Posttraumatic Stress Disorder

WHAT IS PTSD?

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that develops following a frightening or traumatic event. Typically an individual with PTSD will have experienced this event themselves, although some people develop the disorder after witnessing such an event. Following the traumatic event, the individual typically experiences strong feelings of horror, helplessness or fear. PTSD was originally thought to arise as a result of war trauma and was referred to as "shell shock." We now know that this disorder can arise from many different types of traumatic events including natural disasters, rape, child abuse, and other violent attacks, and accidents. Individuals can develop PTSD at any age, including childhood.

People can experience a traumatic event without developing PTSD. Some studies suggest that up to 70% of the U.S. population will be exposed to traumatic stressors. A subset of individuals will develop Acute Distress Disorder, a more immediate reaction to a stressful event in which symptoms only last for 3 months. Symptoms of PTSD typically develop within 3 months, although some do not develop the disorder for a year. Other individuals develop symptoms of PTSD, but not the full-blown disorder. Certain groups of individuals have elevated risk for PTSD. Women appear to be at greater risk than men, although men generally experience more trauma. This may be a result of the type of trauma--with women experiencing a greater level of interpersonal violence. It appears that individuals suffering more trauma (greater frequency), intense trauma, and unpredictable/uncontrollable trauma may be at a greater risk for developing PTSD symptoms.

PTSD SYMPTOMS

Individuals with PTSD repeatedly relive the traumatic event in the form of flashbacks and nightmares. Flashbacks are intrusive memories or recollections that can make the individual feel as though they are re-experiencing the trauma and involve sensory feelings. Flashbacks can involve sights, sounds, tastes and feelings, and can make the person feel that they have lost touch with reality. Often flashbacks are triggered by events or situations that bring back memories, but in some individuals these can occur spontaneously or without any recognizable trigger. These feelings can last for minutes, hours, or even days. Many individuals with PTSD will begin to avoid certain situations or experiences that remind them of the original trauma. For some this can lead to fairly severe restriction in activity. This is particularly true for individuals who suffered trauma at the hands of another person (e.g., rape or child abuse) instead of through a natural event or accident.

Individuals suffering from PTSD may also experience sleep problems, feeling detached or numb(derealization), or they may startle easily. Often there are feelings of anhedonia--a loss of pleasure or interest in previously enjoyable activities. More common mood symptoms include emotional numbing toward positive events and an increased reactivity toward negative events. This often results in the individual having difficulty feeling close to others or showing affection, while also feeling more irritable. Some individuals show an increase in aggression and can become violent. Anniversary reactions, or an increase in difficulty around the same time of year as the experience of the original stressor, are fairly common.

Often individuals with PTSD have symptoms of other disorders, particularly depression, substance abuse, or other types of anxiety. Often individuals "self-medicate" their feelings with alcohol or other substances. This can lead to a temporary dulling of the anxiety, but can lead to a "rebound effect," or intensification of this anxiety, after discontinuing the drugs.

COURSE AND TREATMENT

The course of PTSD differs across individuals. Some individuals recover within six months, others show a more chronic course, lasting years.

Cognitive-behavioral treatments, particularly those involving exposure to feared stimulus situations, are effective although an individual may still experience a recurrence of symptoms during anniversaries or stressful situations.

Please, email us or call at 850 / 645-1766 to find out more about our treatment programs.