3. Extreme or ongoing stress
4. Being assigned female at birth
5. Life stressors, such as financial ruin, divorce, or work stress

What are the types of Post-traumatic stress disorder (PTSD)?

The different types or subcategories of PTSD require different treatment methods. The types of post-traumatic stress disorder (PTSD) are listed below.

• Normal stress response: While in most instances, PTSD begins with a normal stress response, not all normal stress responses result in a full-blown disorder. Everyone responds differently to stress and danger. Life stressors such as illnesses, accidents, or surgeries can cause excessive tension and lead to a normal stress response.
• Acute stress disorder: Although different from PTSD, acute stress disorder can also arise after a life-threatening event. This includes natural disasters, car accidents, or other events that pose a risk of death. Its symptoms occur immediately after a traumatic experience. If left untreated, acute stress disorder could progress to PTSD.
• Uncomplicated PTSD: stems from one major traumatic event rather than multiple events. It is a form of post-traumatic stress disorder that is the easiest to treat. Symptoms of uncomplicated PTSD include nightmares, unwanted flashbacks of the event, mood changes, irritability, and a strong desire to avoid any reminder of the traumatic experience.
• Complex PTSD: is a result of repeated traumatic events, such as neglect, abuse, or violence. Complex PTSD is believed to be more severe if the trauma was experienced earlier in life and if the trauma was inflicted by a parent or other parental figures. Individuals who develop complex PTSD in adulthood often have impaired personal relationships.
• Comorbid PTSD: People diagnosed with comorbid PTSD have one or more mental health illnesses that occur alongside post-traumatic stress disorder. Mental health problems that are frequently comorbid with PTSD include anxiety disorder, panic disorder, or substance use disorder. This diagnosis is extremely common in people with PTSD, as more than one condition is present in patients at the same time. 

Other types of post-traumatic stress disorder (PTSD) include:

1. Delayed expression
2. Dissociative PTSD
3. Non-dissociative PTSD
4. Internalizing PTSD
5. Externalizing PTSD

How is Post-traumatic stress disorder (PTSD) diagnosed?

Post-traumatic stress disorder (PTSD) is diagnosed by performing a physical exam, doing a mental health screening, and comparing the patient’s symptoms with the diagnostic criteria for post-traumatic stress disorder indicated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Although there are no specific lab tests intended to diagnose PTSD, the doctor may perform a physical exam and obtain a complete medical history of the patient to rule out any physical illness that may mimic the symptoms of the disorder.

Once other medical conditions have been ruled out, an individual may be referred to a mental health professional, such as a psychiatrist or psychologist, who is specially trained to make a diagnosis of PTSD. The patient may then undergo a mental health screening, which uses screening tools to evaluate their symptoms and other potential co-existing psychiatric illnesses. 

The reported PTSD symptoms are then assessed for a diagnosis and the mental health professional makes a formal diagnosis if the patient meets the diagnostic criteria for post-traumatic stress disorder as stated in the DSM-5.

When does Post-traumatic stress disorder (PTSD) begin?

Post-traumatic stress disorder (PTSD) begins in a person’s early 20s. In particular, the condition often manifests at age 23, according to an article on PTSD from The Anxiety Institute. Although anyone, children and adolescents included, can develop PTSD, this is the typical age of onset for the condition. 

The course of the disorder also varies from person to person and may depend on the types of PTSD someone is diagnosed with, their symptoms, and whether prompt treatment is sought by the patient. Depending on these factors, post-traumatic stress disorder (PTSD) may last anywhere between a few months to a few years and may even become chronic in some people.

What is the prevalence of Post-traumatic stress disorder (PTSD)?

Estimates of the worldwide prevalence of post-traumatic stress disorder (PTSD) range from 3.9% to 5.6%, according to an article on the condition’s worldwide prevalence published in Neuroscience Research Australia (NeuRA). 

Its symptoms can cause mild to severe impairment in an individual’s occupational and social functioning. Around 1.5% of adults with PTSD will suffer from severe impairment, according to an article on post-traumatic stress disorder (PTSD) from the National Institute of Mental Health.

Furthermore, a 2013 news article titled, “WHO releases guidance on mental health care after trauma” from the World Health Organization states that in a study of 21 countries, as many as 10 percent of respondents have been exposed to trauma in the past year. Nearly all of these people will go on to develop post-traumatic stress disorder.

Who is at risk for Post-traumatic stress disorder (PTSD)?

Individuals who are at risk for post-traumatic stress disorder (PTSD) include war veterans, victims of natural disasters and violent crimes, as well as people who have been through childhood physical abuse, sexual assault, accidents, or other terrifying events. 

The condition was first described in military veterans, hence the terms shell shock and combat stress. Military service members are exposed to different types of traumatic events that may lead to post-traumatic stress disorder, including combat exposure, discharging a weapon, and witnessing life-threatening injuries or death.

Survivors of natural disasters, physical or sexual abuse, assault, and violent crimes are also at an elevated risk of developing PTSD. Witnessing or living through these events can cause trauma due to their physical, emotional, and psychological effects on the victims. 

Even though some people recover within a few months, others may have symptoms for longer periods of time. In some cases, the illness may also be constantly recurring.

What is the treatment for Post-traumatic stress disorder (PTSD)

Treatment for PTSD can help manage symptoms and assist afflicted individuals in developing better coping strategies. If left untreated, PTSD can cause significant physical, social, and psychological impairment, according to a 2009 study by Priebe et al., published in the Croatian Medical Journal. The treatment options for post-traumatic stress disorder (PTSD) are listed below. 

• Medications: Medications such as antidepressants and antianxiety drugs can help relieve the symptoms of post-traumatic stress disorder. The selective serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft) and paroxetine (Paxil) are the only antidepressants approved by the U.S. Food and Drug Administration (FDA) for PTSD, according to a 2017 article on medications for PTSD from the American Psychological Association.
• Psychotherapy: Some forms of psychotherapy that can be used for the treatment of PTSD include cognitive behavioral therapy (CBT), exposure therapy, as well as eye movement desensitization and reprocessing (EMDR). CBT has consistently been found to be effective for PTSD and involves helping a person recognize and challenge unhealthy thinking patterns. Exposure therapy, on the other hand, focuses on helping individuals confront their fears while EMDR involves processing the thoughts or feelings related to the traumatic incident while making eye movements.

What does Post-traumatic stress disorder (PTSD) do to a person?

People with PTSD have recurrent involuntary memories and upsetting thoughts or feelings related to their trauma. These negative effects of post-traumatic stress disorder tend to persist over longer periods, leading to significant impairments to an individual’s physical, social, and occupational functioning. 

A person with PTSD often appears to be distant from others and may seem uninterested in social activities. These make it harder for them to interact with and relate to other people, taking a toll on personal relationships as well as their family life.

Can Post-traumatic stress disorder (PTSD) damage the brain?

Yes, post-traumatic stress disorder (PTSD) can cause damage to the brain by inflicting lasting changes in certain brain areas such as the amygdala, hippocampus, and prefrontal cortex. The amygdala, which is the part of the brain that processes fear and threatening stimuli, becomes hyperactive when a person has PTSD. 

Amygdala hyperactivity can cause an exaggerated response and instantly trigger panic, which could explain PTSD symptoms such as elevated startle response as well as an abnormally heightened state of anxiety. 

On the other hand, the hippocampus is a region of the brain that shows reduced activity and volume in people with the illness. The shrinking of the hippocampus can cause memory loss and may make it difficult for afflicted individuals to distinguish between the past and present. As a result, a person’s ability to calm themselves in places that remind them of their traumatic experience may be affected. 

The prefrontal cortex is another area of the brain that tends to weaken in someone with post-traumatic stress disorder. Another PTSD definition is that it is a disorder of fear dysregulation. And a dysfunction in the prefrontal cortex may cause difficulty in regulating fear, thoughts, actions, and other emotions.

What is the relation between Post-traumatic stress disorder (PTSD) and depression?

Post-traumatic stress disorder (PTSD) and depression are closely related, as the two conditions frequently co-occur and the latter is most frequently present in people with PTSD. Moreover, PTSD and depression are connected as they can share similar symptoms, such as sleep problems, anger outbursts, aggression, and loss of interest in activities once enjoyed. 

Both illnesses can result from experiencing traumatic events and can also interfere with a person’s daily functioning. Additionally, individuals who have had post-traumatic stress disorder at some point in their lives have three to five times increased risk of developing depression than others who did not struggle with PTSD.

However, one key difference between post-traumatic stress disorder (PTSD) and depression lies within their starting point. PTSD appears to be always triggered by a traumatic event. And while depressive disorders can also stem from the same traumatic experiences that cause PTSD, depression can be caused by medical conditions, chronic stress, and difficult life circumstances, as well. 

PTSD treatment aims to relieve symptoms and eliminate avoidance. However, the presence of depression alongside post-traumatic stress disorder may complicate the treatment process. In this case, treatment options should take a holistic approach and be geared towards treating both illnesses at the same time.

Is there a support group for Post-traumatic stress disorder (PTSD)?

Yes, there are support groups for post-traumatic stress disorder (PTSD) that people can turn to for social support. The support groups for post-traumatic stress disorder (PTSD) are listed below. 

• After Silence: A forum that connects survivors of all forms of sexual violence who face similar challenges. The goal of After Silence is to validate the experiences of all survivors, regardless of sexual orientation, race, gender, and type of sexual violence they went through.
• Men’s Group: An online PTSD support group for men that offers resources and help through group therapy, so members can live a more productive life. Because it is an online support group, individuals can have a support network available at any time of the day.
• r/PTSD: A PTSD subreddit that offers a support community for individuals who struggle with the illness. With more than 65,000 members, the large peer community aims to connect people with PTSD along with their friends or family members with other survivors. This subreddit fosters a supportive and judgment-free environment.
• MyPTSD Community: Another forum that features news boards that discuss new research on post-traumatic stress disorder and a wide array of sub-forums that users even without an account can easily access.