What Is PTSD?
After a traumatic experience, it’s normal to feel frightened, sad, anxious, and disconnected. Usually, as time passes, the upset feelings fade and you start to enjoy life again.
But sometimes the trauma you experienced is so overwhelming that you find you can’t move on. You feel stuck with painful memories that don’t fade and experience a constant sense of danger.
If you went through a traumatic experience and are having trouble getting back to your regular life, reconnecting to others, and feeling safe again, you may be suffering from post-traumatic stress disorder (PTSD). When you have PTSD, it can seem like you’ll never get over what happened or feel normal again.
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 it feels unpredictable and uncontrollable (for example, the events of September 11, 2001).
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 depending on the 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.
Three months ago, Gina was in a major car accident. She sustained only minor injuries, but two friends riding in her car were killed.
At first, the accident seemed like just a bad dream. Then Gina started having nightmares about it. Now, the sights and sounds of the accident haunt her all the time.
Gina has trouble sleeping at night, and during the day she feels irritable and on edge. She jumps whenever she hears a siren or screeching tires, and she avoids TV programs that might show a car chase or accident scene. She also avoids driving whenever possible, and refuses to go anywhere near the site of the crash.
PTSD vs. 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.
However, if you have PTSD, the symptoms don’t decrease. You don’t feel a little better each day. In fact, you may start to feel worse.
A normal response to trauma becomes PTSD when you become stuck.
After a traumatic experience, the mind and the body are in shock. But as you make sense of what happened and process your emotions, you come out of it.
With PTSD, however, you remain in psychological shock. Your memory of what happened and your feelings about it are disconnected.
In order to move on, it’s important to face and feel your memories and emotions.
Signs and Symptoms of PTSD
The symptoms of post-traumatic stress disorder 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:
- Re-experiencing the traumatic event
- Avoiding reminders of the trauma
- Increased anxiety and emotional arousal
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)
Avoiding reminders of the trauma
- Avoidance of 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
- A feeling of detachment from others and emotional numbness
- A sense of a limited future (for example, you don’t expect to live a normal life span, get married, have a career)
Increased anxiety and emotional arousal
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance (on constant “red alert”)
- A feeling of jumpiness and being easily startled
Other Common Symptoms of PTSD:
- anger and irritability
- guilt, shame, or self-blame
- substance abuse
- feelings of mistrust and betrayal
- depression and hopelessness
- suicidal thoughts and feelings
- feeling alienated and alone
- physical aches and pains
PTSD is a neurotransmitter–related condition. For more information on the role that neurotransmitters play, please read our article: Severe Anxiety Disorders.
Getting Help for PTSD
It’s important to seek help right away if you suspect you (or a loved one) might be suffering from post-traumatic stress disorder. The sooner PTSD is confronted, the easier it is to overcome. If you are 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, PTSD will only get worse. You can’t escape your emotions completely. They will emerge under stress or whenever you let down your guard, and trying to avoid them is exhausting. The avoidance will ultimately harm your relationships, your ability to function, and the quality of your life.
Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.
PTSD symptoms can change family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.
PTSD can be related to other health problems and can even worsen physical problems. For example, a few studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD, you could also improve your physical health.
Conventional 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.
- 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.
- 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.
- 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.
For a very interesting, informative look at the life-shattering effects of PTSD, you may wish to read the book “Surviving the Shadows” by critically acclaimed authors Bob Delaney (an NBA referee) and Dave Sheiber. The DaSilva Institute’s founder, Guy DaSilva, MD, contributed a chapter entitled “The Physiology of Post-Traumatic Stress Disorder.” Delaney and Sheiber are also known for their book “Covert: My Years Infiltrating The Mob.”