Post Traumatic Stress
It is common for people to feel that no matter what they’ve faced or lived with, no matter how extreme, they should be able to carry on. But sometimes people face situations that are so traumatic that they may become unable to cope and function in their daily lives. Some people become so distressed by memories of the trauma – memories that won’t go away – that they begin to live their lives trying to avoid any reminders of what happened to them.
A person who feels this way months after a traumatic experience has passed may be suffering from Posttraumatic Stress Disorder, or PTSD, a serious and common health condition. For these people, getting beyond the trauma and overcoming PTSD requires the help of a professional.
PTSD may develop following exposure to extreme trauma.
Extreme trauma is a terrifying event or ordeal that a person has experienced, witnessed or learned about, especially one that is life-threatening or causes physical harm. It can be a single event or repeated experience.
The experience causes that person to feel intense fear, horror or a sense of helplessness.
The stress caused by trauma can affect all aspects of a person’s life, including mental, emotional and physical well-being.
Research suggests that prolonged trauma may disrupt and alter brain chemistry. For some people, this may lead to the development of PTSD.
Statistics
An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives, and up to 20 percent of these people go on to develop Posttraumatic Stress Disorder, or PTSD.
An estimated 5 percent of Americans – more than 13 million people – have PTSD at any given time.
Approximately 8 percent of all adults – one of 13 people in this country – will develop PTSD during their lifetime.
An estimated one out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD. This may be due to the fact that women tend to experience interpersonal violence (such as domestic violence, rape or abuse) more often than men.
Almost 17 percent of men and 13 percent of women have experienced more than three traumatic events in their lives.
The estimated risk for developing PTSD for people who have experienced the following traumatic events is:
- Rape (49 percent)
- Severe beating or physical assault (31.9 percent)
- Other sexual assault (23.7 percent)
- Serious accident or injury; for example, car or train accident (16.8 percent)
- Shooting or stabbing (15.4 percent)
- Sudden, unexpected death of family member or friend (14.3 percent)
- Child’s life-threatening illness (10.4 percent)
- Witness to killing or serious injury (7.3 percent)
- Natural disaster (3.8 percent)
Who's at risk for developing PTSD?
Those at risk include:
Anyone who has been victimized or has witnessed a violent act or who has been repeatedly exposed to a life-threatening situation.
Survivors of:
- Domestic or intimate partner violence
- Rape or sexual assault or abuse
- Physical assault such as mugging or carjacking
- Other random acts of violence such as those that take place in public, in schools or in the workplace
- Car accidents or fires
- Natural disasters, such as tornadoes or earthquakes
- Major catastrophic events such as a plane crash or terrorist act
- Disasters caused by human error such as industrial accidents
Survivors of unexpected events in everyday life:
Children who are neglected or sexually, physically or verbally abused or adults who were abused as children
Combat veterans or civilian victims of war
Those diagnosed with a life-threatening illness or who have undergone invasive medical procedures
Professionals who respond to victims in trauma situations such as emergency medical service workers, police, firefighters, military, and search and rescue workers
People who learn of the sudden, unexpected death of a close friend or relative
Myths about Posttraumatic Stress Disorder
PTSD is a complex disorder that often is misunderstood. Not everyone who experiences a traumatic event will develop PTSD, but many people do.
MYTH: PTSD only affects war veterans.
FACT: Although PTSD does affect war veterans, PTSD can affect anyone. Almost 70 percent of Americans will be exposed to a traumatic event in their lifetime. Of those people, up to 20 percent will go on to develop PTSD. An estimated one out of 10 women will develop PTSD at sometime in their lives.
Victims of trauma related to physical and sexual assault face the greatest risk of developing PTSD. Women are about twice as likely to develop PTSD as men, perhaps because women are more likely to experience trauma that involves these types of interpersonal violence, including rape and severe beatings. Victims of domestic violence and childhood abuse also are at tremendous risk for PTSD.
MYTH: People should be able to move on with their lives after a traumatic event. Those who can’t cope are weak.
FACT: Many people who experience an extremely traumatic event go through an adjustment period following the experience. Most of these people are able to return to leading a normal life. However, the stress caused by trauma can affect all aspects of a person’s life, including mental, emotional and physical well-being. Research suggests that prolonged trauma may disrupt and alter brain chemistry. For some people, a traumatic event changes their views about themselves and the world around them. This may lead to the development of PTSD.
MYTH: People suffer from PTSD right after they experience a traumatic event.
FACT: PTSD symptoms usually develop within the first three months after trauma but may not appear until months or years have passed. These symptoms may continue for years following the trauma or, in some cases, symptoms may subside and reoccur later in life, which often is the case with victims of childhood abuse.
Some people don't recognize that they have PTSD because they may not associate their current symptoms with past trauma. In domestic violence situations, the victim may not realize that their prolonged, constant exposure to abuse puts them at risk.
What are the symptoms of PTSD?
People respond in different ways to extreme trauma. Many people who experience extreme trauma do not develop PTSD. However, for those who do, PTSD symptoms usually appear within several weeks of the trauma, but some people don’t experience symptoms until months or even years later.
Three categories – or "clusters" – of symptoms are associated with PTSD.
Clusters
Re-living the event through recurring nightmares or other intrusive _images that occur at any time. People who suffer from PTSD also have extreme emotional or physical reactions such as chills, heart palpitations or panic when faced with reminders of the event.
Avoiding reminders of the event, including places, people, thoughts or other activities associated with the trauma. PTSD sufferers may feel emotionally detached, withdraw from friends and family, and lose interest in everyday activities.
Being on guard or being hyper-aroused at all times, including feeling irritability or sudden anger, having difficulty sleeping or concentrating, or being overly alert or easily startled.
People with PTSD may have low self-esteem or relationship problems or may seem disconnected from their lives. Other problems that may mask or intensify symptoms include:
Psychiatric problems such as depression, dissociation (losing conscious awareness of the “here and now”) or another anxiety disorder like panic disorder.
Self-destructive behavior including:
- Alcohol or drug abuse
- Suicidal impulses
- High-risk sexual behaviors that may result in unintended pregnancy or sexually transmitted diseases (STD), including HIV
- Other high-risk behavior that may be life-endangering, such as fast or reckless driving
Physical complaints, any or all of which may be accompanied by depression, including:
- Chronic pain with no medical basis (frequently gynecological problems in women)
- Stress-related conditions such as chronic fatigue syndrome or fibromyalgia
- Stomach pain or other digestive problems such as irritable bowel syndrome or alternating bouts of diarrhea and constipation
- Eating disorders
- Breathing problems or asthma
- Headaches
- Muscle cramps or aches such as low back pain
- Cardiovascular problems
- Sleep disorders
How is PTSD diagnosed?
A diagnosis of PTSD may be considered if a certain number of symptoms from each of the three “clusters” have lasted for one month or more and if they cause severe problems or distress at home or at work or, in general, affect daily life.
PTSD symptoms usually appear within several weeks of the trauma, but some people don’t experience symptoms until months, even years, later.
PTSD can last six months for some people while others may experience symptoms for much longer. Again, it is important to understand that people respond differently to trauma. Some people will have a few problems, and these problems may go away without treatment. Others will need support and some kind of treatment before they can move forward with their lives.
Why is it hard to diagnose?
The most critical steps in treating PTSD often are the most difficult — recognizing the problem and getting help. There are many reasons why this can be hard to do:
- People who have experienced an extreme traumatic event may hope, or even expect, to be able to “handle it” and “get over it” on their own.
- Sometimes people feel guilty about what happened and may mistakenly believe they are to blame or deserve the hurt and pain. Sometimes the experience may be too personal, painful or embarrassing to discuss.
- Some people avoid dealing with anything related to the trauma, especially as they try to get back to the “normal” activities of their daily lives.
- PTSD can make a person feel isolated or alone, making it difficult to reach out for help.
- People with PTSD don’t always make the connection between the traumatic event and the emotional emptiness, anger, anxiety and sometimes physical symptoms they unexpectedly find themselves feeling months, even years, after the trauma.
- Sometimes people don’t know that help is available or don’t know where to turn for help.
If you or someone you care about has PTSD, you need to know that help is available. PTSD is treatable.
How is PTSD treated?
There are a number of effective treatment options for PTSD. Treatment can involve psychotherapy, medication or a combination of both.
Psychotherapy – Psychotherapeutic or counseling methods such as cognitive behavior therapy (CBT), including exposure and anxiety management treatments, are effective in treating PTSD. Effective psychotherapy usually involves helping the survivor learn skills to manage symptoms and to develop ways of coping; work through the traumatic experience; and make meaning of the experience as a part of the person's life.
Medication – Prescription medication is effective in treating PTSD. For some people, medication can significantly reduce symptoms, enhance the effectiveness of psychotherapy and improve quality of life. Those diagnosed with PTSD should talk with their healthcare provider about the use of medication as a part of their treatment regimen.
Where can you go to find help?
Diagnosis and treatment options should be discussed with a healthcare professional:
A psychiatrist, psychologist, mental health counselor or other qualified healthcare professional who provides counseling related to trauma can identify whether a person has PTSD and can discuss options for appropriate treatment.