By Steven Stein, MD – Board-certified Psychiatrist
Post-traumatic stress disorder (PTSD) is one mental health condition that falls under a category of conditions that develop in response to life stress or traumatic events called Trauma and Stressor Related Disorders. It can occur at any age and any person who experienced or witnessed a traumatic event. Other similar disorders arguably on a spectrum with PTSD include Acute Stress Disorder and Adjustment Disorder. The management of these disorders can be similar, but often vary depending on the severity of symptoms, duration of time and impact on daily life. Identifying there is a problem is the first step in developing a solution and then the healing process can begin. Treatment typically involves a combination of therapy, medication, self-help strategies, and support from friends and family. The goal of this article will be to raise awareness of traumas/microtraumas, PTSD and similar Trauma and Stressor Related Disorders, identify some of the common triggers and traumatic events, and offer guidance on what may help the healing process and overall management.
As mentioned, Post-Traumatic Stress Disorder (PTSD) can develop after an individual experiences or witnesses a traumatic event. These events may include sexual or physical assault, natural disasters, combat, accidents, or any real or perceived life-threatening situations. Symptoms can arise immediately or soon after the event, but for some can be more insidious and even delayed months, if not years, after a trauma or series of traumas. Just like every individual is a unique person, there are no identical presentations of this disorder, but there are characterological similarities. Some of these include:
1) Intrusive thoughts, where the person often experiences disruptive and uninvited thoughts, memories, or nightmares related to past trauma. They may also have intense emotional or physiological reactions when exposed to reminders of the trauma, called triggers. These thoughts often come unannounced and are involuntary but can even be so severe that the person falls into a state where they relive or re-experience the traumatic event emotionally, physically and/or with the senses like sight and sound. These often-horrific events are called flashbacks.
2) Avoidant behaviors: People with PTSD may actively avoid reminders of the traumatic event such as places, people, activities, or conversations that could trigger distressing memories. They may withdraw from social interactions and isolate themselves to prevent further distress. This can further lead to other mental health conditions like depression and anxiety.
3) Negative Alterations in Cognition and Mood: A person with PTSD often has changes in their thoughts and feelings after the trauma which may include a more pessimistic attitude/more negative thoughts, distorted thoughts about oneself or the world, feelings of guilt or shame, and a loss of overall pleasure or enjoyment in life.
4) Hyperarousal: Those with PTSD often exhibit heightened arousal, which can manifest as difficulty sleeping, irritability, hypervigilance, exaggerated startle response, and problems with concentration. They may feel constantly on guard and have trouble relaxing.
It’s important to mention that not everyone who experiences a traumatic event will develop PTSD. The risk factors for PTSD can vary among individuals, including the severity of the trauma, inherent personal factors, social support, and pre-existing mental health conditions. Some may not meet criteria also based on severity of symptoms or the duration of time the symptoms have occurred. This can apply to the following two similar but separate diagnoses 1) Acute Stress Disorder: also known as acute stress reaction, is a psychological condition that can occur immediately after a traumatic event. It shares similarities with PTSD, but the main distinction is that ASD occurs within a shorter timeframe, typically within three days to one month after the traumatic event, whereas PTSD symptoms may persist for months or years. 2) Adjustment Disorder is another similar diagnosis that develops in response to a change in life considered stressful, where the person develops a change in emotions or behaviors that cause impairment in overall functioning. This can be seen or experienced as decreases in mood/depression, increases in anxiety, disturbances to conduct, emotional instability or often a combination.
Some common triggers for trauma reactions, adjustment difficulties and PTSD include:
1. Survivors of physical or sexual assault: Individuals who have experienced physical or sexual assault, whether in childhood or adulthood, are more likely to develop PTSD.
2. Victims of domestic violence or abuse: People who have been subjected to ongoing domestic violence or abuse may develop PTSD because of the trauma they have endured.
3. Natural disaster survivors: Those who have lived through natural disasters like hurricanes, earthquakes, floods, or wildfires may experience symptoms of PTSD.
4. Accident survivors: People who have been involved in severe accidents, such as car crashes or plane crashes, can develop PTSD.
5. Medical trauma: Individuals who have undergone major surgeries, life-threatening illnesses, or medical procedures can develop PTSD due to the traumatic nature of their experiences.
6. Military personnel: Soldiers and veterans who have experienced combat or other traumatic events during their service are at higher risk for developing PTSD.
7. First responders and emergency personnel: Police officers, firefighters, paramedics, and other first responders who frequently witness traumatic events may be at increased risk of developing PTSD.
8. Witnesses of violence or traumatic events: Individuals who have witnessed violent acts, terrorist attacks, or other traumatic events may experience symptoms of PTSD.
Here are some key approaches to manage PTSD and the other discussed Trauma and Related Disorders: For starters, seek professional help. It’s important to consult a mental health professional experienced in treating PTSD. They can provide an accurate diagnosis and develop a tailored treatment plan based on your specific needs. This may include:
1. Psychotherapy: Trauma-focused therapies, such as Cognitive-Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Dialectical Behavior Therapy (DBT), are effective in addressing traumatic experiences, managing symptoms, and promoting healthy coping strategies.
2. Medications such as selective serotonin reuptake inhibitors (SSRIs) or other psychiatric medications may be prescribed to manage specific symptoms like depression, anxiety, or sleep disturbances.
3. Self-Care and Support: Engaging in self-care practices, building a strong support network, and seeking support from friends, family, or support groups can be beneficial in the healing process.
If you or someone you know has experienced a traumatic event and is struggling with symptoms of PTSD, please know that you don’t have to be alone in this struggle. There are things you can do and steps you can take to start feeling better, improve your symptoms and start living life the way you want to live it on your terms. Learning more about PTSD and understanding its effects can empower you to better manage your symptoms. Remember, managing PTSD is a gradual process, and it may take time, but it is effort well spent.
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