PTSD

PTSD has long been associated with war and combat. It was referred to as “shell shock” during World War I and “combat fatigue” after World War II. However, people of any age, gender, and background can develop PTSD after going through (or hearing about) an event involving actual or threatened death, serious injury, or sexual violence.

PTSD is more common after certain types of trauma, such as combat exposure and sexual assault. Other events, such as mass violence or natural disasters, can also lead to PTSD.

There are certain factors that can increase the likelihood of an individual developing PTSD, such as:

• Experiencing an intense or long-lasting traumatic event
• Sustaining an injury during the event
• A strong initial reaction to the event, such as shaking or vomiting
• Having previously experienced trauma, such as childhood abuse
• Military personnel and first responders have an increased chance of being exposed to a traumatic event
• Having co-occurring disorders, such as anxiety or depression; or having family members with mental health problems
• A history of alcohol or substance abuse
• Lack of a support system

Whether or not symptoms of acute stress become manageable can depend on factors that occur after the event. For example, high levels of stress can make it more likely to develop PTSD, while having strong social support can make it less likely.

An individual with PTSD experiences one or more of the symptoms mentioned below, which fall into four categories:

Intrusion

Intrusive memories can present in the following ways:

• Reliving or re-experiencing the traumatic event as if it were happening in the current moment (flashbacks)
• Recurrent, involuntary memories of the event
• Distressing dreams or nightmares

Avoidance

• Severe emotional distress or physical reactions to reminders of the event can lead to avoidance of people or situations that trigger these reactions
• Trying to avoid thinking or talking about the event
• Some people try to stay extra busy in order to prevent themselves from thinking about the event

Alterations in condition and mood

• Inability to remember important aspects of the event
• Negative thoughts about oneself, other people or the world in general that lead to distorted beliefs (such as “I deserve this” or “I cannot trust anyone”)
• An overwhelming sense of guilt or shame
• Lack of interest in activities that used to be enjoyable
• Feeling detached from loved ones
• Being unable to experience positive emotions

Alterations in arousal and reactivity

This category refers to changes in a person’s physical and emotional reactions, including:

• Being irritable and having angry outbursts
• Being easily startled or frightened
• Being on edge and hyper aware of potential danger, or always expecting something bad to happen
• Self-destructive behavior such as abusing substances or alcohol
• Trouble sleeping or concentrating

A healthcare provider, such as a psychiatrist or other mental healthcare professionals, base a diagnosis on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Organization.

In order to be diagnosed with PTSD, an individual must have been exposed to a traumatic event in one of the following ways:

• Directly experiencing a traumatic event
• Witnessing a traumatic event occur to others
• Learning that a loved one experienced a traumatic event, or their life was threatened during an event
• Being repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to scenes where traumatic events occurred or a police officer reading details of trauma such as child abuse)

If you have one of these types of exposure to trauma, and the symptoms of acute stress have lasted longer than a month, it is a good idea to talk to your healthcare provider.