Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder or PTSD is a psychiatric disorder that occurs in the aftermath of traumatic, distressing, and extremely stressful events. It can severely affect a person’s quality of life in the long run.

What Is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder is a mental health condition that may develop after one experiences or witnesses a traumatic or shocking event [mfn] National Institute of Mental Health. (2019, May). Post-Traumatic Stress Disorder. Www.nimh.nih.gov; National Institute of Mental Health. Available from: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd [/mfn].

While it is not unusual for people to get flashbacks, nightmares [mfn] El-Solh A. A. (2018). Management of nightmares in patients with posttraumatic stress disorder: current perspectives. Nature and science of sleep, 10, 409–420. https://doi.org/10.2147/NSS.S166089 [/mfn], or intrusive thoughts after traumatic experiences, these symptoms can persist for months if you are suffering from post-traumatic stress disorder.

People suffering from post-traumatic stress disorder may intentionally avoid situations and things that remind them of the trauma as memories of the event cause them intense anxiety which can disrupt their normal functioning [mfn] Posttraumatic Stress Disorder – an overview | ScienceDirect Topics. (n.d.). Www.sciencedirect.com. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/posttraumatic-stress-disorder [/mfn].

Although PTSD can be quite debilitating, it is possible to recover from it with appropriate treatment and social support.

Case Example – 1

Rajiv had been posted on the border for 5 years. About 6 months ago, a severe leg injury during combat damaged his ability to walk and subsequently ended his career in the Defense. This incident not only changed his life but also transformed him as a person. 

A usually strong Rajiv was now easily triggered by loud noises and would get startled every time someone came into his room while he was not looking. He often woke up screaming from nightmares and found it quite difficult to go back to sleep.

In an attempt to put the army life behind him, Rajiv purposely avoided talking to any of his ex-colleagues. He hid all pictures of himself in uniform so as not to be reminded of that unfortunate day but was still bothered by sudden unwelcome thoughts about the combat that he could not shake off no matter what. As a result, he would often be in a low mood and gradually lost interest in things that used to excite him before.  

Case Analysis

From Rajiv’s symptoms, it seems clear that he was experiencing intense reactions to loud noises, nightmares, and recurring unwanted thoughts about the accident. He was also intentionally suppressing memories related to the event, avoiding places and situations that would remind him of it, and experiencing a persistent low mood along with a lack of interest in activities that were previously pleasurable to him. 

These are classic indications of post-traumatic stress disorder.       

Case Example – 2

At the age of 19, Charu had an unfortunate encounter with two robbers while traveling in a train. When she tried to save her belongings from the thieves, they turned violent and assaulted her. She tried her best to fight but they eventually managed to run away with her wallet. Charu was left bruised and with no money on her.

After the initial shock of this incident wore off, Charu decided to put it behind her and move on with her regular life. However, about a month later, she suddenly woke up sweating from a nightmare where she saw the two men in her room. She couldn’t sleep for the rest of the night. Such dreams kept recurring over the next few weeks and Charu started getting flashbacks of the event even when she was awake. Although she tried to forget it and avoided talking about it, it seemed as though it wasn’t leaving her. She started losing concentration in class and zoning out in the middle of conversations. 

The next time Charu stepped on a train, she felt as if the whole incident were happening again. She was finding it hard to distinguish what was real and what wasn’t. She felt so breathless and dizzy that she had to get off the train and be rushed to a hospital.

Case Analysis
It seems apparent from Charu’s symptoms that she was suffering from post-traumatic stress disorder; she started experiencing nightmares and flashbacks and losing concentration due to unwanted memories of the incident about a month after her trauma. Moreover, it was quite uncomfortable for her to be around triggers that reminded her of the incident, such as the train.

Post-traumatic Stress Disorder vs Acute Stress Disorder

Acute stress disorder (ASD) is a more immediate response to trauma than post-traumatic stress disorder, which is diagnosed only four weeks after the traumatic event. However, most symptoms are common to both disorders.

Read More About Acute Stress Disorder Here

PTSD vs C-PTSD

Complex post-traumatic stress disorder or C-PTSD is a relatively new classification that is used to describe a stress disorder that develops due to exposure to multiple traumatic events over a long period of time.

Experts over the years have found that repeated, prolonged trauma may result in more severe emotional and psychological damage than a single traumatic event [mfn] Herman, J.L. Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. J Trauma Stress 5, 377–391 (1992). https://doi.org/10.1007/BF00977235 [/mfn], leading to the formulation of the C-PTSD diagnosis. Research [mfn] Bryant R. A. (2019). Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges. World psychiatry : official journal of the World Psychiatric Association (WPA), 18(3), 259–269. https://doi.org/10.1002/wps.20656 [/mfn] reveals that long-term adverse childhood experiences are most likely to result in complex PTSD in adults.

How Common Is PTSD?

According to World Mental Health surveys [mfn] Koenen, K. C., Ratanatharathorn, A., Ng, L., McLaughlin, K. A., Bromet, E. J., Stein, D. J., Karam, E. G., Meron Ruscio, A., Benjet, C., Scott, K., Atwoli, L., Petukhova, M., Lim, C. C. W., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Bunting, B., Ciutan, M., de Girolamo, G., Degenhardt, L., … Kessler, R. C. (2017). Posttraumatic stress disorder in the World Mental Health Surveys. Psychological medicine, 47(13), 2260–2274. https://doi.org/10.1017/S0033291717000708 [/mfn], post-traumatic stress disorder possibly affects about 4% of the world population although prevalence rates may vary depending on cultural and ethnic factors.

PTSD often affects rescue workers, emergency personnel, and loved ones of disaster victims. It is also highly common among war veterans [mfn] National Center for PTSD. (2014). How Common is PTSD in Veterans? Va.gov. Available from: https://www.ptsd.va.gov/understand/common/common_veterans.asp [/mfn]. Women are more likely to be affected by PTSD than men.

Signs Of PTSD

The symptoms of post-traumatic stress disorder occur after being exposed (either directly or indirectly) to a traumatic event. A person who has PTSD will commonly show the following signs [mfn] Center for Substance Abuse Treatment (US). (2014). Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD. Nih.gov; Substance Abuse and Mental Health Services Administration (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/ [/mfn]:

1. Unwanted but recurring memories of the event
2. Nightmares related to the event
3. Feeling as if the traumatic event was occurring again
4. Intense reactions to things related to the traumatic event
5. An attempt to suppress memories of the event and avoid situations that remind them of the same
6. Inability to remember certain aspects of the event
7. Low mood and a negative view of their own self and the world
8. Lack of interest in activities they liked before
9. Outbursts of anger and irritability
10. Getting easily startled

People with PTSD also have a higher risk of suicide [mfn] Panagioti, M., Gooding, P.A., Triantafyllou, K. et al. Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 50, 525–537 (2015). https://doi.org/10.1007/s00127-014-0978-x [/mfn] and deliberate self-harm.

Know More About The Symptoms Of PTSD Here

The Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 classifies post-traumatic stress disorder as a ‘trauma and stressor-related disorder’. PTSD diagnosis [mfn] U.S. Department of Veterans Affairs. (2014). PTSD and DSM-5 – PTSD: National Center for PTSD. Va.gov. Available from: https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp [/mfn] requires that after being exposed to a traumatic event, nine of the symptoms from the specified categories namely, intrusive thoughts, negative affect and cognition, arousal, avoidance, and dissociation must be fulfilled.

Learn More About How PTSD Is Diagnosed

Causes Of PTSD

Post-traumatic stress disorder occurs as a result of exposure to a traumatic event – either experiencing it directly, being a witness to it, or learning about it from someone. Although the definition of a ‘traumatic event’ may vary for each individual, some experiences that can commonly lead to PTSD include accidents and injuries, war, abuse, and natural disasters.

Various factors related to brain structure and genetics [mfn] Skelton, K., Ressler, K. J., Norrholm, S. D., Jovanovic, T., & Bradley-Davino, B. (2012). PTSD and gene variants: new pathways and new thinking. Neuropharmacology, 62(2), 628–637. https://doi.org/10.1016/j.neuropharm.2011.02.013 [/mfn] have been implicated in the development of PTSD. Studies [mfn] NHS. (2021, February 17). Causes – Post-traumatic stress disorder. Nhs.uk. Available from: https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/causes/ [/mfn] have also found abnormal levels of stress hormones in patients with the disorder.

Other mental health conditions such as depression or anxiety disorders may act as PTSD risk factors.

Know More About The Causes Of Post-traumatic Stress Disorder

PTSD Treatment

Treatment for post-traumatic stress disorder usually follows a multidimensional approach [mfn] Hetrick, S. E., Purcell, R., Garner, B., & Parslow, R. (2010). Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). The Cochrane database of systematic reviews, (7), CD007316. https://doi.org/10.1002/14651858.CD007316.pub2 [/mfn] involving both psychotherapeutic and pharmacological interventions.

Apart from these, social support and adequate self-care can also play a crucial role in the recovery process. Treatment is generally focused on symptom relief and on improving daily functioning. Rigorous psychotherapy can also help people manage triggers better in the future.

Know About The Different Kinds Of Therapy Techniques And Medications Available For PTSD

Post-traumatic Stress Disorder In Children

Post-traumatic stress disorder in adults is a more widely discussed phenomenon although it can affect children as well. About 5% of adolescents [mfn] National Institute of Mental Health. (2017). NIMH» Post-Traumatic Stress Disorder (PTSD). Www.nimh.nih.gov. Available from: https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd [/mfn] are estimated to experience PTSD and about 1.5% suffer severe impairment. PTSD is usually diagnosed in children above 6 years of age and is more common during later teenage years.

PTSD in teenagers and kids might present differently than it does in adults.

Read More About PTSD In Children

How To Cope With PTSD

Living with post-traumatic stress disorder can be exhausting, to say the least. The journey of recovery is a long one and not without bumps in the road. There are, however, some coping strategies that can make the process slightly smoother.

Some of these techniques include

• Practicing mindfulness-based relaxation techniques, like meditation and deep breathing
• Engaging in regular exercise or physical activity
• Journaling or using expressive writing to honestly express your thoughts and feelings
• Getting enough sleep
• Eating nutritious food on a daily basis
• Pursuing a hobby that you enjoy
• Avoiding caffeine, alcohol, and drugs
• Joining a support group

Read More About The Different Coping Strategies For PTSD Here

Do keep in mind that these methods are simply an ancillary to professional treatment and not a replacement for the same.

Takeaway

Post-traumatic stress disorder is a complex condition that can be quite debilitating. However, the research [mfn] Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. The Cochrane database of systematic reviews, 2013(12), CD003388. https://doi.org/10.1002/14651858.CD003388.pub4 [/mfn] presents strong evidence suggesting that therapy can be highly beneficial for people with PTSD, even if they have been suffering for several years.

If you or your loved one is suffering from PTSD, do not hesitate to seek help from a mental health professional. Post-traumatic stress disorder is a treatable condition and recovery is a gradual but rewarding process.

At A Glance

1. PTSD is a mental health condition that is triggered by the direct or indirect experience of a terrifying or traumatic event.
2. PTSD is associated with anxiety disorders, depression, and substance abuse.
3. People with PTSD also have a higher risk of suicide & deliberate self-harm.
4. Young children, adolescents, and teens may also develop this disorder and the symptoms are usually different from the ones observed in adults.
5. Treatment primarily adopts a multidimensional approach involving psychotherapeutic and pharmacological interventions.

Frequently Asked Questions (FAQs)