It’s likely that most of us have experienced a traumatic event. Even if it didn’t happen to you directly, witnessing or hearing about an emotionally disturbing situation can sometimes be enough to cause emotional damage. As time passes, shock and fear might fade, but what if you can’t shake the anxiety disorder, insomnia, and flashbacks that stem from the past trauma?
When someone’s daily life is disrupted by the aftershocks of a traumatic event, they may be experiencing posttraumatic stress disorder (PTSD) –– a mental health issue that can arise after experiencing a life-threatening event, like war, a rape, or a car accident. According to the National Center for PTSD, about 8 million Americans have PTSD during a given year. Women are more likely to develop PTSD, with a lifetime incidence of 1 in 10. For men, it’s 1 in 25. Yet an even higher number of Americans experience trauma each year. Signs of childhood trauma can be identified in adults as well.
So when does suffering a traumatic event lead to suffering from a traumatic disorder? Should you consider online therapy?
Posttraumatic stress disorder (PTSD) is a psychiatric mental disorder that may occur in people who have experienced or witnessed a traumatic situation or event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury. PTSD has been known by many names in the past, such as “shell shock” during the years of World War I, and “combat fatigue” after World War II. Though it's often associated with military folks, PTSD does not just happen to combat veterans. In fact, PTSD can occur in all people, of any ethnicity, nationality or culture, and at any age.
PTSD affects approximately 3.5 percent of U.S. adults every year, and an estimated one in 11 people will be diagnosed with PTSD in their lifetime. Women are twice as likely as men to have PTSD. Three ethnic groups – U.S. Latinos, African Americans, and American Indians – are disproportionately affected and have higher rates of PTSD than non-Latino whites.
People with PTSD have uncontrollable, intense, and disturbing thoughts and feelings related to their experience that continue past the traumatic event. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; or they may feel detached or estranged from other people. People with PTSD often avoid situations or people that remind them of the traumatic event, and may have strong negative reactions to something as ordinary as a loud noise or an accidental touch, which can trigger the anxiety caused by the traumatic event.
While an official PTSD diagnosis requires exposure to an upsetting traumatic event, the exposure could be indirect rather than first-hand. For example, PTSD could occur in an individual learning about the violent death of a close family or friend. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.
Although it's not clear exactly why people develop PTSD, a number of possible reasons have been shown to induce traumatic stress in patients.
One suggestion is that the symptoms of PTSD are the result of an instinctive mechanism intended to help you survive further traumatic experiences. For example, flashbacks may force a person to think about the event in detail to prepare for a similar experience happening again. Likewise, the feeling of being "on edge" (hyperarousal) may develop to help you react quickly in another crisis. While these physical responses may be intended to help you survive, they're actually very unhelpful when played out in reality because they prevent you from processing and moving on from the traumatic experience.
Studies have shown that people with PTSD have abnormal levels of stress hormones.
Normally, when in danger, the body produces stress hormones like adrenaline to trigger a reaction in the body. This reaction, often known as the "fight or flight" reaction, helps to deaden the senses and dull pain. People with PTSD have been found to continue to produce high amounts of fight or flight hormones even when there's no danger. It's thought this may be responsible for the numbed emotions and hyperarousal experienced by some people with PTSD.
In those suffering from complex PTSD, parts of the brain involved in emotional processing appear different in brain scans. With PTSD, the hippocampus, the part of the brain responsible for memory and emotions, appears smaller in size. It's thought that changes in this part of the brain may be related to fear and anxiety, memory problems and flashbacks. A malfunctioning hippocampus may prevent flashbacks and nightmares from being properly processed, so the anxiety they generate does not reduce over time. Treatment of PTSD results in proper processing of the memories so, over time, the flashbacks and nightmares gradually disappear.
A traumatic event is an incident that causes physical, emotional, spiritual, or psychological harm. The person experiencing the distressing event may feel threatened, anxious, or frightened as a result. In some cases, they may not know how to respond, or may be in denial about the effect such an event has had. The person will need support and time to recover from the traumatic event and regain emotional and mental stability.
Examples of traumatic events include:
This is all to say, not everyone who experiences trauma will develop PTSD. The risk of getting PTSD depends on how the experience affects you. PTSD is more likely to develop if the traumatic event is:
If you already have depression when the trauma happens you are at a higher risk of developing PTSD.
In order to know if you have PTSD, your symptoms fit into the American Psychiatric Association’s criteria for PTSD. You must meet all eight of them in order to be diagnosed with PTSD.
You must have been exposed to or threatened with death. Or, you must have had an actual or serious injury, or actual or threatened sexual violence. You must have experienced at least one of these things in the following ways:
You experience the trauma over and over through at least one of the following:
You avoid things that remind you of the trauma. To meet this criterion, you must do one of these things:
You have negative thoughts or feelings that started or got worse after the trauma. To meet this criterion, at least two of these must be true for you:
If your symptoms started or got worse after the traumatic event, at least two of these things must be part of your experience:
You meet this criterion if any of your symptoms have lasted for more than a month.
Your symptoms create obstacles that make it hard to work or keep up with daily life.
Your symptoms aren’t caused by medicines, illegal drugs, or another illness.
If you meet all of these standards, your doctor will diagnose you with PTSD and start you on a path to treatment. Each person's experience of PTSD is unique to them. You might have experienced a similar type of trauma to someone else, yet be affected in different ways.
While everyone experiences PTSD differently, there are very common signs and symptoms that you might recognize.
This can include:
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A flashback is a vivid experience in which you relive some aspects of a traumatic event or feel as if it is happening right now. This can sometimes be like watching a video of what happened, but flashbacks do not necessarily involve seeing images, or reliving events from start to finish. You might experience any of the following:
You might notice that particular places, people or situations can trigger a flashback for you, which could be due to them reminding you of the trauma in some way. Or you might find that flashbacks seem to happen at random. Flashbacks can last for just a few seconds, or continue for several hours or even days.
If you are experiencing symptoms of PTSD, you might also find that you have difficulty with some everyday aspects of your life, such as:
It's common to experience other mental health problems alongside PTSD mental illness, like anxiety disorders, depression, dissociative disorders, self-harm and suicidal thoughts or feelings.
Untreated post-traumatic stress disorder can have a devastating effect for both those who have the mental health condition and their loved ones. It not only affects relationships with family, friends and others, but it can also trigger serious emotional problems and even cause health problems over time.
A mental health therapist can help a trauma survivor process the trauma in a healthy, effective way by enabling a person to replace negative thoughts with ones that are less distressing. If a person is experiencing guilt or anger, Cognitive Behavioral Therapy (CBT) can help a person cope with their feelings. Other therapies, such as Dialectical Behavior Therapy (DBT) is a trauma focused therapy that can help the individual cope with triggers and quickly resolve panics, communicate better about the trauma, and find new ways to combat flashbacks or physical sensations of trauma.
You can speak to your general practitioner about your concerns. They will be able to talk to you about different types of therapy, treatment options and coping strategies and refer you to psychiatrists, psychologists, and counselors so that you can build the appropriate professional support team.
If you need help finding a therapist for PTSD, Advekit can help you get matched today.