Post-Traumatic Stress Disorder (PTSD)
Overview
For some, experiencing or witnessing a traumatic event, such as a natural disaster, accident, combat, or sexual violence, can have long-lasting effects. The event may have been so emotionally or physically harmful or life-threatening that it leaves a lasting impact on a person’s mind, potentially leading to the development of a mental illness known as post-traumatic stress disorder (PTSD).
The flashbacks, nightmares, intrusive thoughts, and anxiety that can accompany post-traumatic stress disorder can affect an individual's mental and physical well-being, among other aspects of their health. Individuals with PTSD might struggle to complete everyday activities, achieve work-related goals, or interact with others. PTSD can affect those living with it, their loved ones, and society as a whole.
Anyone who has experienced or witnessed a traumatic event can develop PTSD, as the condition does not discriminate based on age, gender, or background. While PTSD can negatively affect mental health, treatment options are available for managing the symptoms. Working with a professional and finding effective treatment may improve the quality of life for those affected.
Symptoms
The symptoms of post-traumatic stress disorder (PTSD) can be categorized into four main groups: re-experiencing symptoms, avoidance symptoms, arousal and reactivity symptoms, and cognition and mood symptoms.
Re-experiencing symptoms
Re-experiencing symptoms of post-traumatic stress disorder may include:
- Flashbacks, or vivid, often unexpected memories that seem as if the person is reliving the event
- Nightmares related to the traumatic event
- Intrusive, distressing thoughts about the event
- Signs of stress and mental health challenges, such as sweating or increased heart rate
Avoidance symptoms
Avoidance symptoms related to post-traumatic stress disorder (PTSD) may be characterized by:
- Avoiding places, people, or activities that remind the person of trauma1
- Emotional numbness or detachment from others, which may lead to loneliness
Arousal and reactivity symptoms
Arousal and reactivity symptoms that people with PTSD may experience could include:
- Irritability, mood swings, or angry outbursts
- Hypervigilance, or being constantly on alert for danger, often related to the traumatic events they experienced
- Difficulty concentrating
- Quick alarm or surprise
- Participating in dangerous, reckless activities
- Sleep disturbances, such as difficulty falling or staying asleep
Cognition and mood symptoms
Cognition and mood symptoms may feature:
- Negative thoughts about oneself, others, or the world
- Distorted guilt, shame, or blame related to the event
- Difficulty experiencing positive emotions
- Loss of interest in activities the person once enjoyed
- Difficulty remembering certain aspects of the traumatic event
- Social isolation
According to a study by the National Institute of Mental Health, PTSD often starts to show symptoms within three months of a distressing event. However, in some cases, these signs might not appear until later. For a diagnosis of PTSD to be considered by a health professional, these symptoms need to last more than a month and be intense enough to disrupt various parts of daily life, such as work, relationships, or household duties.
For those experiencing symptoms of post-traumatic stress disorder, a mental health professional may determine an appropriate treatment plan, which could include a combination of therapy and health care interventions, such as medication. Early treatment may improve the quality of life of those impacted by posttraumatic stress disorder. For more information, it may be helpful to review other studies by the National Institute of Mental Health on the treatment of PTSD.
Causes
The cause of PTSD is witnessing, experiencing, or hearing about a traumatic event. Some common events that may increase the risk of developing PTSD include:
- Physical or sexual assault
- Combat exposure
- Natural disasters
- Car accidents
- Childhood or domestic abuse
- Witnessing substance misuse in childhood
PTSD can affect anyone, regardless of age. However, not everyone who experiences a traumatic event develops PTSD. Certain factors may increase the risk of developing the disorder, including the nature of the traumatic event, personal history of trauma, and genetic or psychological factors. For example, a person with a family history of mental health disorders like anxiety disorders or depression might be more likely to develop PTSD after a traumatic event.
According to the VA’s National Center for PTSD, reminders of the traumatic event directly cause symptoms of this mental illness. The Center for PTSD notes that triggers can vary from person to person, but common examples may include loud noises, specific sights or smells, and anniversaries of the event. Facing these triggers can cause the person to re-experience the trauma, leading to increased anxiety and stress.
The causes and risk factors of PTSD, like with many mental disorders, are complex, and they often involve both the initial trauma and an individual's mental health history. Knowing the cause and potential triggers of symptoms may help individuals find an appropriate treatment plan.
Treatments
Often, the goal of treatment for post-traumatic stress disorder is to help those experiencing it regain control over their lives and reduce their symptoms. Various treatment options, including therapy, medications, and self-care practices, may help people achieve these goals.
Therapy
The National Center for PTSD states that psychotherapy (talk therapy) is the primary treatment for PTSD, and several types of therapy may be helpful for individuals. Cognitive behavioral therapy (CBT)2 is one approach that helps people reframe their thoughts and behaviors linked to traumatic events. CBT typically involves:
- Identifying negative thoughts and emotions
- Learning coping skills
- Managing stress and anxiety
Another therapy option for PTSD is eye movement desensitization and reprocessing (EMDR)3 . EMDR helps individuals process traumatic memories and reduce their emotional impact. During EMDR sessions, the therapist guides the patient through eye movements or other types of bilateral stimulation while they recall traumatic experiences.
Prolonged exposure therapy (PET)4 is another evidence-based treatment for PTSD. PET focuses on gradually exposing individuals to memories or situations they have been avoiding to reduce their fear and anxiety. This therapy usually includes:
- Breathing exercises to manage anxiety
- Imaginal exposure, where individuals vividly recall the traumatic event
- In-vivo exposure, which involves facing real-life situations that incite anxiety
For people with complex traumas that lasted years or were severe during childhood, other modalities may be helpful, such as internal family systems (IFS) therapy, which focuses on treating a fractured sense of self, dissociation, and other trauma-related symptoms, often connected to experiences of abuse in childhood.
Medication
In addition to therapy, medications may be a valuable part of PTSD treatment. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to help clients manage symptoms of depression and anxiety linked to PTSD. Some examples of SSRIs and SNRIs that may be used to treat PTSD include:
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
Other medications like anti-anxiety medications or sleep aids might be prescribed on a short-term basis to alleviate specific PTSD symptoms.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
Other treatment options
Alternative treatments for PTSD may also be beneficial for some individuals. These options could include:
- Hypnotherapy: A trained hypnotherapist can use guided relaxation and focused attention to help clients explore traumatic memories and change their negative context.
- Yoga: Yoga is a practice involving physical movements and meditative exercises that may help individuals manage stress.
- Acupuncture: Acupuncture is a traditional Chinese medicine technique that involves needle insertions at specific body points to potentially alleviate stress.
Self-care
Self-care practices may play a part in managing PTSD symptoms. Some self-care tips for individuals with PTSD may include:
- Regular exercise, which could reduce stress and release endorphins
- A balanced diet and consumption of foods rich in nutrients
- Relaxation techniques, such as meditation or deep breathing exercises
- A regular sleep schedule and comfortable sleep environment
- Support from friends, family, or support groups to share thoughts and feelings
Resources
Various resources are available to provide support for individuals living with PTSD. While an in-person therapist can be a supportive resource, online therapy may also be an effective treatment method. Online therapy platforms, such as BetterHelp, have licensed mental health professionals who can help those who experience PTSD from home via phone, video, or live chat sessions.
In addition to therapy, mental health organizations and support groups can cater specifically to individuals with PTSD. The National Center for PTSD may be a valuable resource for understanding the disorder and learning about effective treatments. They also provide educational materials and information on support groups for assistance in coping with PTSD.
Another organization offering resources on PTSD is the Anxiety and Depression Association of America (ADAA). Their resources include comprehensive information about PTSD symptoms, treatment options, and recovery support. The National Institute of Mental Health (NIMH) also provides a detailed brochure on PTSD, which discusses topics like understanding the disorder, recognizing symptoms, and finding help. You can search for providers on the National Institute of Mental Health’s website, as well as explore information from clinical trials and studies done by the National Institute of Mental Health.
If you or someone you love is experiencing a crisis related to PTSD, please reach out to one of the following hotlines for assistance:
- Veterans Crisis Line: https://www.veteranscrisisline.net
- Crisis Text Line: Text "DESERVE" TO 741-741
- Suicide & Crisis Lifeline: Call or text 988
- Trevor Lifeline (LGBTQ Lifeline): (866) 488-7386
- Child Help Hotline: Call 1-800-422-4453 or use the online chat feature
- Sexual Assault Hotline: Call RAINN at 1-800-656-4673
- BlackLine: Call 1-800-604-584 for peer support if you are a Black American experiencing a mental health crisis
- Domestic Violence Hotline: at 1-800-799-SAFE (7233)
- National Institute of Mental Health: Find Help Page
Please see our Get Help Now page for more immediate resources.
Research
Current research is evaluating the causes of PTSD and exploring potential treatments. Recent updates in the treatment strategies for PTSD have supported the effectiveness of trauma-focused therapies, such as cognitive processing and prolonged exposure therapy. These therapies are considered the gold standard and may be more beneficial than medications, especially for long-term symptom relief. In cases where medication is needed, fluoxetine, venlafaxine, or paroxetine have shown the most positive results. On the other hand, benzodiazepines have been strongly advised against due to their potential long-term harm.
Another study looked at how a meditation-based technique called the Mantram Repetition Program (MRP) may reduce symptoms of PTSD. More specifically, it may alleviate hyperarousal, a symptom that could be overlooked when looking for effective treatments. In this study, data was retrieved from an earlier trial consisting of 173 veterans with PTSD. Researchers compared the MRP to a non-specific psychotherapy method. While both treatments saw improvements across all symptoms of PTSD, the MRP was more effective at reducing hyperarousal and numbing symptoms.
Statistics
3 out of every 50 people are affected by PTSD
Below are several statistics on PTSD:
- Women are more likely to develop PTSD, with a lifetime prevalence rate of 9.7%, as compared to 3.6% in men. The difference may be attributed to several factors, including societal and biological factors, as well as the types of trauma to which men and women may be exposed.
- 11% to 23% of veterans have experienced PTSD within a given year, which may underscore the need for effective mental health services and support for veterans during and after their military service.
- Cognitive-behavioral therapy (CBT) designed for trauma can be effective in treating those with PTSD, especially when combining exposure and cognitive restructuring. Around 61% to 82% of people who underwent CBT no longer had PTSD after six months, which is 26% more than those who underwent other methods in the study.