Post Traumatic Stress Disorder—An In-Depth Look

Published on Oct 27, 2017

Post Traumatic Stress Disorder (PTSD) is a condition with clusters of distressing symptoms that persist for more than one month related to experiencing or witnessing a harrowing, shocking or distressing ordeal. The symptoms may emerge almost immediately or be delayed by days, weeks, months or even years. Causative events include, but are not limited to, rape, torture, imprisonment, child abuse, car accidents, train wrecks, plane crashes, bombings, natural disasters, terrorism, and war.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual-5 (DSM-5), almost 9% of Americans will experience symptoms consistent with a diagnosis of PTSD at some point in their lives. During the course of any given year, 3-4% of the adult population in the United States will suffer from this level of symptoms. In absolute terms, that is about 8.5 million adults in the U.S. When addressed early in its course, there are many reasons to be hopeful for a resolution of symptoms.

PTSD Symptoms

An acute stress reaction may occur immediately upon experiencing a traumatic event and resolved within days to one month, but PTSD is when the symptoms persist for more than one month. Symptoms may vary per person, but several features are generally present. Some of the symptoms that may be present include:

  • A sense of feeling emotionally numb, even around loved ones.
  • Needing to avoid certain places, activities or people that may bring the trauma to mind.
  • A continued re-experiencing of the event as flashbacks or nightmares, difficult memories or intrusive images.
  • A sense of needing to be extra alert or vigilant.
  • Reacting with an exaggerated startle response.
  • Outbursts of irritability or edginess.
  • Feeling anxious or worried.

Who Gets PTSD and Why

There is no particular personality type or characteristic that causes a person to develop PTSD: the toughest individual you know may develop it while the seemingly most vulnerable person you know may not. In other words, there is no good evidence-based answer for why one person develops PTSD after a terrible experience and another person does not and we have no way of predicting this difference on an individual level. The best information that we have for predicting its occurrence on a population level is using population data to understand what risk factors may be involved. People with the following characteristics are thought to be more likely to experience PTSD after a trauma:

  • Low economic status.
  • Family or personal history of psychiatric illness.
  • Past history of parental neglect.
  • Having low levels of support from friends or family.

There are some data that show that PTSD might run in families. Studies to find genetic predispositions for PTSD are ongoing. Researchers hope to discover whether or not specific gene mutations cause a person to be vulnerable to developing the disorder. Despite some preliminary promising leads, this research is in its very early stages, and no conclusions can yet be drawn.

The Type of Event Plays a Role in PTSD

The type of event may also influence whether or not someone experiencing it will develop the disorder. The following types of events and the estimated percentages of people experiencing the event who are thought to develop PTSD demonstrate how uncertain the emergence of the disorder after a trauma can be:

  • Natural Disasters: 4% to 5%.
  • Accidents: 6% to 9%.
  • Witness of a traumatic event: 6% to 8%.
  • Rape: 46% to 65%.

Addressing PTSD

There are several treatment options for PTSD that involve psychotherapy, or “talk therapy” and/or pharmacological therapy with certain approved prescription antidepressant or other medications. If you are suffering from intrusive symptoms that disrupt your normal activities, and you think you might have PTSD, there are several things you can do:

  • Tell your doctor about your symptoms right away.
  • Get a trusted referral to a psychiatrist, psychologist or psychotherapist who is well trained in trauma.
  • Make sure anyone you see for professional help is appropriately credentialed and licensed.
  • Alert family members to the situation for support.
  • The sooner you get help and find ways of expressing your thoughts and feelings about the traumatic event, the better your chances of recovery are.

Instead of seeking help, some people isolate and suffer in silence. Others use drugs or alcohol to cope with their symptoms. In fact, the rate of substance abuse is two to three times higher in individuals with PTSD compared with non-trauma-exposed people. If alcohol or illicit substances have become a means of coping with the distressing feelings related to trauma, greater difficulties will likely emerge and the situation must be addressed with a medical professional.

When Someone You Love Has PTSD

How can you help when someone you care about (adult or child) is suffering from PTSD? Here are some things you can do:

  • Allow the person the time and space to talk about the traumatic event.
  • Neither ignore what happened, nor demand that they speak about it. Instead, simply let them know you are there to listen whenever they feel like talking.
  • When listening to a loved one with PTSD, be attentive and non-judgmental. You may be surprised to learn some of the feelings your loved one has.
  • With a child who may be experiencing PTSD, you may want to provide a space for talking by focusing on a shared activity together.

The most important thing to know about PTSD is that no one needs to suffer alone. There is support available from medical professionals, community organizations, and others who have experienced similar trauma. Getting help increases the likelihood of recovery.

Daniel R. Karlin, MD, MA is a practicing board-certified psychiatrist, and a Director in the Neuroscience Research Unit at Pfizer.

[1] [2] [3] [4] [5] [6]

References

  • 1. Bisson JI. Post-traumatic stress disorder. BMJ. 2007;334:789-793. doi: 101136/bmj.39162.538553.80.
  • 2. Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5). Washington, DC: American Psychiatric Association, Inc; 2013.
  • 3. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry. 1995;52:1048-1060. Accessed December 1, 2014.
  • 4. National Insitute of Mental Health. Post-traumatic stress disorder (PTSD).
  • 5. United States Census Bureau. State and county quick facts. Accessed December 2, 2014.
  • 6. Yehuda R. Post-traumatic stress disorder. N Eng J Med. 2002;346(2):108-114.
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