What is PTSD?
PTSD stands for post-traumatic stress disorder. This psychiatric disorder can result from experiencing a frightening or life-threatening event, such as combat, car accidents, physical or sexual violence.
PTSD affects about 3.5 million adults in the United States, and it is estimated that about one in 11 people will be diagnosed with PTSD during their lifetime. It can occur in anyone, but women are twice as likely as men to be diagnosed with PTSD. Rates of PTSD among veterans from Iraq and Afghanistan have been estimated to be as high as 20 percent.
PTSD Risk Factors
Most people will feel scared during or after a traumatic event. This is part of a fear response known as “fight or flight” that serves us by helping us protect ourselves by either fighting back in some way or getting away from the dangerous situation.
Doctors are not exactly sure how or why PTSD develops in some people and not others. That being said, certain risk factors can make a difference. For example, people who have experienced childhood trauma, who have a limited support network, additional stressors, or a history of mental illness may be more susceptible to PTSD.
On the other hand, certain resilience factors may help reduce the chances of PTSD. These factors include things like seeking help from family and friends or finding a support group and having other positive coping strategies.
After a traumatic event, most people will experience a range of symptoms for a period of time. These may include anxiety, nightmares, replaying the event in their mind, and difficulty sleeping. In some people these symptoms may continue or grow worse, developing into acute stress disorder.
Acute stress disorder symptoms develop between about three days to one month after the traumatic event. The symptoms are distressing and disruptive. About 50 percent of people who experience acute stress disorder will develop PTSD.
PTSD symptoms may appear for months or even years after the traumatic event.
Symptoms of PTSD fall into four categories:
- Intrusive thoughts or memories: Repeated and unexpected memories or upsetting dreams about the event or flashbacks, which are sometimes so powerful that the individual feels like they are reliving the event.
- Avoidance of reminders: People experiencing PTSD may avoid certain places, people, activities, or even objects that remind them of the trauma. They may try to avoid thinking or talking about the event.
- Negative thinking or moods: These are ongoing distorted negative thoughts or beliefs an individual with PTSD may have about themselves. They may also experience strong upsetting emotions such as fear, horror, anger, guilt, or shame. They may also feel emotionally detached from others or show less interest in activities they enjoyed in the past.
- Changes in arousal and emotional reactions: These symptoms include irritability, self-destructive or reckless behavior, angry outbursts, difficulty concentrating or sleeping, and being startled easily.
An adult must experience all of the following criteria for at least one month to be diagnosed with PTSD:
- One or more symptom of avoidance
- One or more symptom of changes in arousal or emotional reactions
- One or more symptom of negative thinking or mood changes
- One or more symptom of re-experiencing the event (intrusive thoughts or memories)
How is PTSD Treated?
PTSD is typically treated with antidepressant medications or psychotherapy (“talk therapy”) or a combination of the two. It’s crucial to find a mental health therapist or counselor who is experienced in working with clients struggling with PTSD. If you are also dealing with a co-occurring condition such as a substance use disorder, it is essential to find a counselor who also has experience helping clients with addiction.
There are a variety of different types of talk therapy that are used to help people struggling with PTSD. Some focus on the PTSD symptoms. Others focus on family, social, or work-related issues. In some cases, the doctor or psychotherapist may combine therapies depending on the needs of the patient. One commonly used form of psychotherapy is cognitive behavioral therapy, also known as CBT, which works to help a person understand how their thoughts and feelings shape their behavior.
Exposure therapy and cognitive restructuring are two kinds of CBT that are often used to treat CBT. Exposure therapy uses tools such as writing about the traumatic incident or visiting the location where the trauma occurred to help the patient face their fears and learn how to cope. Cognitive restructuring helps people to confront and reevaluate their memories.
EMDR, which stands for eye-movement desensitization and processing, is another therapy option that has shown success in treating patients with PTSD. In the past, it was controversial, but it has grown in acceptance as an effective treatment for both civilian and military patients.
A therapist using EMDR will guide the patient to make eye movements or follow certain hand taps while they recall the traumatic event. This helps the patient to focus on something else while they revisit the experience, which helps them to reframe or reprocess the event as no longer traumatizing.
PTSD and Substance Use Disorder
Sometimes PTSD is accompanied by a substance use disorder (SUD) and/or alcohol use disorder (AUD).
About 50 percent of people who are looking for substance use disorder treatment also satisfy the criteria for PTSD. If a person has both PTSD and a SUD, that means they have comorbidity or a co-occurring condition. Getting professional help through an addiction treatment program is key to a successful recovery from a SUD.
When a SUD is combined with PTSD, treatment may take longer as it can be more challenging to recover from a combination of PTSD-SUD. PTSD tends to result in stronger cravings and a greater likelihood of relapse after treatment. However, that does not mean it is not possible to get treatment for PTSD-SUD and have a successful recovery. Finding a program that addresses the needs of both conditions in what is known as an integrated model of treatment can make a big difference in treatment outcome.
PTSD can develop after someone experiences a terrifying or life-threatening event. It has become common among many Iraq and Afghanistan military veterans. However, PTSD often occurs after other traumatic events, such as car accidents, and physical or sexual violence. It is more common in women than in men.
Medication and/or talk therapy may be used to treat PTSD. If someone has comorbidity with PTSD, such as a co-occurring condition like a substance use or alcohol use disorder, it is vital to find a treatment program that is designed to treat both disorders.