Post-traumatic stress disorder

Post-traumatic stress disorder

Stress is a physical and psychological response to external events that are taxing or perceived to be taxing our ability to cope and respond. Such events can be physiological, events that put strain on our body such as illness, pain, and injury, or they can also be psychological such as events, situations, or anything we interpret as negative or threatening. There is an expectation that one would experience anxiety or fear following these types of events, however, Post Traumatic Stress Disorder (PTSD) has symptoms that are unexpected and/or last longer than expected. Events may be stressful for some people, and not others if the event contains one or more of the following elements:

• Novelty
• Unpredictability
• Threat to ego
• Sense of control

No matter the event or severity, your feelings are valid — The experiences that led to your PTSD were unique to you, and your reactions to PTSD are also unique to you. 

What is PTSD?

Contrary to popular belief, combat veterans are not the only ones who experience PTSD. It is not limited to any age, ethnicity, nationality, culture, or gender. PTSD is a psychiatric disorder that is characterized by trauma, intrusion symptoms, avoidance symptoms, negative alterations in cognitions or mood, or arousal and reactivity symptoms.

1. Trauma is the expsoure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:
   1. Directly experiencing the event
      1. Witnessing the event in person
      2. Learning that the event happened to a close friend or family member
      3. Experiencing repeated or extreme exposure to averise details of the event 
   2. Intrusion symptoms
      1. Recurrent involuntary, and intrusive memories of the event
      2. Recurrent distressing dreams
      3. Dissociative reactions (e.g., flashbacks)
      4. Physiological reactions
      5. Intense or prolonged psychological distress at exposure to internal or external triggers
   3. Persistent avoidance
      1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings
      2. Avoidance of or efforts to avoid external triggers 
   4. Negative alterations in cognitions or mood
      1. Unable to remember the event or important details (not related to head injury, alcohol, or drugs)
      2. Exaggerated beliefs or expectations about the self, others and the world (e.g., “No one can be trusted”)Persistent negative emotions of fear, anger, guilt, or shame
      3. Inability to feel positive emotions
      4. Detachment from the world and others
   5. Arousal and reactivity symptoms
      1. Irritability, anger, aggressiveness
      2. Hypervigilance: ongoing anxiety; constantly on alert for threats
      3. Sleep disturbance
      4. Reckless or self-destructive behaviors
      5. Problems with concentration

PTSD in Men and Women

Though PTSD can happen to anyone, women are twice as likely to develop PTSD compared to men; five out of ten women experience a traumatic event in their lifetime. Women also tend to experience different trauma than men. It is reported that both men and women experience the same symptoms, but some are more common for women or men. Research also suggests that women may be more at risk to mental health consequences because they are more likely to experience trauma within personal or intimate relationships or their traumatic exposures are more chronic (e.g., repeated domestic violence). 

What causes PTSD?

The development of PTSD can be attributed to several factors:

• Biological factors
  • Genetics
  • Heightened stress reactivity 

• Psychological factors
  • Pre-existing mental health conditions
  • Dissociation during and after the trauma
  • Aspects of the trauma (e.g., greater severity, more interpersonal)

• Social factors
  • Strong social support before and after can increase resilience
  • Weak or absent social support can increase the risk of developing PTSD
  • Childhood adversity or trauma
  • Family instability

• Sociocultural factors
  • Gender
  • Socioeconomic status
  • racial / ethic minority status 

These different factors interact with each other and combine in different ways for each individual. While some elements are risk factors, others include protective factors.

Treatment for PTSD

Many people with PTSD require professional treatment; however, it is also important to note that not all individuals who experience a traumatic event develops PTSD, and not everyone who develops PTSD requires psychiatric treatment. There are several research-proven effective treatments to help in the recovery from PTSD. 

1. Medication: Medication can help control the symptoms of PTSD which allow individuals to participate more effectively in psychotherapy. The most common medications used in treatment are antidepressants (SSRIs and SNRIs) and benzodiazepines (used to lower anxiety or sleep disruption).
2. Trauma-focused psychotherapies: Cognitive behavior therapies (CBT) are among the most common and effective in treating PTSD. Therapies such as cognitive processing therapy, prolonged exposure therapy, stress inoculation therapy, and group therapy have been proven to be the best treatment for PTSD.

With the right medications and therapy, about half of individuals diagnosed with PTSD will recover within three months, others may persist longer.