PTSD Symptoms (Post-traumatic stress disorder)

This guide discusses the PTSD symptoms, diagnosis in DSM 5, causes, risk factors and how PTSD symptoms can be treated.

History of PTSD Symptoms

Post-traumatic stress disorder (PTSD) is a mental disorder that is found in individuals who have been through or seen a painful and frightening trauma.

These traumas can be natural disasters, war, rape, bomb blasts or a serious accident.

In the past, PTSD has been known by different names. During World War I, it was known by the name of “shell shock” and after World War II as “combat fatigue”.

But combat veterans are not the only ones who experience PTSD.

It is found in all peoples regardless of their age, ethnicity, nationality, and culture.

Initial PTSD Symptoms

PTSD is diagnosed when an individual is exposed to a frightening traumatic event.

Everyone feels frightened when they experience a traumatic event.

Fear is a natural response that the person experiences during a dangerous situation.

It helps the person to protect himself or herself from harm. People naturally are able to recover from the initial symptoms.

Those who are unable to do so are diagnosed with PTSD.

Individuals suffering from PTSD symptoms may feel terrified and strained.

PTSD Symptoms in DSM 5

PTSD symptoms appear within one month of the disturbing event.

However, in some cases, symptoms may appear years after the event has occurred.

The symptoms may affect the person’s functioning in all areas of life such as school, work, social activities, and daily routine. 

The symptoms of PTSD are categorized into four types which are as follows:

• intrusive memories
• avoidance
• negative changes in thinking and mood.
• Changes in physical and emotional reactions.
• Psychosis

These symptoms can differ from person to person or differ over time.

Intrusive memories

Following are the symptoms of intrusive memories:

• Repeated, undesirable stressful memories of the distressing event
• Experiencing flashbacks that is reliving of the traumatic event
• Disturbing dreams or nightmares about the distressing incident
• Severe physical and emotional reactions to something that make the person recall the traumatic event

Avoidance

Following are the symptoms of avoidance:

• Try to avoid talking or thinking about the traumatic incident
• Try to avoid places, people or things that remind the individual of the traumatic incident.

Negative changes in thinking and mood

Following are the symptoms of negative changes in thinking and mood:

• Negative thinking that involves oneself, others or the world
• Bleakness about the future
• Problems in memory that may include not able to remember important facets of the traumatic event
• Difficult to maintain close relationships
• Feeling disconnected from family and friends
• Absence of interest in pleasurable activities
• Difficult to experience positive emotions
• Feeling emotionally disoriented

Changes in physical and emotional reactions

Following are the symptoms of changes in physical and emotional reactions (also known as arousal symptoms):

• Being easily frightened or startled
• Always being conscious of threat (Hypervigilance)
• Self-destructive behaviour like driving too fast or drinking too much
• Trouble going to sleep
• Difficulty in concentrating
• Angry outbursts, violent behaviour or irritability
• Overwhelming guilt
• Following are the signs and symptoms for children 6 years old and younger:
• Re-enactment of the traumatic incident or its facets through play
• Terrifying dreams that may or may not contain facets of the traumatic incident

The intensity of PTSD symptoms

The intensity of PTSD symptoms can differ over time.

When an individual is stressed or comes across the reminders of a traumatic event, he or she may experience more PTSD symptoms.

For example, an individual may see a news report covering a sexual assault and may experience flashbacks of his or her own assault.

Causes

A person may develop PTSD symptoms when he/she experiences, witness or learn about an incident involving actual or threatened death, sexual assault, serious injury or accident.

Following are some of the causes of PTSD symptoms (PTSD):

• Traumatic experiences, its amount and severity experienced by an individual in his/her life.
• Family histories of mental health risks, such as anxiety and depression
• The temperament of a person that is the inherited features of his or her personality
• Brain functioning involved in the regulation of chemicals and hormones the body releases as a response to stress.

Risk factors:

It is not possible to predict that who will develop PTSD as a result of trauma but there are certain risk factors that can increase the susceptibility of a person to develop PTSD symptoms.

The nature of the traumatic event is very important in determining many risk factors.

Traumatic events that pose a severe threat to life or personal safety are more likely to cause PTSD.

Harm such as rape, assault, and torture are inflicted by humans intentionally and they tend to be more traumatic than natural disasters.

The degree to which the traumatic incident was unpredicted, uncontrollable, and inevitable also plays a role.

Following are the risk factors of PTSD that may increase its chances:

• Experiencing additional problems after the incident, for example, loss of a loved one or a job
• Lack of social support following an event
• Possessing a history of mental health problems
• Having a history of substance use
• Experience of childhood abuse
• Deprived physical health before or as a result of a traumatic event
• The risk factors of PTSD also include some physical and genetic factors.
• Brain structure: As compared to others, the hippocampus of the people with PTSD appears different as shown by brain scans. The function of the hippocampus is the processing of emotions and memories, and it could influence the chance of having flashbacks.
• Response to stress: People with PTSD symptoms (PTSD) have different levels of hormones that are usually released in a fight-or-flight state.
• Gender: This plays a very vital role in developing PTSD symptoms. According to a study, women have greater chances to acquire PTSD although men are more likely to experience violence.

Types of traumatic events

Following are the most common events that lead to the development of PTSD:

• War exposure
• Physical abuse during childhood
• Sexual assault
• Physical violence
• Being intimidated with a weapon
• A severe accident
• Other traumatic events that also lead to PTSD include natural disasters (like earthquake, tsunami, and floods), fire, robbery, plane crash, abduction, life-threatening illnesses, terrorism, and other dangerous events.

Problems due to PTSD

PTSD symptoms can disturb the whole life of an individual.

It can cause difficulties and complications at a job, in relationships with others, personal health, and other everyday activities.

Individuals suffering from PTSD may also be at a high risk of developing other mental health problems such as the following:

• Anxiety and depression
• Problems with alcohol or drug use
• Eating disorders
• Suicidal thoughts and attempts

How to prevent PTSD symptoms from developing?

After an individual survives a traumatic event, he/she may develop PTSD-like symptoms at the beginning, such as keep on thinking about the incident.

Common reactions to trauma include fear, anxiety, depression, anger, and guilt.

Yet, most people do not develop long-term PTSD symptoms (PTSD) after a traumatic event.

If an individual gets help and support on time than normal stress reactions can be prevented from becoming worse and developing into PTSD symptoms.

This support involves talking to family and friends who will listen and console.

It also includes seeking professional help for short-term therapy.

Getting support from others may also prevent a person from indulging in alcohol or drugs.

Treatment

The purpose of PTSD treatment is to improve daily life functioning by decreasing the physical and emotional symptoms and to help the individual cope with the incident that caused the disorder.

Treatment for PTSD symptoms includes psychotherapy, medications or a combination of both. 

Medications

In order to treat PTSD and to regulate feelings of anxiety, individuals with PTSD symptoms are prescribed certain antidepressants.

These antidepressants include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

Following are the examples of the SSRIs:

• Paxil
• Celexa
• Luvox
• Prozac
• Zoloft

Following are the examples of the tricyclic antidepressants: 

• Elavil
• Doxepin
• Mood stabilizers and atypical antipsychotics are also sometimes recommended by doctors.

According to researches, tranquillizers such as Klonopin or Ativan should not be used to treat PTSD symptoms as they are found to be unhelpful and they increase the chances of addiction or physical dependence.

Psychotherapy

The treatment of PTSD symptoms also involves Psychotherapy.

Psychotherapy helps the individual to learn different skills in order to manage their symptoms and to develop different ways of coping with the incident that triggered the symptoms.

Psycho-education is given as a part of psychotherapy in which the therapist provides knowledge to the person and his or her family members about the disorder.

The goal of the therapy is to help individuals with PTSD symptoms to work through the fear related to the traumatic incident.

People with PTSD are treated with a variety of psychotherapy approaches.

Following are some of the approaches that are used with people with PTSD:

Cognitive-behavioural therapy (CBT)

In cognitive-behavioural therapy, individuals are treated by helping them learn to recognize and change their thinking patterns that are responsible for upsetting emotions, feelings, and behaviour.

Prolonged exposure therapy

In prolonged exposure therapy the individuals with PTSD symptoms are helped by exposing them to the situations or things that are related to traumatic experience leading to feelings of anxiety.

This therapy is carried out in a controlled and safe environment.

Prolonged exposure therapy enables the individual to face his or her fears and become more comfortable with the circumstances that are traumatic and leads to feelings of anxiety.

PTSD symptoms have been treated successfully with this therapy.

Psychodynamic therapy:

In this therapy, the emotional struggles that are caused as a result of the traumatic event are focused on.

Family therapy:

In family therapy, family members are involved as the behaviour of the individuals with PTSD symptoms also influences the other members of the family.

Group therapy:

In group therapy, people with PTSD symptoms share their traumatic experiences and the emotions that are associated with them. 

Conclusion

In short, Post-traumatic stress disorder is a mental disorder that an individual experience when he or she is unable to cope with the initial symptoms that result from experiencing a traumatic or life-threatening event.

It affects people of all ages and can be treated through medications and therapies along with the support from family and friends.

Frequently asked questions

Please feel free to ask any questions related to PTSD and leave your comments and suggestions in the comments section below

References

Psychiatry.org

NIMH

Mayoclinic

Medical News Today

Recommended readings:

PTSD: Time To Heal

The Truth About PTSD

Cognitive Processing Therapy for PTSD: A Comprehensive Manual

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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