How do you know if you have it?
You’ve survived a tragic event and, initially, it has a significant impact on how you function every day, but, gradually, it gets easier. However, one day, out of the blue, you feel like you’re experiencing the situation all over again. After a few moments, you realize that you’re just imagining being in the situation. Why did this happen? What is causing it? How is it treated?
Definition
Post Traumatic Stress Disorder, or PTSD, is a condition that arises after experiencing or witnessing a harrowing event, such a threatened/actual death, serious injury or sexual violation. While it’s normal to have temporary difficulty adjusting back to your normal life after such an event, most of the time people recover without long lasting impacts. However, some individuals struggle to return to their normal lives. When you have PTSD, it can be a struggle to function on a daily basis. The exact cause of PTSD is unknown, but thought to be a mix of experiencing a traumatic event, especially the amount and severity of the event, inherited mental health risks (ex. family history of depression or anxiety), your temperament and the way your brain controls chemicals and hormones that your body releases when you’re stressed. The most common events that lead to PTSD are combat exposure, sexual violence, child abuse, physical assault, being threatened with a weapon or being in an accident. Other possible events include fire, natural disaster, robbery, mugging, plane crash, torture, kidnapping, terrorist attack and life-threatening medical diagnosis. While anyone can develop PTSD, certain factors increase your risk, including going through intense/long-lasting trauma, being subjected to trauma earlier in your life, working in a profession that exposes you to traumatic events, having other mental health disorders, alcohol or drug use and lacking a good support system. Besides increasing your risk for depression, anxiety and alcohol/drug use, PTSD also increases your risk for eating disorders and suicidal thoughts/actions.
While symptoms usually appear about one month after an event, they might not appear until several years later. Symptoms vary not only over time, but from person to person. Often when you’re stressed, you’re more likely to have symptoms and certain things can trigger them to occur. There are four types of symptoms, including intrusive memories, avoidance, negative changes in thinking/mood or changes in physical/emotional reactions. Intrusive memories can be recurrent, unwanted distressing memories of the event, reliving the event as if it was currently happening (flashbacks), nightmares or severe emotional/physical distress to something that reminds you of the event. Avoidance is either not talking/thinking about the event or staying away from places, activities or people that remind you of it. Negative changes in thinking/mood can include having negative thoughts about yourself/others/world, feeling hopeless, having memory problems, not being able to maintain relationships, feeling detached, lacking interest in activities that you used to enjoy, difficulty having positive emotions and feeling emotionally numb. Changes in physical/emotional reactions are being easily startled/frightened, trouble sleeping, issues concentrating, always being on guard for danger, self-destructive behavior, irritability, angry outbursts, aggressive behavior and overwhelming feelings of guilt/shame. For children who are 6 years old or younger, they might have nightmares that may or may not include aspects of the event and re-enact the event or aspects of it while playing.
Treatment
You should seek treatment for PTSD if you have symptoms for more than a month, if they’re severe or you feel like you’re struggling to get your life in order. The key is to get help early to prevent the symptoms from getting worse. If you’re having suicidal thoughts, reach out to a friend or loved one, contact a minister/spiritual leader or call a suicide hotline. The National Suicide Prevention Lifeline is 1-800-273-TALK (8255). If you’re a veteran, call the number and press 1 to get to the Veterans Crisis Line. If you think that you might hurt yourself or attempt suicide, call 911 immediately. If you’re with someone that you’re concerned might attempt suicide, don’t leave them alone and call 911 immediately.
The goal of treating PTSD is to help you get control over your life by teaching you necessary skills to address your symptoms, helping you think better about yourself and others, learning coping mechanisms and treating any other problems that have occurred as a result of PTSD. The two primary forms of treatment are psychotherapy and medications. While there are several types of psychotherapy, the most common are cognitive therapy, exposure therapy and eye movement desensitization and reprocessing (EMDR). Cognitive therapy helps you to identify the ways that your thinking is keeping you stuck. Exposure therapy assists you in facing situations and memories that you find terrifying by gradually exposing you to these things in a safe environment. Typically, you start with lesser concerns and work your way up to those that are more difficult. EMDR combines exposure therapy with a series of guided eye movements designed to help you process traumatic memories and change your reaction to them. It’s also key to develop stress management skills to reduce the chance of it triggering PTSD symptoms.
The two main classes of medicines that are used are antidepressants and anti-anxiety medications. Antidepressants not only help with depression and anxiety symptoms, but can improve sleep and concentration problems. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline and paroxetine, are the most commonly ones used. Anti-anxiety medications are reserved for severe anxiety and only used for short periods of time due to their potential for abuse.
In order to cope with PTSD, there are several things you should consider doing. It’s vital to follow your treatment plan and remind yourself that it takes time, but you will recover. It’s also helpful to learn as much as you can about PTSD and don’t self-medicate with alcohol and drugs. If you’re feeling anxious, find some way to break the cycle, like taking a brisk walk. Avoid caffeine and nicotine since these can make anxiety worse. Taking care of yourself is crucial, so make sure you get plenty of rest, eat a healthy diet, exercise regularly and take time to relax. One last vital component is to stay connected to family and friends. This doesn’t mean you have to talk about the event if you don’t want, just sharing time together can provide comfort and support.
If someone you care about has PTSD, there are some things you can do to help. The most important thing to remember is that you can’t change them, but by learning as much as you can about the disorder, you’ll be better prepared to assist them in their recovery. It’s key to understand that avoidance and withdrawal are hallmark signs of the disorder. So, it’s imperative that you give your loved one space, but reassure them that when they’re ready, you’re there to help. This can take many forms, such as listening to them talk or accompanying them to medical appointments. Definitely encourage them to participate in activities with family and friends. Another important consideration is your own health. Make sure you’re taking the time to take care of yourself, by eating healthy, being physically active, getting enough sleep and doing activities that help you to recharge. If you’re having difficulty dealing with the situation, it’s a good idea to seek help from a medical professional. Also, make sure that you have a plan in place for you and your children if your loved one becomes violent or abusive.
Prevention
Not everyone that goes through a traumatic event ends up with PTSD. There are steps you can take to try to prevent it. First, it’s essential to realize that it’s normal to initially feel fear, anxiety, guilt, anger or depression after experiencing an upsetting event. The key is getting timely help and support. This could be talking to family and friends who are willing to listen or speaking to a mental health professional. There is nothing wrong with getting therapy to help you process what you’ve gone through. Often this support from others, can help prevent you from developing unhealthy coping mechanisms.
PTSD is a serious condition, but by getting help as soon as you can, you’ll be back to functioning in your everyday life. If you have any questions or concerns about PTSD, please speak with your doctor. If you would like information, please visit the American Psychiatric Association’s PTSD page at https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd