Post-Traumatic Stress Disorder (PTSD)

What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) can start after you witness or are involved in a very stressful event. The event usually involves a real or possible severe injury or the threat of death. It causes feelings of extreme fear, helplessness, or horror. After being involved in such an event, many people have trouble sleeping, have nightmares or daytime memories of the event, and feel emotionally numb and cut off from others. For most people, these symptoms stop within a month after the stressful event. When these symptoms continue for months or years, it is called post-traumatic stress disorder.

What is the cause?

It is not fully clear why one person involved in something like a robbery, rape, or severe car accident develops PTSD while another does not. Some factors that may lead to PTSD include:

• a family or personal history of mental illness
• the severity of the stressful event
• lack of family and social support available after the event

Not everyone who is exposed to a stressful event gets PTSD. Studies show that 1 to 14% of people will have PTSD for some period in their lives, at least in a very mild form.

PTSD can occur at any age. Symptoms can start right after the stressful event, but sometimes symptoms begin 3 months or more after the event. Having PTSD symptoms lasting up to a month after a stressful event is a normal human reaction and is not considered PTSD. It is called acute stress disorder. If symptoms last more than a month it is called PTSD.

What are the symptoms?

PTSD symptoms fall into 3 areas. You may not have all the symptoms, but most people with PTSD have some symptoms in each area.

1. Reexperiencing the stressful event
   • bothersome and repeated thoughts, emotions, and images of the event
   • repeated dreams about the event
   • moments when you feel the event is happening again
   • panic attacks when things happen that remind you of the stressful event
2. Avoiding things related to the stressful event or feeling numb
   • avoiding conversations, thoughts, or places that remind you of the event
   • not being able to remember important parts of the event
   • feeling and acting very distant and detached from others close to you
   • having fewer emotions than you had before the event, or seeming emotionally flat to others
   • feeling hopeless about the future
3. Being physically alert all or most of the time
   • having a lot of trouble falling or staying asleep
   • being very irritable or having angry outbursts
   • having trouble concentrating or staying focused
   • being startled or jumping at sudden or loud noises
   • feeling very suspicious and being on guard all the time

How is it diagnosed?

Your healthcare provider or a mental health professional can tell you if your symptoms are PTSD. He or she will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical problems, such as hormone imbalances.

Your healthcare provider may ask you to change medicines or dosages you are currently taking to make sure medicines are not causing or increasing your symptoms.

How is it treated?

Do not try to overcome PTSD by yourself. PTSD can be successfully treated with psychotherapy, medicine, or both. Discuss this with your healthcare provider or therapist.

Medicine

Medicines are sometimes needed when the symptoms are very severe. Medicines may help reduce symptoms of anxiety and panic, having nightmares, and having flashbacks. If you have symptoms of depression, antidepressant medicine may be prescribed.

No nonprescription medicines are available to treat PTSD.

Therapy

Seeing a psychiatrist or other psychotherapist can help when you are having symptoms of PTSD. Therapy may last just a short time or may need to last for months or years. Two types of psychotherapy sometimes used to treat PTSD are cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR).

CBT is a way to help you identify and change thoughts that lead to PTSD symptoms. Replacing negative thoughts with more positive ones can help you to control your symptoms.

EMDR is a fairly new psychotherapy technique that uses eye movement to activate the brain while you remember the stressful event and your feelings about the experience. The therapy is designed to release "trapped" emotional experiences from the stressful event. Dealing with these experiences may help you to have more peaceful, calm feelings.

Claims have been made that certain herbal and dietary products help control PTSD symptoms. No herb or dietary supplement has been proven to consistently or completely relieve PTSD. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe.

Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and psychotherapy.

How long will the effects last?

For at least half of the people who get PTSD, it goes away within 3 months. For some people, the symptoms last for more than a year. How long it lasts depends on your being able to talk about the trauma with others, the severity of the trauma, and how often you are reminded of the stressful event.

How can I take care of myself?

Maintaining a healthy lifestyle is important. To help control PTSD:

• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

When should I seek help?

Do not try to get over a severely stressful event all by yourself. Seek professional help if you have experienced a stressful event or have the symptoms of PTSD.

When should I seek immediate help?

Get emergency care if you or a loved one has serious thoughts of suicide, violence, or harming others. Also seek immediate help if you have severe chest pain or trouble breathing.