Post-traumatic Stress Disorder (PTSD)

SYMPTOMS, TREATMENT, AND SELF-HELP

Melinda Smith, M.A., and Jeanne Segal, Ph.D., contributed to this article. Last reviewed: March 2011

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a disorder that can develop following a traumatic event that threatens your safety or makes you feel helpless.

Most people associate PTSD with battle–scarred soldiers–and military combat is the most common cause in men–but any overwhelming life experience can trigger PTSD, especially if the event feels unpredictable and uncontrollable.

Post-traumatic stress disorder (PTSD) can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma.

PTSD develops differently from person to person. While the symptoms of PTSD most commonly develop in the hours or days following the traumatic event, it can sometimes take weeks, months, or even years before they appear.

Traumatic events that can lead to PTSD include:

War Natural disasters Car or plane crashes Terrorist attacks Sudden death of a loved one

Rape Kidnapping Assault Sexual or physical abuse Childhood neglect

The difference between PTSD and a normal response to trauma

The traumatic events that lead to post-traumatic stress disorder are usually so overwhelming and frightening that they would upset anyone. Following a traumatic event, almost everyone experiences at least some of the symptoms of PTSD. When your sense of safety and trust are shattered, it’s normal to feel crazy, disconnected, or numb. It’s very common to have bad dreams, feel fearful or numb, and find it difficult to stop thinking about what happened. These are normal reactions to abnormal events.

For most people, however, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift. But if you have post-traumatic stress disorder (PTSD), the symptoms don’t decrease. You don’t feel a little better each day. In fact, you may start to feel worse.

Signs and symptoms of post-traumatic stress disorder (PTSD)

The symptoms of post-traumatic stress disorder (PTSD) can arise suddenly, gradually, or come and go over time. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell.
While everyone experiences PTSD differently, there are three main types of symptoms:

1. Re-experiencing the traumatic event
2. Avoiding reminders of the trauma
3. Increased anxiety and emotional arousal

Symptoms of PTSD: Re-experiencing the traumatic event

• Intrusive, upsetting memories of the event
• Flashbacks (acting or feeling like the event is happening again)
• Nightmares (either of the event or of other frightening things)
• Feelings of intense distress when reminded of the trauma
• Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

Symptoms of PTSD: Avoidance and numbing

• Avoiding activities, places, thoughts, or feelings that remind you of the trauma
• Inability to remember important aspects of the trauma
• Loss of interest in activities and life in general
• Feeling detached from others and emotionally numb
• Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Symptoms of PTSD: Increased anxiety and emotional arousal

• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hypervigilance (on constant “red alert”)
• Feeling jumpy and easily startled

Symptoms of PTSD in children and adolescents

In children—especially those who are very young—the symptoms of PTSD can be different than the symptoms in adults. Symptoms in children include:

• Fear of being separated from parent
• Losing previously-acquired skills (such as toilet training)
• Sleep problems and nightmares without recognizable content
• Somber, compulsive play in which themes or aspects of the trauma are repeated
• New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters).
• Acting out the trauma through play, stories, or drawings.
• Aches and pains with no apparent cause
• Irritability and aggression

Post-traumatic stress disorder (PTSD) causes and risk factors

While it’s impossible to predict who will develop PTSD in response to trauma, there are certain risk factors that increase your vulnerability.

Many risk factors revolve around the nature of the traumatic event itself. Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Other risk factors for PTSD include:

Previous traumatic experiences, especially in early life Family history of PTSD or depression History of physical or sexual abuse History of substance abuse

History of depression, anxiety, or another mental illness High level of stress in everyday life Lack of support after the trauma Lack of coping skills

Getting help for post-traumatic stress disorder (PTSD)

If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.

It’s only natural to want to avoid painful memories and feelings. But if you try to numb yourself and push your memories away, post-traumatic stress disorder (PTSD) will only get worse. You can’t escape your emotions completely – they emerge under stress or whenever you let down your guard – and trying to do so is exhausting. The avoidance will ultimately harm your relationships, your ability to function, and the quality of your life.

Treatment for post-traumatic stress disorder (PTSD)

Treatment for PTSD relieves symptoms by helping you deal with the trauma you’ve experienced. Rather than avoiding the trauma and any reminder of it, you’ll be encouraged in treatment to recall and process the emotions and sensations you felt during the original event. In addition to offering an outlet for emotions you’ve been bottling up, treatment for PTSD will also help restore your sense of control and reduce the powerful hold the memory of the trauma has on your life.

In treatment for PTSD, you’ll:

• Explore your thoughts and feelings about the trauma
• Work through feelings of guilt, self-blame, and mistrust
• Learn how to cope with and control intrusive memories
• Address problems PTSD has caused in your life and relationships

Types of treatments for post-traumatic stress disorder (PTSD)

• Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
• Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems.
• Medication. Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
• EMDR (Eye Movement Desensitization and Reprocessing). EMDR incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress, leaving only frozen emotional fragments which retain their original intensity. Once EMDR frees these fragments of the trauma, they can be integrated into a cohesive memory and processed.

Finding a therapist for post-traumatic stress disorder (PTSD)

When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can start by asking your doctor if he or she can provide a referral, however, he or she may not know therapists with experience treating trauma. You may also want to ask other trauma survivors for recommendations, or call a local mental health clinic, psychiatric hospital, or counseling center.

Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe, so there is no additional fear or anxiety about the treatment itself. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel respected and understood.

Help for veterans with PTSD

If you’re a U.S. veteran suffering from PTSD or trauma, you can turn to your local VA hospital or Vet Center for help. Vet Centers offer free counseling to combat veterans and their families. To find out more about the resources and benefits available to you, you can also call the VA Health Benefits Service Center at 1-877-222-VETS.

Click here for a nationwide directory of facilities for veterans, including VA hospitals and Vet Centers, provided by the U.S. Department of Veterans Affairs.

Canadian veterans: visit Operational Stress Injury Social Support (OSISS) or call 1-800-883-6094 to talk to a peer who has been through similar experiences.

UK veterans: visit Combat Stress or call the 24-hour helpline 0800 138 1619.

Australian veterans: visit Veterans and Veterans Families Counselling Service (VVCS) or call 1800 011 046.

Self-help and support for post-traumatic stress disorder (PTSD)

Recovery from post-traumatic stress disorder (PTSD) is a gradual, ongoing processing. Healing doesn’t happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many things you can do to cope with residual symptoms and reduce your anxiety and fear.

Reach out to others for support

Post-traumatic stress disorder (PTSD) can make you feel disconnected from others. You may be tempted to withdraw from social activities and your loved ones. But it’s important to stay connected to life and the people who care about you. Support from other people is vital to your recovery from PTSD, so ask your close friends and family members for their help during this tough time.

Also consider joining a support group for survivors of the same type of trauma you went through. Support groups for post-traumatic stress disorder (PTSD) can help you feel less isolated and alone. They also provide invaluable information on how to cope with symptoms and work towards recovery. If you can’t find a support group in your area, look for an online group.

Avoid alcohol and drugs

When you’re struggling with the difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But while alcohol or drugs may temporarily make you feel better, they make post-traumatic stress disorder (PTSD) worse in the long run. Substance use worsens many symptoms of PTSD, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can add to problems at home and in your relationships.

Challenge your sense of helplessness

Overcoming your sense of helplessness is key to overcoming post-traumatic stress disorder (PTSD). Trauma leaves you feeling powerless and vulnerable. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.

One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity. Taking positive action directly challenges the sense of helplessness that contributes to trauma.

Post-traumatic stress disorder (PTSD) and the family

If a loved one has post-traumatic stress disorder (PTSD), it’s essential that you take care of yourself and get extra support. PTSD can take a heavy toll on the family if you let it. It can be hard to understand why your loved one won’t open up to you – why he or she is less affectionate and more volatile. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems.

Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to take care of your loved one, you first need to take care of yourself. It’s also helpful to learn all you canabout post-traumatic stress disorder (PTSD). The more you know about the symptoms and treatment options, the better equipped you’ll be to help your loved one and keep things in perspective.

Helping a loved one with PTSD

• Be patient and understanding. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery and offer a sympathetic ear. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on.
• Try to anticipate and prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you’ll be in a better position to offer your support and help your loved one calm down.
• Don’t take the symptoms of PTSD personally. Common symptoms of post-traumatic stress disorder (PTSD) include emotional numbness, anger, and withdrawal. If your loved one seems distant, irritable or closed off, remember that this may not have anything to do with you or your relationship.
• Don’t pressure your loved one into talking. It is very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Never try to force your loved one to open up. Let the person know, however, that you’re there when and if he or she wants to talk.

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The Bach Flower Remedies can help deal with PTSD, here are some suggestions:

Star of Bethlehem: Helps remove the trauma
Aspen: Helps when you have fears but cannot put a name to them
Mimulus: Helps when you have fears that you can put a name on
White Chestnut: Helps when you have repeated unwanted thoughts
Elm: When you feel overwhelmed and depressed
Red Chestnut: When you fear bad things might happen to your loved ones
Rock Rose: When you have frozen fears, unable to think, react, or move
Sweet Chestnut: When you need faith that everything will be okay

The Bach Flower Remedies are 100% safe and can be used by the whole family

Learn more about the Bach Flower Remedies at www.BachFlower.com
Questions info@BachFlower.com

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