Everyone feels stress at some point in their lives. It is inevitable that events will occur throughout the day that cause a person to feel that they are being overwhelmed by the pressures of the world. While no one can control anything other than themselves, the manner in which a person deals with stress will determine how the stress effects them. Unfortunately, some stressful events are so overwhelming that they cause a recurring sense of dread and anxiety that persists well after the event has been resolved. It is not clear why some people will react to a situation and recover without any lasting effects and why other people develop long term problems. When a person has recurring reactions after a stressful or traumatic event, that person may have Post Traumatic Stress Disorder.
It is important to understand that PTSD may occur from a directly experienced traumatic event or could occur by observing a traumatic event that occurs to a loved one. PTSD can be either short-term (acute) or long-term (chronic), depending on how long the stress reaction lasts. After a traumatic event, the symptoms can appear as early as three months to as late as many years later. It is important to remember that the reaction is not immediate and the person can start feeling symptoms well after the trauma has passed.
The disorder is characterized by four symptom categories that must be present for at least a month. These symptoms include, re-experiencing, avoidance, two arousal and reactivity, and two cognition and mood. The re-experiencing symptoms are bad dreams, frightening thoughts and flashback which is defined as reliving the experience again and again with physical symptoms also being present. Any reminder of the experience can trigger a re-experiencing symptom. This could be thoughts, words, objects, events or even situations that remind the person of the event and therefore trigger a symptom. Avoidance is the staying away from thoughts, places, or events that remind or trigger the traumatic event. This can lead to the person changing their routine and interfere with their life. For example, a person might avoid certain stores if they had fall or injury there. The symptoms of arousal and reactivity can be constant and create feelings of being anxious, stressed, angry, trouble sleeping, irritability and other similar sequelae or emotions. Obviously, these feelings can completely interfere with common daily activities and prevent the person from functioning normally. The symptoms related to cognition and mood are similar to depression and can present as mood swings, feelings of guilt and negativity, memory loss, loss of interest and can be accompanied by anxiety, substance abuse, and difficulty functioning in a meaningful way. These symptoms can occur without PTSD and if the symptoms are present less than a month after a major trauma, it is called Acute Stress Disorder. To clarify, PTSD is a specific set of symptoms occurring after a trauma, starting months to years later, and interferes with normal daily activities.
It is unclear why some people develop PTSD and others do not. Genetics may play a role as does a person’s environment, support structure and coping mechanisms. People with good family support and a more positive outlook tend to be less likely to develop PTSD but it can still happen. It is estimated about 7-8% of people develop PTSD to some degree. It can occur from direct trauma or witnessing trauma to a loved one. Sexual assault can lead to PTSD and lead to a significant impact in sexual function, issues of intimacy and wellbeing. For an example, a woman experiences a sexual assault and develops PTSD from the trauma and then years later hears about someone else having a similar trauma and that triggers the memory and events all over again. This is a serious condition with lifelong implications.
Recognizing and diagnosing PTSD is only the first step in the process. The next step is treatment, which involves both counseling (talk therapy) and medications. No one treatment method fits each person as PTSD is a very individualized experience. Talk therapy helps the person to overcome the fear, anger, depression and emotions caused by PTSD. It may involve exposure therapy where the person is slowly introduced to situations that mimic the trauma, but in a controlled setting, to desensitize them to the trauma. In other forms of therapy, the person may be given stress reliving techniques and mechanisms to try to put the trauma into a different perspective in order to function in daily activities while coping with the stress of the trauma. Another treatment option is medication with therapy being aimed at both treating the current condition as well trying to prevent any recurrent symptoms. The main stain of medication therapy is in the family of anti-depressants. The medications help to increase serotonin levels in the brain, which is believed to help in regulating the pleasure center of the brain. Most patients will need a combination of both talk therapy and medication to address the chemical changes that occur in the brain as well as help with coping mechanisms to deal with the psychological stress induced by PTSD.
One of the greatest difficulties in dealing with PTSD is the very fact that the symptoms and presentation is usually removed, by months to years, from the original traumatic event. It is necessary to be aware of the various ways PTSD can present and try to minimize the impact on the individual. Through medication, therapy and the input of a specialized physician, PTSD can be managed. This is a serious condition with long lasting effects that can recur at any time. Patients need to seek medical attention as soon as they feel these symptoms in order to treat as early as possible. What is also necessary is a good support system of friends and family to assist the person in adjusting to the events after a trauma. Patients with PTSD need as much emotional support as possible as the emotions and feelings they are experiencing are very real to them, even though the trauma has long since passed. If you think you may have PTSD, or know someone who does, it is important to seek medical attention from a qualified physician.
