PTSS Vs. PTSD: How The Body And Brain Respond To Trauma
Post-traumatic stress disorder, or PTSD, tends to be widely known in today’s world. Yet few people have heard of the closely related concept of post-traumatic stress syndrome, also known as PTSS. While these conditions may have many symptoms in common, they’re considered separate diagnoses. Knowing the difference could help you distinguish between a distressing but non-pathological response to trauma and a mental health disorder.
PTSS generally refers to a collection of distressing responses that can appear following a traumatic experience. They’re typically the same symptoms that define PTSD, but they may not be as long-lasting, severe, or disruptive to healthy functioning. Not everyone with PTSS goes on to develop PTSD, though they may be at a significantly higher risk. Some early interventions may reduce these symptoms before an individual reaches the threshold for diagnosis. Both PTSS and PTSD can be addressed with therapy.
What is PTSD?
Not every psychological difficulty that emerges in the wake of harmful or frightening experiences necessarily constitutes PTSD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), post-traumatic stress disorder involves a combination of the following:
A. Exposure to a traumatic event
The kinds of experiences that can lead to PTSD vary, but they typically involve actual or threatened death, harm, or violation. Examples include (but aren’t limited to) those listed below:
- Severe accidents
- Exposure to war zones and other violent conflicts
- Terrorist attacks
- Sexual assault
- Physical, emotional, or sexual abuse
- Exposure to natural disasters
- The sudden or violent loss of a loved one
In some cases, witnessing or learning about these events happening to someone else may lead to PTSD. For example, first responders or law enforcement officers sometimes develop PTSD as a result of repeatedly seeing the effects of violence on others.
B. Intrusion symptoms
Disruptive and hard-to-avoid thoughts or memories related to a traumatic event tend to be characteristic symptoms of PTSD, though they can also be present in other disorders. Intrusion symptoms include the following:
- Involuntary, distressing thoughts of the incident occurring repeatedly
- Stressful nightmares involving features of the event
- Re-experiencing events (often called “flashbacks”) in which the individual temporarily senses they are reliving their traumatic experiences
- Severe distress when reminded of past trauma, sometimes including physiological symptoms like elevated heart rate, sweating, or a sensation of respiratory difficulty
C. Avoidance symptoms
People with PTSD tend to go out of their way to avoid scenarios that remind them of their inciting traumas. They may refuse to participate in certain activities, go to certain places, or talk to certain people. This can also involve avoiding memories or topics of conversation that may touch on their painful experiences.
Avoidance may be difficult to recognize as a symptom of a mental health disorder. However, it can cause significant disruptions in a person’s life, preventing them from following up on opportunities, making connections, and enjoying enriching experiences.
D. Mood and cognitive symptoms
Changes in a person’s moods or thought processes can be common responses to traumatic stress, and a PTSD diagnosis requires at least two of the following:
- Persistent anger, fear, shame, or other negative emotions
- Sensations of isolation or detachment from other people
- Distorted or exaggerated negative beliefs, such as “Bad things happen to me because I’m a bad person,” or “Letting your guard down will always hurt you”
- Anhedonia (a limited ability to experience happiness or pleasure)
- Lack of interest in activities the individual formerly enjoyed
- Extreme, persistent self-blame
- Difficulty recalling significant aspects of traumatic experiences
E. Arousal and reactivity symptoms
Other PTSD symptoms involve changes in physiological emotions and reactions:
- Being easily startled or constantly alert for danger
- Difficulty concentrating or sleeping
- Reckless behavior, often with self-destructive aspects
- Persistent irritability or unprovoked outbursts
What is PTSS?
Post-traumatic stress syndrome, sometimes referred to as post-traumatic stress symptoms or acute stress disorder, is also a potential reaction to experiencing traumatizing events. It can involve any of the PTSD symptoms described above.
In general, duration, severity, and onset time are what separate PTSS from PTSD. Many people experience symptoms of PTSS following trauma exposure, but they don’t meet the criteria for post-traumatic stress disorder unless:
- They experience at least one symptom each in categories B and C and two each in categories D and E
- These symptoms persist for at least one month
- Their symptoms cause significant distress or impair their ability to function in their career, interpersonal relationships, family responsibilities, or other aspects of life
While no one can be diagnosed with PTSD until at least a month has passed since the inciting traumatic event, symptoms of PTSS can be observed within the first 30 days.
PTSS can be a warning sign of PTSD risk
Although PTSS can be considered within the boundaries of a normal reaction to extreme stress, its presence can still serve as an indicator of a person’s risk of developing PTSD. More drastic symptoms, especially those appearing within days of experiencing a traumatic situation, seem to be associated with a higher chance of meeting the diagnostic threshold.
In one study, slightly more than half (52.3%) of people who exhibited severe symptoms of PTSS were found to have PTSD when reassessed three months later. Percentages were lower for moderate symptoms (36.4%) and mild symptoms (22.6%). None of the participants in the “minimal symptoms” category went on to develop PTSD.
The absence of PTSS doesn’t necessarily mean an individual has no risk of PTSD. Some people experience post-traumatic stress disorder with delayed expression, meaning that the condition doesn’t fully emerge until six months or more after the initial traumatic occurrence. While people with this condition usually display some early symptoms, researchers have noted a few cases in which individuals remain asymptomatic for some time after their distressing experiences.
How is PTSS detected?
Clinicians and researchers have developed several experimentally validated psychological assessment tools that can identify the presence of post-traumatic stress symptoms:
- The Post-Traumatic Stress Scale (PTSS-10 or PTSS-14)
- The PTSD checklist for DSM-5 (PCL-5)
- The Impact of Event Scale-Revisited (IES-R)
These questionnaires can be completed by patients, resulting in a score that describes the severity of their symptoms of post-traumatic stress. Studies suggest that high scores on these assessments shortly after traumatic experiences seem to reliably indicate a higher risk of meeting PTSD diagnostic criteria later on.
Can PTSD be prevented in people with PTSS?
A common goal of efforts to identify people with severe PTSS is to provide them with treatment to reduce their chances of developing PTSD.
Current research into PTSD prevention suggests that providing psychological care for everyone who has experienced a traumatic event, regardless of their symptoms, may have little benefit. The types of interventions currently available don’t appear to help people who are already showing signs of recovering well. Certain strategies, such as “psychological debriefing,” may increase some people’s risk for PTSD.
That said, some studies show that providing targeted interventions for people who show early signs of PTSS may be more effective. The following forms of treatment may reduce symptoms and reduce the risk of long-term PTSD:
- Trauma-focused cognitive-behavioral therapy (CBT-T)
- Cognitive therapy without exposure
- Eye movement desensitization and reprocessing (EMDR)
Some pharmacological treatments, such as hydrocortisone, may also protect against PTSD when taken shortly after traumatic experiences. However, evidence for this effect remains limited.
How to protect your mental health despite PTSS symptoms
If you’re experiencing distressing symptoms following a traumatic occurrence, certain kinds of behaviors and mental habits may reduce your risk of developing PTSD. Researchers have identified a wide range of apparent protective factors that can make significant differences in how people recover from trauma.
While some protective factors may be outside of your control, such as genetic differences and early childhood experiences, others may be modifiable. They include the following:
- Optimism: Even if you’re not naturally optimistic, you may be able to cultivate this quality using techniques like picturing your best possible future self.
- Facing your fears: Although it might be tempting to avoid reminders of your trauma, this may increase your instinctive fear reaction and make PTSD more likely.
- Social support: Drawing on interpersonal resources — for example, spending more time with close friends and family members — could help you stay mentally healthy.
- Adaptive coping: PTSD risk may be decreased by constructive coping mechanisms, such as those listed below:
- Healthy lifestyle changes (e.g., exercise and getting plenty of sleep)
- Relaxation practices (e.g., meditation, yoga, or deep breathing)
- Positive reframing of thoughts
- Gratitude
- Use of humor
- Conscientious planning
- Spiritual or religious practices
Talking with a licensed mental health professional can also be an adaptive coping strategy. Finding a therapist with whom you can form a constructive connection isn’t always easy, but seeking therapy online may make it easier. Internet therapy platforms can put you in touch with a wide pool of licensed professionals and match you with one who meets your preferences and needs.
Despite being a relatively new option, online psychotherapy has demonstrated beneficial results in people with PTSD symptoms. For example, a 2016 meta-analysis concluded that Internet-delivered cognitive-behavioral therapy could be an effective treatment for post-traumatic stress.
Takeaway
PTSS can be considered an early precursor to PTSD, involving similar symptoms that may not be severe or persistent enough to qualify for diagnosis. People with PTSS may be at higher risk for a PTSD diagnosis, but certain kinds of protective strategies may protect them against developing this illness. If you’re experiencing signs of post-traumatic stress syndrome, practicing self-care and seeking in-person or online therapy may help you work through the traumatic experience and prevent the development of post-traumatic stress disorder.
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