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  Post Traumatic Stress Disorder  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Recommendations

 

There is a growing awareness among healthcare providers that traumatic experiences are widespread and that it is common for people who have been traumatized to develop medical and psychological symptoms associated with the experience. Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD. Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape. PTSD is associated with an extremely high rate of medical and mental health service use, and possibly the highest per-capita cost of any psychological condition.

But there is help and there is hope.

PTSD is a long-term problem for many people. Studies show that 33-47% of people being treated for PTSD were still experiencing symptoms more than a year after the traumatic event. Without treatment many people continue to have PTSD symptoms up to ten years after the traumatic event.

What are the symptoms of PTSD?
PTSD symptoms are divided into three categories. People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. However, the diagnosis of PTSD means that someone has met very specific criteria. The symptoms for PTSD are listed below.

  • Intrusive Re-experiencing People with PTSD frequently feel as if the trauma is happening again. This is sometimes called a flashback, reliving experience or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.
  • Avoidance People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.
  • Arousal Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled, irritable and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.
Who gets PTSD?
PTSD can affect anyone at any age who has been exposed to a traumatic event where he/she experienced terror, threat (or perceived threat) to life, limb or sanity and his/her ability to cope was overwhelmed. Conservative estimates show that 9-10% cent of the general population has PTSD. Among people who were victims of specific traumatic experiences (rape, child abuse, violent assaults, etc.), the rate of PTSD is 60-80%.

Diagnosis
Unfortunately, it is common for those with PTSD to avoid treatment. Also, it is common for those who do seek treatment to be misdiagnosed. Because PTSD often occurs at the same time as other physiological and mental health disorders, PTSD symptoms may be masked or difficult to identify. Examples of common co-occurring conditions are depression, substance use/dependence and bipolar disorder. Trauma survivors may also experience headaches, chest pain, digestive or gynecological problems as well. However, there is a growing number of clinicians who are skilled at recognizing PTSD and still others who are specializing in treatment of traumatic stress disorders. If you think you might have PTSD you should seek professional help for a thorough physical and mental health assessment.

Can PTSD be treated?
Yes. A person who has survived a traumatic event will probably never feel as if the event didn't happen, but the disruptive, distressing effects of PTSD are completely treatable. Depending on the source of the trauma (manmade versus natural), the nature of the trauma (accidental versus purposeful), and the age of the victim at the time of the trauma, treatment strategies may vary. Treatment involves both managing symptoms and working through the traumatic event. Most experts agree that psychotherapy is an important part of recovery. Medications can help reduce some symptoms allowing psychotherapy to be more effective.
 

 
 

Signs, symptoms & indicators of Post Traumatic Stress Disorder:
 
 
Symptoms - Mind - Emotional  Difficult memories
 People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD. Many with PTSD often feel as if the trauma is happening all over again.

  Irritability

Symptoms - Mind - General

  Jumpiness
 Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may seem constantly on guard and may find it difficult to concentrate.

  Trouble concentrating

Symptoms - Respiratory

  Sudden shortness of breath or air hunger

Symptoms - Sleep

  Bizarre/vivid/nightmarish dreams
 People suffering from PTSD may have intrusive mental images or hallucinations about a trauma, or recurrent nightmares.

  Unsound sleep
  (Frequent) difficulty falling asleep
  Being a light sleeper
 
 

Conditions that suggest Post Traumatic Stress Disorder:
 
 
Addictions  Alcohol-related Problems
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Mental

  Panic Attacks
 New Geisinger-lead research dispels a recent notion in psychiatry that if a person experiences a panic attack during a traumatic event that they will likely suffer from post-traumatic stress disorder (PTSD) in the future.

The study appears in the April edition of the journal Psychiatry Research and was co-authored by Geisinger Senior Investigator Joseph Boscarino, Ph.D., MPH, and Kent State University social psychologist Richard E. Adams, Ph.D.

The new research suggests that factors such as a prior history of depression, a person's emotional support network and self-esteem are better indicators of a person's susceptibility to PTSD.

It was previously thought that panic attacks immediately following traumatic events such as a car accident would trigger or predict PTSD in the long-term. But the study's authors say there is more to it.

"Clinicians should look at other signs of mental-health stress such as not sleeping, recently experiencing stressful life events and withdrawing from social interactions," Boscarino said. "Our study suggests that many factors contribute to post-traumatic stress disorder not just panic attacks during the event." [08 Apr 2009 ]
 
 

Risk factors for Post Traumatic Stress Disorder:
 
 
Childhood  (Severe) sexual abuse during childhood
 Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

  Physical abuse/harsh punishment during childhood
 Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

Supplements and Medications

  (Past) marijuana use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) cocaine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) heroin/morphine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) LSD use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) methamphetamine use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

  (Past) ecstacy use
 Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Symptoms - Mind - Emotional

  Having been raped
 Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape.
 
 

Recommendations for Post Traumatic Stress Disorder:
 
 
Oriental Medicine  Emotional Freedom Technique (EFT)

Physical Medicine

  EMDR
  Craniosacral Therapy (CST)

Psychological

  Counseling
 Cognitive-behavioral therapy (CBT) involves working with cognitions to change emotions, thoughts, and behaviors. Exposure therapy is one form of CBT that is unique to trauma treatment. It uses careful, repeated, detailed imagining of the trauma (exposure) in a safe, controlled context to help the survivor face and gain control of the fear and distress that was overwhelming during the trauma. In some cases, trauma memories or reminders can be confronted all at once ("flooding"). For other individuals or traumas, it is preferable to work up to the most severe trauma gradually by using relaxation techniques and by starting with less upsetting life stresses or by taking the trauma one piece at a time ("desensitization").

Along with exposure, CBT for trauma includes:
  • learning skills for coping with anxiety (such as breathing retraining or biofeedback) and negative thoughts ("cognitive restructuring")
  • managing anger
  • preparing for stress reactions ("stress inoculation")
  • handling future trauma symptoms
  • addressing urges to use alcohol or drugs when trauma symptoms occur ("relapse prevention"), and communicating and relating effectively with people (social skills or marital therapy).

[The National Center for Post-Traumatic Stress Disorder - Department of Veterans Affairs]
 
 


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