What is Post Traumatic Stress Disorder and how is it Treated?

Most people will have a traumatic experience at some time in their life, and approximately one third of these people are likely to develop Posttraumatic Stress Disorder (PTSD). Trauma is defined as “exposure to actual or threatened death, serious injury, or sexual violence” (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) and can be experienced in a variety of ways. A person may directly experience the trauma, witness it happening to someone else, learn about a violent or accidental death of someone close to them, or have repeated exposure to traumas through their work (e.g., being a first responder or a police officer).

In order to have a diagnosis of Posttraumatic Stress Disorder, an individual must be evaluated by a trained mental health professional to see if various symptoms are present and creating significant distress. All symptoms must also last for at least one month – it is normal to have these symptoms immediately following a traumatic event, but when they persist longer than one month, the risk for PTSD is higher. The following is a list of the categories of PTSD symptoms. If you believe that you or someone you care about experiences some of these symptoms, we recommend that you talk to a therapist about completing an assessment for PTSD. 

Re-experiencing symptoms (one required): The traumatic event is persistently re-experienced, in the following way(s):

·       Intrusive trauma-related thoughts or memories

·       Nightmares

·       Flashbacks

·       Emotional distress after experiencing reminders of the trauma

·       Physical reactivity when experiencing reminders of the trauma (e.g., heart racing, sweating, nausea, trembling)

Avoidance symptoms (one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

·       Avoiding trauma-related thoughts or feelings

·       Avoiding external reminders (e.g., people, places, conversations, objects, situations) that arouse distressing memories, thoughts, or feelings about the traumatic event

Changes in thinking and feeling (two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

·       Inability to recall key features of the trauma

·       Overly negative thoughts and assumptions about oneself or the world

·       Exaggerated blame of self or others for causing the trauma

·       Persistent negative emotional state (e.g., fear, anger, guilt, shame)

·       Decreased interest in activities

·       Feeling detached or distant from other people

·       Difficulty experiencing positive emotions (e.g., inability to experience happiness, satisfaction, loving feelings)

Hyperarousal symptoms (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

·       Irritability or aggression

·       Risky or destructive behavior

·       Hypervigilance or being on guard

·       Heightened startle reaction

·       Difficulty concentrating

·       Difficulty sleeping

PTSD is a treatable, meaning that individuals can experience a significant reduction or complete remission of PTSD symptoms. There are several therapies that were developed to treat individuals with PTSD, including Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE). These therapies have strong empirical support for their effectiveness, and a therapist would have to undergo specific training to gain competence in using them. Other treatments include Eye Movement Desensitization and Reprocessing (EMDR). Some individuals with PTSD also chose to take a medication such as an SSRI to help stabilize their mood, though medication alone is not likely to lead to a complete remission of PTSD symptoms. For more information about PTSD and treatment options, consult a skilled trauma therapist or visit https://www.ptsd.va.gov/.