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Post-traumatic stress disorder, or PTSD, is a type of anxiety disorder that develops following a terrifying event. According to the National Institute of Mental Health, nearly 7 percent of the adult population in the United States is affected by PTSD. Although PTSD can be debilitating, treatment helps alleviate symptoms. There is no shame in having PTSD; reaching out for help is the first step in overcoming PTSD.
HISTORY
Writers throughout history have described the long-lasting mental and emotional effects of horrific human experiences. Although war and natural disasters inflict this damage to large numbers of people in a discrete time frame, personal trauma due to violent assaults and abuse contribute to the prevalence of PTSD in the population. After World War I, psychiatrists saw large numbers of combat veterans suffering from what was then referred to as "shell shock." During and after World War II and the Korean War, medical personnel caring for soldiers described symptoms they termed "battle fatigue," which is now recognized as PTSD. In 1980, the American Psychiatric Association formally recognized and described PTSD in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. The American public has become increasingly familiar with PTSD due to the high prevalence of the disorder among veterans of the Vietnam conflict, the Gulf War and the wars in Iraq and Afghanistan.
CAUSE
PTSD develops when a person has experienced a traumatic event that is outside of usual human experience. Military combat, violent assaults, kidnapping, captivity, child abuse, sexual assaults, catastrophic accidents and natural disasters are examples of stressors that can lead to PTSD. The traumatic event typically provokes feelings of horror, intense fear and helplessness. It is unclear why some people who experience horrific trauma develop PTSD and others do not. There is some evidence that the tendency for PTSD may run in families. PTSD is often accompanied by other mental health problems, including depression, substance abuse and other anxiety disorders.
SIGNS AND SYMPTOMS
People with PTSD repeatedly relive their trauma in the form of nightmares and disturbing recollections during the day. Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A person having a flashback -- which can come in the form of images, sounds, smells or feelings -- may temporarily lose touch with reality and believe that the traumatic event is happening again. People with PTSD commonly feel detached or numb and are easily startled. They may lose interest in things they used to enjoy and have trouble feeling affection. Irritability and aggressive behavior are common. Situations that remind a person with PTSD of the trauma may be very distressing, leading to avoidance of certain places and situations. Anniversaries of the traumatic event are often very difficult.
Symptoms usually begin within three months of a trauma, although there can be a delayed onset. In some cases, years pass before symptoms appear. In this case, symptoms are often triggered by the anniversary of the trauma or another traumatic event. Symptoms may vary in frequency and intensity over time. In severe cases, the person may have trouble working or socializing.
TREATMENT
The two primary forms of treatment for PTSD are psychotherapy and medication. There are different forms of psychotherapy for PTSD, including cognitive-behavioral therapy, group therapy, exposure therapy, cognitive restructuring and stress inoculation training. For most people, a combination of treatment approaches works best.
As of publication time, two psychiatric medications are FDA approved for the treatment of PTSD: sertraline and paroxetine. Psychiatrists may also prescribe other medications, including certain sedatives, antipsychotics and antidepressants.
GETTING HELP
If you or someone you care about has symptoms of PTSD, it is important to seek help. Talk to your family doctor, call a hot line or contact your local VA or mental health center. PTSD is not a sign of weakness; it is evidence of your humanity. With treatment, the symptoms of PTSD can be managed or overcome, and you can move on with your life.
References
- National Institute of Mental Health: Post-Traumatic Stress Disorder (PTSD)
- United States Department of Veterans Affairs: National Center for PTSD
- "The VVA Veteran"; A Short History of PTSD: From Thermopylae to Hue Soldiers Have Always Had A Disturbing Reaction To War; Steve Bentley; March/April 2005
