Post-Traumatic Stress Disorder (PTSD)
What Is Post-Traumatic Stress Disorder (PTSD)?
From time to time, we experience distressing events that briefly shake our sense of security. Yet, for some individuals, certain severe traumas may linger long after the incident has passed. These manifest as vivid flashbacks, heightened anxiety and disrupted sleep.
This persistent psychological distress is known as post-traumatic stress disorder or PTSD. It originates from deeply distressing or life-threatening events – from military combat and natural disasters to personal assaults or accidents.
PTSD is not just about the echoes of a traumatic event; it is about how the mind and body continue to react to them. Though PTSD might be a term casually thrown around in everyday conversations, its implications are profound and life-altering for those affected.
Throughout this guide, we will explore the nuances of PTSD and write about its symptoms, causes, and underlying factors that fuel this condition.
Whether you are seeking clarity, understanding, or ways to support a loved one, familiarising yourself with PTSD is the first step in a journey of empathy and awareness.
Symptoms of PTSD
Psychological Symptoms
Post-traumatic stress disorder, also called PTSD, is a mental health condition that surfaces after exposure to traumatic events.
Typically manifesting within three months post-event, though sometimes surfacing later, its symptoms are distressing and can impede one’s daily life.
The DSM-5, issued by the APA (American Psychiatric Association), has outlined specific criteria for a PTSD diagnosis.
These criteria encompass exposure to traumatic events, such as near-death experiences, grave injuries, or sexual violence. Importantly, this exposure can be direct, or even indirect as a bystander. Indeed, one can experience vicarious or secondary trauma through tales of loved ones or during professional obligations (eg as a social worker).
Furthermore, the person persistently exhibits:
Intrusion Symptoms
These remind an individual of the trauma and might include:
Flashbacks
Flashbacks transport individuals directly back to the traumatic incident, often evoking visual memories and associated sounds, scents, tastes, sensations, and emotions.
While certain environmental stimuli can act as triggers, sometimes these flashbacks surface unexpectedly. Their duration varies, from fleeting moments to prolonged hours.
Avoidance Symptoms
This involves avoiding reminders of the trauma. This could manifest as:
Negative Mood and Thinking Patterns
This can manifest as:
Emotional Arousal and Reactivity Changes
These symptoms may encompass:
These symptoms can hinder an individual’s ability to function normally in both personal and professional domains.
More importantly, to diagnose someone with PTSD – these symptoms should not be due to the use of medications, substances, or other health conditions.
Physical Symptoms
Understanding PTSD goes beyond its psychological effects. While often linked with emotional trauma, it also manifests physically in many individuals.
When overwhelmed with distress, our body secretes cortisol and adrenaline — hormones associated with the ‘fight, flight, or freeze‘ reaction.
For those with PTSD, this hormonal surge persists even without immediate threat, resulting in heightened alertness and startle responses.
Moreover, it is common for these individuals to endure symptoms similar to anxiety: headaches, dizziness, chest discomfort, and gastrointestinal issues.
PTSD-Related Conditions
Several conditions, like acute stress disorder, adjustment disorder, and disinhibited social engagement disorder (DSED), are related to post-traumatic stress disorder.
Acute Stress Disorder (ASD)
Acute stress disorder, often abbreviated as ASD, surfaces following a traumatic event.
Symptoms arise almost immediately post-trauma and generally remain for a duration between 3 days to a month. Recognising ASD is important, given its potential to evolve into PTSD if left untreated.
Adjustment Disorder
Emerging from significant life transitions or events, adjustment disorder is characterised by emotional disturbances, ranging from anxiety to depression.
The onset is typically within three months of the triggering event. As reactions can vary, personalised care and intervention are necessary for those affected.
Disinhibited Social Engagement Disorder
Specific to children who have undergone substantial early-life trauma or neglect, disinhibited social engagement disorder is a unique challenge.
Children with this disorder may show unsettling or maladaptive behaviours, such as being overly familiar with strangers, having minimal social boundaries, or being extremely sociable. Addressing this requires a two-pronged approach: creating a stable environment and seeking therapeutic interventions.
PTSD Causes and Risk Factors
Causes of PTSD
Post-traumatic stress disorder is a multifaceted mental health condition often emerging after exposure to traumatic events. While what constitutes trauma can differ individually, certain circumstances consistently stand out as PTSD triggers.
These include:
Moreover, individuals in professions such as the emergency services or the military often confront distressing situations, potentially leading to vicarious or secondary trauma.
Natural calamities, disturbing experiences in medical settings, witnessing traumatic events, or even confronting unsettling personal losses can also be the causes of PTSD.
Risk Factors of PTSD
Not everyone who faces traumatic events develops PTSD. However, understanding the risk factors is pivotal for early identification and intervention.
Key risk factors elevating the odds of developing PTSD include:
Prior traumas: Those with previous traumatic exposures, especially during their formative years, are more susceptible.
- Witnessing harm: Observing harm or fatalities, either firsthand or to loved ones, can be particularly triggering.
- Intense emotional responses: Experiencing feelings of profound horror, helplessness, or extreme fear during the event.
Post-trauma strain: Enduring subsequent stresses such as grief, physical injuries, or socio-economic upheavals like job loss or homelessness can increase the risk.
- Limited social safety net: A lack of social support systems in the aftermath can worsen the emotional toll.
Psychological history: Individuals with a personal or familial background of mental health conditions or substance misuse may be more vulnerable.
What Is Complex PTSD (CPTSD)?
CPTSD is characterised not only by the typical flashbacks and heightened alertness but also by intense emotional dysregulation, a pervasive sense of worthlessness, and a detachment from reality.
Individuals may grapple with feelings of uncontrollable anger or find it challenging to trust the world around them. Others may avoid forming close personal bonds, fearing the potential emotional toll.
A distinct sense of being ‘different’ or the belief that their trauma is incomprehensible to others further worsens their isolation.
What Causes Complex PTSD?
Typical triggers of CPTSD include childhood abuse, extended domestic violence, witnessing or experiencing recurring violence, and situations where escape is elusive, such as kidnapping or wartime captivity.
Its onset is more probable when trauma occurs early, persists over time, or is inflicted by someone intimately known. Understanding these nuances is essential for both those affected and professional therapists aiming to provide appropriate care.
Treatment and Prevention
PTSD symptoms can be debilitating, affecting daily life and relationships. Fortunately, effective treatments are available tailored to each individual’s unique needs.
Contacting a mental health professional informed about PTSD is important. They can guide individuals through treatments such as psychotherapy, medications, or a combination of both.
It is worth noting that some individuals with PTSD might still be in traumatic situations, like abusive relationships. In such instances, a holistic approach addressing both the ongoing trauma and PTSD symptoms is crucial.
Additionally, it is common for those with PTSD to concurrently suffer from conditions like depression, panic disorder, substance misuse, or even harbour suicidal thoughts.
Addressing these issues can significantly aid in the recovery process. Moreover, the role of a supportive network comprising family and friends is an integral part of facilitating healing.
Psychotherapy
Post-traumatic stress disorder (PTSD) affects many people after they experience a traumatic event. One effective way to help them is through psychotherapy, often known as ‘talk therapy’. This method helps individuals understand and manage difficult emotions, thoughts, and behaviours.
For those with CPTSD, trauma-focused treatments are especially helpful. One key approach is trauma-focused cognitive behavioural therapy (TF-CBT). This helps people recognise what triggers their PTSD and teaches them how to handle these triggers.
Within trauma-focused CBT, there are two main techniques: exposure therapy and cognitive restructuring.
Exposure Therapy
Exposure therapy for PTSD involves carefully and gradually introducing individuals to aspects of their trauma.
This might mean talking about the event or visiting related places with the support of a therapist. The goal is to reduce the fear and distress these memories cause.
Cognitive Restructuring
This approach helps people think about their trauma in a clearer way. Sometimes, people remember events in a way that makes them feel guilty or ashamed, even if it is not their fault. This technique helps them see the event more realistically.
In short, psychotherapy offers valuable tools for those with PTSD, helping them move towards a more peaceful state of mind.
Medications
For many with PTSD, medication can be a beneficial part of their treatment plan. Here is how it can help:
Depression and PTSD: If you are experiencing depression symptoms with your PTSD, antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) like sertraline or venlafaxine, might be prescribed. They have been found effective even though PTSD is different from depression.
- Sleep issues: PTSD can lead to sleep disturbances. In such cases, certain medications can assist in improving sleep quality.
- Preference over talking treatments: Some individuals might not be comfortable with or able to access talking therapies. For them, medication can be an alternative option.
For those with more severe symptoms, such as constant alertness or even psychosis, antipsychotics are usually recommended by doctors. However, usage of any medication must be regularly reviewed by a specialist to ensure its effectiveness and safety.
Other Treatment Options
In recent years, the understanding and treatment of PTSD have evolved significantly. While traditional therapies remain crucial, there is a growing recognition of alternative treatments that helps with disorders like PTSD.
From the rhythmic bilateral stimulation of Eye Movement Desensitisation and Reprocessing (EMDR) to the expressive release of art therapy, these methods provide diverse options.
Family therapy brings loved ones into the healing journey, while animal-assisted therapy taps into the profound bond between humans and animals.
Exploring these treatments can offer fresh perspectives and hope for those grappling with PTSD.
Managing PTSD
Self-help strategies can help with your journey towards healing.
For instance, have you considered the calming effect of rhythmic breathing? You can anchor yourself during overwhelming moments by simply focusing on inhaling and exhaling.
Or, think about carrying a tactile reminder of the present, like a textured keyring, to ground you during flashbacks. Affirmations, too, can be powerful. A gentle reminder that “I am safe now” can be a beacon of light during darker moments.
And while self-soothing, like wrapping yourself in a soft blanket or indulging in your favourite film, can offer immediate relief, maintaining a diary can provide long-term insights into triggers and patterns.
Grounding techniques – like pointing our five blue things in a room or collecting round objects – can also be invaluable tools. Remember, these techniques might offer support, but you might have to explore and see what personally works best for you.
Finding Professional Support
It is essential to find a therapist who’s qualified and a good fit for your needs. Here are some practical tips to consider:
Research qualifications and specialisations: Make sure the therapist is licensed and has specific training in trauma and PTSD.
Seek recommendations: Word of mouth can be invaluable. Friends, family, or even your doctor might have suggestions. However, remember what works for one person might not work for another.
Consider therapy methods: There are various therapeutic approaches to treating PTSD, such as cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR). Research these methods and consider which might resonate with you.
Prioritise comfort: Your relationship with your therapist is crucial. It is essential you feel safe, respected, and understood. Do not hesitate to ‘interview’ potential therapists or have an initial session to gauge your comfort level.
Online reviews and testimonials: While personal recommendations are great, online reviews can provide a broader perspective. Visit our reviews page to find out what people are saying about TYHO Therapists.
Consider logistics: Think about location, session times, and fees. Some therapists offer sliding scale fees depending on financial and employment status, while others may have a fixed price. Ensure their availability aligns with yours.
Trust your instincts: Lastly, trust your gut. If something feels off or you believe the therapist is not a good fit, it is okay to look for someone else instead.
Asking for help is always a sign of strength. With the proper guidance and support, recovery from PTSD is possible.
Frequently Answered Questions
Do I have PTSD?
Wondering if you might have PTSD? Ask yourself these questions:
1) Did something really scary or upsetting happen to you?
2) Do you think about that event often, even when you do not want to?
3) Do loud noises or surprises make you jump more than they used to?
4) Are you avoiding places or people that remind you of that event?
5) Are you finding it hard to sleep or focus since then?
6) Have these feelings been around for more than a month, making everyday tasks difficult?
Remember, answering ‘yes’ to these questions does not mean you definitely have PTSD. If you are worried and relate to the above symptoms, it is best to have a talk with a professional therapist or counsellor about how you are feeling.
How does PTSD affect your life?
PTSD deeply affects daily life for anyone who experiences traumatic events. It can:
Cause emotional distress
Harm physical health
Lead to problems at work
Strain personal relationships
Children show different symptoms, such as:
Re-enacting the trauma in play
Clinging to adults excessively
Lose certain skills, like talking or toilet use
Can PTSD occur in children and teens?
Children and teenagers, too, can experience this condition, albeit with manifestations that differ considerably according to age.
Responses for those six and under might range from bedwetting, even after learning toilet training, to a heightened attachment to adults.
As children age, particularly between 5 and 12 years, the expression of trauma can be observed in their drawings, play activities, and narratives. However, flashbacks might be less common.
Once they reach adolescence, between 12 and 18 years, reactions to traumatic events can morph into disruptive behaviours, impulsiveness, or even aggressive tendencies.
Child psychologists can recognise these signs. Understanding the underlying causes is necessary, as childhood PTSD can significantly impact their development, mental well-being, and interpersonal relationships. These symptoms may develop into challenges in adulthood if unaddressed.
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