PTSD

What is post-traumatic stress disorder? Post-traumatic stress disorder, often abbreviated to PTSD, is defined by the Mayo Clinic as “...a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it.” Do you know the stereotype or cliche of a soldier or veteran hearing a loud noise, or seeing or sensing something that makes them feel extremely anxious or as if they are still fighting or witnessing violence and death? That is usually an oversimplification, but what is being described is PTSD flashback; a moment where someone feels transported back to a traumatic moment that triggers intense feelings of anxiety. What are the symptoms of post-traumatic stress disorder? Though there are many ways that PTSD symptoms can manifest, PTSD is characterized by three main symptoms according to the Anxiety and Depression Association of America: ​

• Re-experiencing the original trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.

• Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.

• Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.

However, some more specific ways PTSD can show up are as follows;

• Spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events (Note: In children repetitive play may occur in which themes or aspects of the traumatic events are expressed.)

• Recurrent distressing dreams in which the content or affect (i.e. feeling) of the dream is related to the events (Note: In children there may be frightening dreams without recognizable content.)

• Flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring (Note: In children trauma-specific reenactment may occur in play.)

• Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events

• Physiological reactions to reminders of the traumatic events

• Irritable or aggressive behavior

• Reckless or self-destructive behavior

• Hypervigilance

• Exaggerated startle response

• Problems with concentration

• Difficulty falling or staying asleep or restless sleep

• Inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)

• Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” "The world is completely dangerous").

• Persistent, distorted blame of self or others about the cause or consequences of the traumatic events

• Persistent fear, horror, anger, guilt, or shame

• Markedly diminished interest or participation in significant activities

• Feelings of detachment or estrangement from others

• Persistent inability to experience positive emotions

What causes post-traumatic stress disorder? PTSD is caused by experiencing or witnessing trauma, such as war, assault or abuse (often sexual or physical), an accident, disaster, terror attack, or any other traumatizing event. However, not everyone suffering from PTSD has experienced these things firsthand; even learning that someone close to you, such as a relative or friend, has experienced these can cause trauma, PTSD, and PTSD symptoms. According to the National Health Service, about 1 in 3 people who experience severe trauma will develop PTSD in their lifetime. PTSD can be developed immediately after experiencing the trauma, but can also develop over time, with some individuals developing it months, or even years later. Nothing other than trauma can really cause PTSD, however there are some risk factors that make someone more likely to develop PTSD after trauma. Risk factors for developing PTSD after a traumatic event include…

• Having a history of mental health disorders such as panic disorder, depression, or obsessive compulsive disorder.

• Having a history of abuse or substance abuse.

• Having a family history of PTSD or mental health issues. Genetics can also be a risk factor; as some genetic and brain-chemistry-based mental health disorders can make an individual more susceptible to PTSD.

• Having poor coping skills and a lack of emotional and social support. Being unable to or having a difficult time processing the traumatic event not only changes how you interact with others about the trauma; it can also make you more susceptible to PTSD.

• Ongoing stress; once trauma, stress and a lack of support build up, it can really do damage to your emotional and mental well being. Sometimes stress and poor mental health just build up until your brain can’t take it anymore, causing you to develop PTSD as a way for your brain to “deal” with the trauma.

• Having intergenerational trauma.

How common is post-traumatic stress disorder? About 7-8% of people living in the USA will develop PTSD at some point in their life; that’s about 4% of men, and 10% of women. Around 8 million adults in the USA develop PTSD in any given year. However, of children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys will develop PTSD. Though, this is just a portion of those who have experienced trauma as not all trauma survivors develop PTSD. In the USA, around 60% of men and 50% of women experience trauma in their lifetime, and 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. However, the statistics change around the world for a variety of reasons; the main one being that different types of traumatic events are more (or less) common in certain places. World prevalence of PTSD is around 3.6% of people, and 5.6% of people with trauma exposure. How is post-traumatic stress disorder diagnosed? PTSD is diagnosed by a medical professional who takes all symptoms, changes, and personal histories into account to determine if an individual fits the diagnostic criteria for PTSD. Often, this process is done with the help of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM. A medical professional, such as a psychiatrist, may also prescribe treatment to help the individual cope with having PTSD. What are the treatment and care options for post-traumatic stress disorder? For PTSD, there are many different treatment and care options. According to the American Psychological Association, the most strongly recommended treatment for PTSD is cognitive behavioral therapy, which is a type of talk therapy. In cognitive behavioral therapy, the individual will work with a mental health counselor (such as a therapist) to help them become aware of inaccurate or negative thinking so they can view challenging situations more clearly and respond to them in a more effective and safe way. Cognitive behavioral therapy often includes learning about the individual’s mental health condition, and learning and practicing techniques like relaxation, exposure-and-response, coping, assertiveness, and stress management skills. There are many different subcategories of cognitive behavioral therapy, many of which are prescribed to treat PTSD. These include prolonged exposure therapy, cognitive processing therapy, and cognitive therapy. However, medications and other treatments such as narrative exposure therapy, eye movement desensitization and reprocessing therapy, and brief eclectic psychotherapy are sometimes prescribed and used to treat PTSD. “Four medications received a conditional recommendation for use in the treatment of PTSD: sertraline, paroxetine, fluoxetine and venlafaxine,” according to the APA. How does post-traumatic stress disorder affect someone long-term? While long-term effects of PTSD vary from person to person and trauma to trauma, PTSD certainly does have evident negative or dangerous effects on one’s life. Children who have developed PTSD from childhood trauma may have a compromised ability to function as adults, as they never had time and were never in a mental state where they properly learned how to cope and mature. Children who experienced childhood trauma and who have PTSD are also more likely to become victims of abusive relationships later in life, re-traumatizing them. PTSD also has visible effects on brain function and structure, most notably the amygdala, prefrontal cortex, and hippocampus. PTSD also makes someone more susceptible to other mental health conditions, such as eating disorders, anxiety, or depression. Long term effects of PTSD also include maladaptive coping mechanisms like substance abuse or self-harm, and having emotional difficulty with things like safely expressing anger or sadness. What’s the difference between post-traumatic stress disorder and regular anxiety, fear, or stress? Post-traumatic stress disorder is a trauma and anxiety disorder, meaning the symptoms are severe and persistent enough for it to have extreme negative impacts on one's life. While everyone has fears, stress, and experiences feelings of anxiety sometimes, it is not usually a disorder. You can exhibit some symptoms or traits of PTSD, such as being anxious, without actually fitting the criteria for a diagnosis of PTSD. If I am feeling alone or concerned because I or a loved one am showing signs of PTSD, what should I do? If you are concerned about the mental health of yourself or someone close to you or think you or they may have PTSD, reach out to a medical professional, such as your physician, and ask about getting a referral to a mental health specialist. If you feel like you need to speak to someone or need advice or a safe space, below are hotlines to call. If there is an emergency, if you or a loved one is in immediate danger, or you think you or they may hurt themselves or others, call your emergency number (such as 911 in the USA) or go to/get them to a hospital immediately. These hotlines are available 24/7, are confidential, and are free to use. In the United States you can call…. 1-800-273-8255 for the Suicide Prevention Hotline, press 1 for veterans. 1-800-799-7233 for the Domestic Violence Hotline 1-800-942-6908 for the Domestic Violence Hotline in Spanish 1-800-656-4673 for the Rape, Abuse & Incest National Network (RAINN) hotline 1-800-448-4663 for the Youth Crisis Hotline 1-800-366-8288 for the S.A.F.E. (Self Abuse Finally Ends)/Self-Harm Hotline 1-888-236-1188 for the Eating Disorder Center Or text HOME to 741-741 for the crisis text line. For veterans, text 838255. In Canada you can call… (403) 297-1700 to speak with the Canadian Mental Health Association and get help if you are contemplating suicide, feeling overwhelmed, or experiencing abuse (Calgary area), or 780-482-4357 in the Edmonton region, 1-888-353-2273 people in Kootenays, 450-375-4252 in Haute-Yamaska, and 450 759-6116 in Lanaudière. Click HERE for the full list. Sources: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967 https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/ https://www.healthline.com/health/mental-health/ptsd-causes#causes https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/ https://www.winchesterhospital.org/health-library/article?id=20074 https://www.choosingtherapy.com/intergenerational-trauma/ https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/ https://mentalhealthathome.org/2020/06/12/what-is-intergenerational-trauma/ https://www.apa.org/monitor/2019/02/legacy-trauma https://psychcentral.com/blog/caregivers/2018/06/inter-generational-trauma-6-ways-it-affects-families#1 https://www.ptsd.va.gov/understand/common/index.asp https://www.ptsd.va.gov/understand/common/common_adults.asp https://www.ptsd.va.gov/understand/common/common_children_teens.asp http://www.ptsdalliance.org/diagnosis/ http://www.ptsdalliance.org/professionals/ https://pubmed.ncbi.nlm.nih.gov/26001922/ https://pubmed.ncbi.nlm.nih.gov/28385165/ https://www.riverdell.org/cms/lib05/NJ01001380/Centricity/Domain/111/DSM5%20Student%20Abridged%20Version.pdf https://www.psychiatry.org/psychiatrists/practice/dsm https://www.apa.org/ptsd-guideline/treatments https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610 https://www.psychologytoday.com/us/blog/understanding-ptsd/202006/how-ptsd-affects-the-quality-your-life https://www.brainline.org/article/how-ptsd-affects-brain https://neurohealthah.com/blog/how-ptsd-affects-families/ https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/symptoms https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/resources https://www.pleaselive.org/hotlines/ https://www.fcc.gov/sites/default/files/988-fact-sheet.pdf https://www.rainn.org/ https://www.psychguides.com/guides/ptsd-hotline/ https://www.therapyroute.com/article/suicide-hotlines-and-crisis-lines-in-canada https://cmha.calgary.ab.ca/