Post-traumatic stress disorder (PTSD), Symptoms, Causes, Treatment & Prevention

 

Post-traumatic stress disorder (PTSD) is a mental health condition caused by an extremely stressful or distressing experience, either as a participant or by watching it. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.

Most people who have experienced traumatic situations may struggle to adjust and cope for a short period of time. However, with time and proper self-care, they usually improve. They may have PTSD if their symptoms worsen over time and interfere with their ability to function daily.

Post-traumatic stress disorder (PTSD) is a common mental health illness that occurs following a traumatic experience. Symptoms include flashbacks, anxiety, negative ideas and beliefs, hypervigilance, and more. The primary treatment for PTSD is psychotherapy (talk therapy).

Also Read: Brain diseases: Types, Causes, Symptoms, Diagnosis, Treatment & Prevention

What is PTSD?

PTSD (post-traumatic stress disorder) is a mental health condition that can develop after experiencing or witnessing a stressful event. The traumatic experience could be fatal or seriously harm your physical, emotional, or spiritual well-being. PTSD affects individuals of all ages.

People suffering from PTSD endure acute and intrusive thoughts and sensations about the event that last for a long time. PTSD includes stress responses such as:

• Anxiety, depression, guilt, or shame.
• Have flashbacks or nightmares.

Avoid circumstances, places, and activities associated with the traumatic event.
These symptoms create distress and interfere with your everyday activities.

What is a traumatic event?

 A traumatic occurrence is anything that severely threatens your life or sense of safety.  It does not have to be a single occurrence (such as a car accident); it can be long-term trauma, such as living through war or being abused repeatedly. Trauma does not have to occur directly to you; you can observe a terrible occurrence. You may develop PTSD after learning about a tragic event that happened to a loved one.

Traumatic occurrences can include, but are not limited to:

• Serious accidents, such as vehicle collisions.

• A severe injury or sudden illness.

• War and military combat.

• Natural calamities include tornadoes, earthquakes, fires, and floods.

• Physical abuse.

• Verbal abuse.

• Sexual abuse or assault.

• Bullying.

• The sudden death of a loved one.

Types of PTSD

Two conditions are closely related to PTSD.

• Acute stress disorder is a short-term mental health condition that can develop during the first month of experiencing a severe event. Symptoms that last longer than four weeks may indicate PTSD.

• Complex PTSD (CPTSD) is a mental health condition that can develop after experiencing chronic (long-term) trauma. Chronic trauma can be defined as long-term physical or sexual abuse of children, long-term domestic violence, or war. People with CPTSD often exhibit PTSD symptoms as well as substantial problems with emotion control, sense of self, and relationships.

What are the PTSD symptoms?

To be diagnosed with PTSD, symptoms must continue for  more than a month and produce severe discomfort or impairment in everyday functioning. PTSD symptoms come into four categories:


Intrusion:

• Intrusive thoughts include recurring and involuntary memories

• Nightmares

• Flashbacks to the distressing experience might be extremely vivid and feel real

Avoidance:

•  Avoiding reminders of the traumatic incident, such as people, places, activities, things, and situations.

•  Avoiding remembering or thinking about the traumatic experience.

•  Avoid discussing what happened or your feelings about it.

 Changes in thought and mood:

•  Ongoing terror, horror, rage, remorse, or shame.

•  Memory loss for significant portions of the stressful experience.

•  Continuous negative and distorted thoughts and sentiments toward oneself or others.

•  Distorted ideas regarding the cause or impact of the event lead to incorrectly blaming oneself or others.

•  Feeling disconnected from others.

•  No longer enjoy the activities you previously did.

•  Being unable to feel good emotions.

Changes in arousal and reactivity

•  Irritation and angry eruptions.

•  Risky or self-destructive activity.

•  Being extremely attentive to surroundings (hypervigilance).

•  I am easily surprised.

•  Problems focusing or sleeping.

Childhood PTSD symptoms:

Children with PTSD may struggle to articulate their emotions, or they may have suffered trauma that you are unaware of. They may appear agitated, fidgety, or have difficulty paying attention and staying organized.

These symptoms may be confused with those of attention-deficit/hyperactivity disorder (ADHD). As a result, it is critical to take your child to a specialist (such as a child psychologist) who is skilled at diagnosing PTSD.

Causes:

Post-traumatic stress disorder can occur after experiencing, witnessing, or learning about an event that involved real or threatened death, significant injury, or sexual assault.

 Healthcare professionals are unsure why some people get PTSD.  As with most mental health problems, it is likely caused by a combination of circumstances, including

 Extremely stressful circumstances, as well as the number and degree of trauma you've encountered in your life.

 A family history of anxiety and depression is one example of an inherited mental health risk.

 Inherited personality traits are often known as temperament.

 The way your brain controls the chemicals and hormones that your body produces in response to stress.

Risk Factors:

People of any age can develop post-traumatic stress disorder. However, you may be more likely to acquire PTSD following a distressing event if:

• Had severe or long-term traumatic events.

• We were injured during the traumatic event.

• Have already experienced trauma, such as childhood abuse.

• Have a career that exposes you to stressful situations, such as serving in the military or as a first responder.

• Have other mental health issues, such as anxiety or depression.

• Drinking excessively or misusing drugs.

• Do not have a strong support network of family and friends.

• Have biological relations with mental health issues, such as PTSD or depression.

Traumatic events that raise risk
The most prevalent incidents that can cause PTSD are:

• Combat exposure.

• Child physical abuse.

• Sexual violence.

• Physical assault.

• Being threatened with a weapon.

• An accident.

Other traumatic events that might cause PTSD include a fire, natural catastrophe, mugging, robbery, plane accident, torture, kidnapping, a life-threatening medical diagnosis, a terrorist attack, and other extreme or life-threatening events.

Complications:

Post-traumatic stress disorder can impact your entire life, including your education, work, interpersonal relationships, physical health, and enjoyment of daily activities.  PTSD may also increase your risk of other mental health problems, including:

• Depression and anxiety disorders.

• Issues with drug or alcohol use.

• Considering and attempting suicide.

How is PTSD diagnosed?

There is no test to diagnose PTSD. Instead, a healthcare provider makes the diagnosis by asking about your:

• Symptoms.

• Medical history.

• Mental health history.

• Exposure to trauma.

It may be difficult to discuss the trauma. You may want to bring a loved one with you to the visit for support and to assist in providing information about your symptoms and behavioral changes.

The diagnostic criteria for PTSD are based on the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The most recent edition is the DSM-5-TR ("TR" stands for "text revision"). To receive a PTSD diagnosis, you must have experienced the following symptoms for at least one month:

• At least one intrusive symptom.

• At least one avoidance symptom.

• At least two cognitive and emotional symptoms.

• At least two arousal or reactivity symptoms.

Your physician might perform a physical examination and order specific tests (such as blood tests) to see whether physical problems are causing some of your symptoms.

How is PTSD treated?

Psychotherapy (talk therapy) is the primary treatment for PTSD, particularly types of cognitive behavioral therapy (CBT).

This therapy is conducted by a qualified, licensed mental health professional, such as a psychologist or psychiatrist. They can offer you and/or your loved ones assistance, information, and guidance to help you perform better and improve your overall well-being.

Specific forms of cognitive behavioral therapy for PTSD include:

• Cognitive processing therapy was developed primarily to treat PTSD. It emphasizes changing painful negative emotions (such as shame and guilt) and trauma-related beliefs. It also helps you deal with upsetting memories and emotions.

• Eye movement desensitization and reprocessing (EMDR) therapy includes moving your eyes in a certain pattern while processing unpleasant memories. EMDR's purpose is to assist you in recovering from trauma or other difficult life situations. Compared to other therapy modalities, EMDR is relatively young. However, scores of scientific research have shown that this strategy is helpful and can heal people more quickly than many other methods.

• Group therapy allows survivors of similar traumatic events to discuss their experiences and thoughts in a safe and nonjudgmental environment. Family treatment may also be beneficial, as PTSD symptoms can affect the entire family.

• Prolonged exposure therapy involves repeated, detailed imaginings of the event or gradual exposures to symptom triggers in a safe, controlled setting. This allows you to confront and regulate your fear while also learning to cope.

• Trauma-focused CBT includes learning about how your body reacts to trauma and stress. You will also learn how to identify and reframe problematic thought patterns, as well as how to manage symptoms. It includes exposure therapy as well.

Medication for PTSD

There are currently no drugs approved by the United States Food and Drug Administration (FDA) to treat PTSD. Healthcare providers may prescribe particular drugs to aid with certain PTSD symptoms, such as:

Antidepressants include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).
Anti-anxiety drug.

Prevention:

You cannot always prevent a traumatic incident. However, some research suggests that taking specific precautions can help you avoid PTSD in the future. These are known as "protective factors" and include:

• Seeking assistance from others following the occurrence, such as family and friends. This helps to provide a sense of security.

• Joining a support group following a tragic experience.

• Learning to feel confident in your activities in the face of risk.

• Developing a healthy coping approach following the stressful incident.

• Capable of acting and responding successfully in the face of fear.

Helping others, especially if the incident is distressing and affects a large number of people, such as in a natural disaster.

References:

• Eapen BC, et al., eds. Posttraumatic stress disorder. In. Brain Injury Medicine: Board Review. Elsevier; 2021. https://www.clinicalkey.com. Accessed April 25, 2024.

• American Psychiatric Association. What is Posttraumatic Stress Disorder (PTSD)? (https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd) Last reviewed 11/2022. Accessed 10/6/2023.

• Mann SK, Marwaha R. Posttraumatic Stress Disorder (https://www.ncbi.nlm.nih.gov/books/NBK559129/). 2023 Jan 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Accessed 10/6/2023.

• Mulvaney SW, et al. The successful use of left-sided stellate ganglion block in patients that fail to respond to right-sided stellate ganglion block for the treatment of post-traumatic stress disorder symptoms: A retrospective analysis of 205 patients. CNS Spectrums. 2022; doi:10.1093/milmed/usab056.

• Helping a family member who has PTSD. Department of Veterans Affairs. https://www.ptsd.va.gov/family/how_family_member.asp. Accessed April 25, 2024.

• Kellerman RD, et al. Posttraumatic stress disorder. In: Conn's Current Therapy 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed April 25, 2024.

• National Library of Medicine (U.S.). Post-Traumatic Stress Disorder (https://medlineplus.gov/posttraumaticstressdisorder.html). Accessed 10/6/2023.

• Prazosin. MedlinePlus https://medlineplus.gov/druginfo/meds/a682245.html. Accessed April 29, 2024.

• National Institute of Mental Health (U.S.). Post-Traumatic Stress Disorder (https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd). Last reviewed 5/2023. Accessed 10/6/2023.