Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Many people who go through traumatic events have difficulty adjusting and coping for a while. But with time and taking care of yourself, such traumatic reactions usually get better. In some cases, though, the symptoms can get worse or last for months or even years. Sometimes they may completely shake up your life. In a case such as this, you may have post-traumatic stress disorder.
Getting treatment as soon as possible after post-traumatic stress disorder symptoms develop may prevent long-term post-traumatic stress disorder.
Post-traumatic stress disorder symptoms typically start within three months of a traumatic event. In a small number of cases, though, PTSD symptoms may not appear until years after the event.
Post-traumatic stress disorder symptoms are generally grouped into three types: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal (hyperarousal).
Symptoms of intrusive memories may include:
Symptoms of avoidance and emotional numbing may include:
Symptoms of anxiety and increased emotional arousal may include:
Post-traumatic stress disorder symptoms can come and go. You may have more post-traumatic stress disorder symptoms when things are stressful in general, or when you run into reminders of what you went through. You may hear a car backfire and relive combat experiences, for instance. Or you may see a report on the news about a rape and feel overcome by memories of your own assault.
When to see a doctor
But if you have these disturbing thoughts and feelings for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your health care professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
In some cases, post-traumatic stress disorder symptoms may be so severe that you need emergency help, especially if you're thinking about harming yourself or someone else. If this happens, call 911 or other emergency medical service, or ask a supportive family member or friend for help.
You can develop post-traumatic stress disorder when you go through, see or learn about an event that causes intense fear, helplessness or horror.
Doctors aren't sure why some people get post-traumatic stress disorder. As with most mental health problems, PTSD is probably caused by a complex mix of:
People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, including:
Women may be at increased risk of PTSD because they are more likely to experience the kinds of trauma that can trigger the condition.
Kinds of traumatic events
The most common events leading to the development of PTSD include:
But many other traumatic events also can lead to post-traumatic stress disorder, including fire, natural disaster, mugging, robbery, assault, civil conflict, car accident, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack and other extreme or life-threatening events.
Post-traumatic stress disorder can disrupt your whole life: your job, your relationships and even your enjoyment of everyday activities.
Having PTSD also may place you at a higher risk of other mental health problems, including:
In addition, PTSD may increase your risk of certain medical illnesses, including:
Preparing for your appointment
If you have thoughts of suicide, go to an emergency room or call 911 or your local emergency number immediately.
If you have less urgent symptoms of post-traumatic stress disorder, make an appointment with your family doctor or general practitioner. Your doctor can help you begin the process of understanding whether your physical and emotional symptoms may be related to a traumatic experience. In many cases, your doctor may refer you to a mental health professional who can help make a diagnosis and create the right treatment plan for you.
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
For PTSD, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
What you can do in the meantime
You may find it especially helpful to talk with others who have gone through a traumatic experience similar to yours. Your doctor or mental health professional may be able to recommend a support group in your area. Exercise and relaxation techniques such as yoga or meditation also may improve your symptoms.
Tests and diagnosis
Post-traumatic stress disorder is diagnosed based on signs and symptoms and a thorough psychological evaluation. Your doctor or mental health professional will ask you to describe the signs and symptoms you're experiencing — what they are, when they occur, how intense they are and how long they last. Your doctor also might ask you to describe the event that led up to your symptoms. You may also have a physical exam to check for any other medical problems.
To be diagnosed with PTSD, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health professionals to diagnose mental conditions and by insurance companies to determine reimbursement for treatment.
Criteria for post-traumatic stress disorder to be diagnosed include:
Treatments and drugs
Post-traumatic stress disorder treatment can help you regain a sense of control over your life. With successful post-traumatic stress disorder treatment, you can also feel better about yourself and learn ways to cope if any symptoms arise again.
Post-traumatic stress disorder treatment often includes both medication and psychotherapy. Combining these treatments can help improve your symptoms and teach you skills to cope better with the traumatic event — and life beyond it.
You and your doctor will need to work together to figure out the best treatment, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks.
Be sure to tell your health care professional about any side effects or problems you have with the medications, as you may be able to try something different.
Some types of therapy used in PTSD treatment include:
All these approaches can help you gain control of lasting fear after a traumatic event. The type of therapy that may be best for you depends on a number of factors that you and your health care professional can discuss.
Medications and psychotherapy also can help you if you've developed other problems related to your traumatic experience, such as depression, anxiety, or alcohol or substance abuse. You don't have to try to handle the burden of PTSD on your own.
Acupuncture may be helpful in improving the symptoms of PTSD. More research is needed to fully understand the safety and effectiveness of acupuncture as a treatment for PTSD. Talk with your doctor if you're interested in adding acupuncture to your treatment plan.
Coping and support
If stress and other problems caused by a traumatic event affect your life, seeing your health care professional is an important first step. But you can take actions to help yourself cope as you continue with treatment for post-traumatic stress disorder. Things you can do include:
When someone you love has PTSD
Hearing about the trauma that led to your loved one's PTSD may be extremely painful for you, and may cause you to relive difficult events in your own life. The person you love may seem like a different person than you knew before the trauma — angry and irritable, for example, or withdrawn and depressed.
If someone you love has PTSD, you may find yourself avoiding his or her attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty that you can't fix your loved one or hurry up his or her process of healing.
In order to take care of yourself and your loved one, it's critical that you make your own mental health a priority. Eat right, exercise and rest. Continue to take time alone or with friends, doing activities that help you recharge. If you continue to have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your emotions.
After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt — all are common reactions to trauma. Although you may not want to talk about it to anyone or you don't want to even think about what's happened, getting support can help you recover. This may mean turning to supportive family and friends who will listen and offer comfort. It may mean that you seek out a mental health professional for a brief course of therapy. Some people also may find it helpful to turn to their faith community or a pastoral crisis counselor.
However you choose to get support and help, doing so can help prevent normal stress reactions from getting worse and developing into post-traumatic stress disorder. Getting support may also help prevent you from turning to unhealthy coping methods, such as alcohol use.
Last Updated: 2011-04-08
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