POST-TRAUMATIC STRESS DISORDER

Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. People who have PTSD may feel stressed or frightened, even when they are not in danger.

SYMPTOMS

While most but not all traumatized people experience short term symptoms, the majority do not develop ongoing (chronic) PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

  • At least one re-experiencing symptom

  • At least one avoidance symptom

  • At least two arousal and reactivity symptoms

  • At least two cognition and mood symptoms


Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.


Re-experiencing symptoms include:


  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating

  • Bad dreams

  • Frightening thoughts

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine.

Avoidance symptoms include:

  • Staying away from places, events, or objects that are reminders of the traumatic experience

  • Avoiding thoughts or feelings related to the traumatic event


Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events.  These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Arousal and reactivity symptoms include:

  • Being easily startled

  • Feeling tense or “on edge”

  • Having difficulty sleeping

  • Having angry outbursts               


Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

Cognition and mood symptoms include:

  • Trouble remembering key features of the traumatic event

  • Negative thoughts about oneself or the world

  • Distorted feelings like guilt or blame

  • Loss of interest in enjoyable activities


Children and teens can have extreme reactions to trauma, but some of their symptoms may not be the same as adults. Symptoms are sometimes seen in very young children (less than 6 years old).

Symptoms in children can include:

  • Wetting the bed after having learned to use the toilet

  • Forgetting how to or being unable to talk

  • Acting out the scary event during playtime

  • Being unusually clingy with a parent or other adult

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors.

  

RISK FACTORS

According to the National Center for PTSD, about 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men.

Some factors that increase risk for PTSD include:

  • Living through dangerous events and traumas

  • Feeling horror, helplessness, or extreme fear

  • Having little or no social support after the event

  • Dealing with extra stress after the event

  • Having a history of mental illness or substance abuse


TREATMENT

Some factors that may promote recovery include:

  • Finding a support group or seeking support from others

  • Learning to feel good about one’s own actions in the face of danger

  • Having a positive coping strategy, or a way of getting through the bad event and learning from it

  • Being able to act and respond effectively despite feeling fear

 
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