Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that involved the threat of injury or death.
Causes, incidence, and risk factors
Doctors do not know why traumatic events cause PTSD in some people but not in others. Your genes, emotions, and family setting may all play roles. Past emotional trauma may increase your risk of PTSD after a recent traumatic event.
With PTSD the body's response to a stressful event is changed. Normally, after the event the body recovers. The stress hormones and chemicals the body releases due to the stress go back to normal levels. For some reason in a person with PTSD the body keeps releasing the stress hormones and chemicals.
PTSD can occur at any age. It can occur after events such as:
There are three types of PTSD symptoms:
1. Reliving the event, which disturbs day-to-day activity
Flashback episodes in which the event seems to be happening again and again
Repeated upsetting memories of the event
Repeated nightmares of the event
Strong, uncomfortable reactions to situations that remind you of the event
Emotional numbing or feeling as though you do not care about anything
Not able to remember important parts of the event
Not interested in normal activities
Showing less of your moods
Avoiding places, people, or thoughts that remind you of the event
Feeling like you have no future
Always scanning your surroundings for signs of danger (hypervigilance)
Not able to concentrate
Feeling irritable or having outbursts of anger
Trouble falling or staying asleep
You may feel guilt about the event, including survivor guilt.
Your health care provider may ask how long you have had symptoms. PTSD is diagnosed when you have had symptoms for at least 30 days.
Your health care provider may also do a mental health exam, physical exam, and blood tests. These are done to look for other illnesses that are similar to PTSD.
Treatment for PTSD involves talk therapy (counseling), medicines, or both.
During talk therapy, you talk with mental health professionals, such as psychiatrists or therapists, in a calm and accepting setting. They can help you manage your PTSD symptoms. They will also guide you as you work through your feelings about the trauma.
There are many types of talk therapy. One type that is often used for PTSD is called desensitization. During therapy, you are encouraged to remember the traumatic event and express your feelings about it. Over time, memories of the event become less frightening.
During talk therapy you may also learn ways to relax, especially when you start to have flashbacks.
Your provider may suggest that you take medicines. They can help ease your depression or anxiety. They can also help you sleep better. Medicines need time to work. Do not stop taking them or change the amount (dosage) you take without talking to your provider. Ask your provider about possible side effects and what to do if you experience them.
Support groups, where people who have similar experiences with PTSD, can be helpful. Ask your provider about groups in your area.
PTSD can be treated. You can increase the chance of a good outcome:
See a health care provider right away if you think you have PTSD.
Take an active part in your treatment and follow your provider's instructions.
Accept support from others.
Take care of your health. Exercise and eat healthy foods.
Do not drink alcohol or use recreational drugs. These can make your PTSD worse.
Calling your health care provider
Although traumatic events can cause distress, not all feelings of distress are symptoms of PTSD. Talk about your feelings with friends and relatives. If your symptoms do not improve soon or are making you very upset, contact your health care provider.
Seek help right away if:
You feel overwhelmed
You are thinking of hurting yourself or anyone else
You are unable to control your behavior
You have other very upsetting symptoms of PTSD
Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007;(3):CD003388.
Gilbertson MW, Orr SP, Rauch SL, Pitman RK. Trauma and posttraumatic stress disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 34.
Hetrick SE, Purcell R, Garner B, Parslow B. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2010;(7):CD007316.
Roberts NP, Kitchiner NJ, Kenardy J, Bisson JI. Early psychological interventions to treat acute traumatic stress symptoms. Cochrane Database Syst Rev. 2010;(3):CD007944.
Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.