Post-Traumatic Stress Disorder (PTSD)

What is PTSD?

PTSD is a condition that sometimes develops after a person has experienced or witnessed a traumatic event, such as an accident or a violent assault. Affected people experience “flashbacks” of the event, which can be triggered by stress, sounds, sights, or smells that are similar to those that were present during the trauma. During these episodes, a person may feel helpless and extremely anxious. It is not uncommon for people with PTSD to develop problems with anxiety, depression and alcohol or drug abuse as a result of their condition. Unless treated, these problems can lead sometimes to severe dysfunction and disability.

It is well established that military personnel who are involved in or witness active combat during a war are at high risk of developing PTSD. In a recent study, an estimated 18% of soldiers deployed in Iraq had symptoms of PTSD. Studies of soldiers who served in Vietnam showed that approximately 30% suffered from PTSD. PTSD has also recently been recognized as a condition experienced by World War II Veterans. Since wars usually expose people to violence and traumatic events, it is likely that the condition is as old as war itself.

Key points:

What are the signs and symptoms of PTSD?

There are generally four categories of sings and symptoms associated with PTSD:
1. Flash backs of the event
2. Avoidance of reminders of the events
3. Emotional numbness or isolation
4. Heightened emotional arousal

Flashbacks are vivid episodes in which a person recalls the event, almost as though he or she is reliving it. Flashbacks can be triggered by an image, such as a news clip on television, or a sound, such as a car backfiring, or even a smell, such as smoke, that reminds the affected person of the traumatic event. During a flashback, the person often feels the same intense fear or horror that they felt during the event and may react with the same panic, fear, or anger that they experienced during the original event.

In order to cope, people may make great efforts to avoid things or situations that remind them of the event. War veterans may feel uncomfortable watching the news, going to movies that include war or other violent scenes, visiting areas frequented by uniformed military personnel, or being in situations where there are loud noises similar to gun fire or bombs, such as a fireworks display.
People with PSTD also describe feeling “numb”, unable to feel or express emotions, and find themselves isolating from others.

At the same time, they experience emotional arousal and are unable to relax, as though they are always on guard. This can lead to increased irritability, difficulty concentrating, and overreactions to small disturbances.

Key Points:
– Symptoms of PTSD include:

– People may also feel anxious and on guard, and overreactive to stressful events

What are the complications?

PTSD is a potentially serious condition that can wreak havoc with people’s lives.
While many people who have experienced trauma may experience some anxiety and symptoms similar to those associated with PTSD for several days or weeks following the event, people with PTSD experience these symptoms weeks, months, or even years afterward. As a result of experiencing chronic, long-term symptoms, it is not uncommon for people with PTSD to develop depression. Drug and alcohol abuse are also very common; it is estimated that up to half of men with PTSD develop problems with substance abuse.

This complex of symptoms and coexisting problems with depression and substance abuse can lead to difficulties with family relations, difficulties at work, and problems interacting socially. In fact, people with PTSD have a higher rate of divorce, are at higher risk of being fired or unemployed, and have higher than average problems with social interactions.

PTSD is also associated with physical problems, such as chronic fatigue, insomnia and general pain. A recent study of Iraqi war veterans showed that veterans had a high rate of sick days, healthcare visits, and severe physical symptoms due to combat-induced stress.

Key points:
– Complications can include:

What causes PTSD and who is at risk?

Experiencing or witnessing a traumatic event is an obvious cause of PTSD. But why some people develop PTSD after a traumatic event and others don’t and what underlying factors lead to PSTD are questions that researchers still are trying to answer.

Studies of veterans of war have provided some insights into the causes and risks associated with PTSD. For example, a large-scale study of Vietnam veterans showed that military personnel who experienced high exposure to combat zones during their tour of duty were at greater risk of developing PTSD, presumably due to greater exposure to violent and life-threatening events. Greater exposure to combat zones also resulted in more severe symptoms and problems with readjustment for Vietnam War veterans.

Studies in veterans have also suggested that there is more to PTSD than an emotional response that people can get over at will. As with many mental disorders, neurochemical changes and changes in the brain also factor into PTSD, making it a complex condition involving psychological and neurophysiological processes.

Key Points:
– The main risk factor for PTSD is exposure to a traumatic event
– Veterans with high exposure to combat zones are at high risk
– High exposure to combat zones also increases the risk of severe symptoms

How PTSD diagnosed?
There are no tests for diagnosing PTSD. It is mainly diagnosed through a comprehensive history of trauma and symptoms suggesting PTSD. Psychiatric experts have compiled a list of criteria that point to PTSD, which includes one or more of the following:
A history of involvement in or witnessing one or more traumatic events that was frightening, violent, and/or life threatening or perceived as life threatening.
Recurrent episodes of vivid flashbacks of the event, during which affected individual feel fearful, extremely anxious, or panicked.
Recurrent nightmares about the event.
Intense distress when exposed to situations, images, sounds, or smells that remind the individual of the event.
A feeling of being on guard and anxious, as though something dangerous is about to happen.
A tendency to over-react to stimuli, such as shouting, loud noises, or stressful situations
A feeling of emotional distance and numbness or an inability to feel emotions
These types of symptoms, sometimes accompanied by depression, physical symptoms of fatigue, headaches, and pain, in someone with a history of trauma strongly suggest PTSD.

How is PTSD treated?

PTSD is usually treated with a combination of medications to relieve anxiety and depression and psychotherapy. Three different types of psychotherapy may be used for PTSD: Cognitive therapy, which involves redirecting the thought process, behavioral therapy, which involves adapting behavioral responses to stressors and triggers, and exposure therapy, which involves helping an affected person face their fears and work through them. Sometimes a combination of these three types of therapy may be useful.

The best choice of medication and psychotherapeutic approaches to PTSD varies from individual to individual and is best determined by a qualified professional who specialized in treating this disorder.

Examples of so medications that can be used for PTSD include Selective serotonin reuptake inhibitors (SSRIs). These pills are a type of antidepressant medicine, but are useful in those with PTSD. These can help you feel less sad, as well as curb anxiety symptoms. SSRIs include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Chemicals in your brain affect the way you feel. When you have or depression you may not have enough of a chemical called serotonin. SSRIs raise the level of serotonin in your brain.

There are other medications that have been used with some success for PTSD, such as Buspirone (Buspar), and class of drugs called Benzodiazepines: ((such as diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan),)). Many of these drugs, such as benzodiazepines just mentioned, are potentially addictive and are not recommended for long term use. Please consult your doctor to see which medicine may be right for you.

Although treatment can help veterans cope with symptoms of PTSD and readjust to their lives, research indicates that many veterans who may have PTSD do not seek the help they need. If you or someone you know is suffering with symptoms that may be due to PTSD, it is important to reach out to a qualified therapist, healthcare provider, or a military advisor for help.

For more information about treatment for PTSD, you can call the PTSD information line at (802) 296-6300, or visit http://www.ncptsd.va.gov/ncmain/help/.

Key points:
– PTSD is diagnosed through a history of exposure to trauma and one or more symptoms that suggest PTSD
– PTSD is treated with a combination of medications and psychotherapy
– If you or someone you know is suffering from symptoms of PTSD, it is important to reach out for help

Fast Facts: