Posttraumatic Stress Disorder
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, describes the diagnostic criteria of posttraumatic stress disorder as:
- The direct experience, observation, or knowledge of a one-time or repeated traumatizing event such as death, severe injury, or sexual violence
- The experience of intrusive symptoms after the event’s occurrence, such as intrusive memories, flashbacks, dreams, or physiological reactions to things that remind a person of the event
- Avoidance of stimuli associated with the trauma; detachment and loss of trust
- Exaggeration of negative and pessimistic thinking
- Possible memory loss around the event
- Reactions to these memories or thoughts about the event, such as sudden irritability or anger, hypervigilance, an exaggerated startle response, or problems sleeping1
In posttraumatic stress disorder, these symptoms are not a result of substance abuse or any other physical or mental medical condition. They are the direct results of exposure to an event or series of events that one was not prepared to confront.
Posttraumatic stress disorder can affect both adults and children, though the symptoms might vary based on a person’s age. For example, children may have frequent nightmares that have nothing to do with the particular negative experience in place of the specific memories in dreams or flashbacks that a traumatized adult might suffer. While an adult might avoid things that remind him or her about the trauma, a child might reenact the event over in play.
Depersonalization and de-realization describe an “out of body” feeling, when a person feels detached from the body, often describing the feeling of watching him or herself from another location. Time may seem to move at an unrealistic slowness, and the world may come to feel like a dream. These are called dissociative symptoms. They may last from a few seconds to hours, and may range from sensing reminders of the trauma with only one or two senses to believing that it is taking place again and being completely unaware of the reality that surrounds you.
Emotional reactions are not necessarily a requirement for PTSD diagnosis. Some who suffer from PTSD experience extreme emotional reactions in the way of expressing fear, horror, and helplessness, while others suffer more from the dissociative symptoms described above, or from a debilitated cognitive state, which leads them into the trust issues and a cycle of pessimistic behavioral symptoms. Many suffer from a combination of all of these elements.
Some of the most common causes of PTSD are the following:
- War activity
- Physical assault
- Sexual violence
- Natural disasters
- Automobile accidents
- Witnessing and unnatural death
Traumatic events are sudden and catastrophic. For example, dealing with a life threatening illness may lead to certain anxiety disorders, but not to PTSD, as the situation does not happen suddenly. However, a traumatic experience could be related to a medical condition. While uncommon, an example of such an event could be waking up in surgery or experiencing sudden life-threatening and horrifying symptoms of a disease.
It is not rare to experience trauma. An estimated 60% of men and 50% of women experience severe trauma at least once in a lifetime. The experience of one traumatic event does not by any means guarantee the development of a long-term posttraumatic stress disorder. Nonetheless, nearly 8% of the population does develop the disorder, at least temporarily. Reportedly, women are about twice as likely to develop PTSD as men when exposed to trauma, statistically speaking.2
If you are experiencing symptoms of PTSD, it is important to seek support in an environment that feels safe. If there is an ongoing event in your life that is leading to continued trauma, such as abuse, then especially reach out right away. The cause of trauma must discontinue so that you can move forward with your life. The alternative to treatment is often a worsening of conditions, perhaps including the development of panic disorder, substance abuse disorder, depression, and suicidal thoughts.
Psychotherapy is an effective treatment for PTSD. In this form of treatment, a professional will meet with you either privately or in a group setting. The programs for therapy in ‘talk sessions’ usually lasts for a few months, though it can go longer if necessary. Cognitive behavioral therapy is acknowledged as an effective therapy option for PTSD, and can help you gently face and control your fear while reducing anxiety. Other treatments include EMDR therapy, or eye movement desensitization and reprocessing therapy, which many people find to be a gentle and calming approach to recovery. Other effective therapies include exercise and body movement, combined with supportive counseling. In severe cases, some people elect to try medical treatment through antidepressants or other medicines, although this is not always necessary.
Therapy for PTSD seeks to help you develop a balanced way of viewing the traumatic event that won’t leave you feeling guilty or having unrealistic negative beliefs about what actually happened. Enlisting a support team of family and friends in treatment is extremely valuable, so do not be afraid to include them. A consultation can help you to understand your needs and establish a treatment plan uniquely effective for you.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
2. U.S. Department of Veterans Affairs. “PTSD: National Center for PTSD.” Found online 2/2/16 at http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp.