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A specialized edition intended for medical institutions and doctors.
Reviewer of the articleLidiia Gonchar-CherdakliPh. D. (Medical Sciences). Deputy Medical Affairs Director, Darnytsia Pharmaceutical CompanyReviewer's page
18 September 2022
Posttraumatic stress disorder (PTSD): symptoms and treatment
Posttraumatic stress disorder (PTSD) is a mental health condition that can occur in people who have experienced traumatic events. For example, they witnessed a war or hostilities, a natural disaster, a serious accident, a terrorist act, or rape.
What is PTSD
PTSD (posttraumatic stress disorder) is a common reaction to an abnormal situation. After traumatic events, it is quite normal to lose faith or withdraw from others, have unpleasant memories or sleep problems. If the symptoms last more than a month and interfere with your everyday life, it may be PTSD.
PTSD: statistics
It is estimated that 50% of people experience trauma at some point in their lives. A characteristic feature of a traumatic event is its ability to cause fear, helplessness, or horror.
The prevalence of post-traumatic stress disorder in countries where hostilities took place extended from 11 to 50% of the population.
If you divide these PTSD statistics by gender, then 6 out of 10 men and every second woman experience at least one trauma in their lifetime. Men are more likely to be involved in accidents caused by physical violence or natural disasters, witness death or injuries. Women find themselves in traumatic situations due to sexual violence against them or their own children.
However, women suffer from post-traumatic stress disorder twice as often as men.
serious health issues or a stay in the intensive care unit;
complicated birth delivery;
a life threatening disease;
terrorist attacks;
natural or technogenic disasters (tsunami or fire, for example) .
What else can cause PTSD? There is a huge number of events that can cause posttraumatic stress disorder. If your experience is not described here, it does not mean that you should not seek help and support from a specialist. It is very important to do this as early as possible to return to your usual life as soon as possible.
Why are traumatic events so shocking? Because we cannot understand them. They differ from our perception of the world. They often seem “random”, and the reason behind them is unclear. Such events do not fit our view of the world, which complicates our understanding of their meaning. This dissonance can cause the development of PTSD.
Posttraumatic stress disorder: symptoms
Symptoms of PTSD usually appear within 3 months after the traumatic event, but sometimes they can appear later.
In order to meet the criteria for posttraumatic stress disorder, the symptoms must last more than 1 month and be strong enough to interfere with everyday life - work or relationships.
The symptoms should also not be related to medication, the use of psychoactive substances, or some illness. Each person experiences PTSD and reacts to traumatic events differently. For example, you and your friend experienced the same trauma, but it influenced you differently and your symptoms will be different. Many people having experienced trauma have some symptoms that disappear after a few weeks. However, if these symptoms last longer than a month and affect your daily life, they may indicate the presence of posttraumatic stress disorder. The intensity of PTSD symptoms can change over time. Some people with post-traumatic stress disorder are able to “manage” their symptoms, that is, they have long periods of calm. Some people suffer from severe symptoms of PTSD all the time, and others experience them only when stressed or reminded of the experience.
The symptoms of PTSD vary from person to person, but some of them have common signs. Next, we will talk in detail about each such group of symptoms separately.
Symptoms of re-experiencing (flashbacks)
Re-experiencing is the most typical symptom of PTSD. It is manifested by a spontaneous and vivid experience of a traumatic event, for example:
flashbacks – feeling as if the traumatic event is happening now. Simultaneously, excessive sweating starts or the heartbeat increases;
recurring memories or nightmares that are associated with the event or remind about it;
disturbing and obsessive thoughts or feeling of insult;
physical sensations, such as sweating, shivering.
These symptoms can be triggered by thoughts, words, objects, or events associated with a stressful situation.
Avoidance symptoms
Attempts to avoid reminders of traumatic events are another key symptom of PTSD. It manifests itself like this:
dissociative amnesia – is the inability to recall fragments of a traumatic event;
a feeling of detachment or distance from previously close people;
avoidance of conversations and thoughts about the traumatic events;
avoidance of associations: thoughts, feelings, things, people and places associated with the event;
a feeling that it’s necessary to be constantly busy;
the use of alcohol or drugs to avoid memories;
a feeling of emotional numbness or detachment from your feelings.
Avoidance symptoms can make people change their routine.
Symptoms of alertness (hypervigilance or suspicion) and excessive excitability
Feeling nervous, always being on the lookout or looking for potential danger is one of the symptoms of PTSD:
The way you think about yourself and others can change because of trauma. And this also indicates that you have PTSD. Signs of this group of symptoms are as follows:
negative beliefs and expectations: toxic thoughts about yourself, others or the whole world;
blaming oneself or other people for the causes of the traumatic event or its consequences;
a feeling that you can’t trust anyone;
negative emotions: constant experience of fear, horror, anger, guilt or shame;
loss of interest in activities you used to enjoy;
inability to experience positive emotions, even some insignificant joys.
In case such changes of mood, feelings, self-perception and eating disorders persist for a long time, you should take them seriously and consult a doctor to prevent the development of a chronic form of PTSD.
Please use the link below to pass the test and find out if you have PTSD.
Symptoms of posttraumatic stress disorder can appear both immediately after the traumatic event and after weeks or even months. Usually, the symptoms of PTSD appear within 6 months after the event. However, there are cases when symptoms develop even after 6 months. Unfortunately, many people do not seek help when they have the first symptoms. PTSD cannot be diagnosed in the first month after a traumatic event. If you immediately feel the symptoms of trauma, which are quite pronounced and prevent you from functioning, perhaps it is an “acute stress reaction”.
Types of PTSD
In general, there are 3 main types of PTSD expression: acute, chronic, and delayed.
Acute – is defined by symptoms lasting for 1 to 3 months.
Chronic – when the disorder symptoms remain for more than 3 months.
Delayed – may manifest itself after 6 months. Within this period the clinical picture of the disease will be most pronounced. That is, before the characteristic symptoms manifest themselves, the patient feels normal and may not even suspect that PTSD is already developing.
Treatment of PTSD
How is posttraumatic stress disorder treated? There are two main approaches to PTSD therapy: psychotherapy or drug therapy.
Psychotherapy as a method to treat PTSD
PTSD psychotherapy will focus on the traumatic experience, not on your past life. Any psychotherapy must be conducted by a person who has the appropriate training and accreditation. With PTSD, sessions usually take place at least once a week with the same therapist and often last 8-12 weeks. Each session lasts 1-1.5 hours. Psychotherapy will allow you to correctly accept, recall events, talk about your experience and feel safe.
Treatment of PTSD includes the following psychotherapeutic approaches:
Trauma-focused cognitive behavioral therapy is a talk therapy that can help you change the way you think about PTSD: feel better and behave differently. Usually, this type of therapy for PTSD is carried out one-on-one, sometimes it can take place in groups.
Eye Movement Desensitization and Reprocessing is a technique that uses eye movements to help the brain process traumatic memories and gradually reduce PTSD. You will be asked to recall the traumatic event and how it made you think and feel. While recalling, you need to make eye movements or get some “bilateral stimulation”, for example, by tapping. This reduces the intensity of emotions that a person experiences in connection with a traumatic memory, helping to eliminate the trauma.
Medication treatment of PTSD
If you have tried different methods of treatment for posttraumatic stress disorder, but they appeared to be not effective, your doctor may prescribe medication, in particular, antidepressants. Selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors are antidepressants that can help reduce the symptoms of PTSD. Also, if you suffer from depression, antidepressants can help with treatment. If selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors do not help to tackle posttraumatic stress disorder, you may be offered alternative drugs, but they should be taken on the advice of a mental health specialist.
Possible preventive therapy of PTSD
Do keep in mind that an acute reaction to a stressful event is normal. Remember that PTSD can develop in any person during his life. Traumatic events can bring a feeling that life is out of control, that it is difficult for us to feel safe and trust other people, ourselves, and our judgments. Our experience often seems unfair, unreasonable, inhumane, and cruel, and can make us question our beliefs about the world and other people. Since we can’t always prevent trauma, we should remember certain protective factors that can lead to a more favorable expression of posttraumatic period:
constant contact and support of important people in your life,
opening up about trauma to your close people,
identifying yourself as a survivor, not as a victim,
using positive emotions and laughter,
finding positive meaning in trauma,
helping others in the process of treatment,
confidence in being able to manage your feelings and tackle the situation.
It’s important to remember that despite your experience, life goes on.
Zohar J, Juven-Wetzler A, Sonnino R, Cwikel-Hamzany S, Balaban E, Cohen H. New insights into secondary prevention in post-traumatic stress disorder. Dialogues Clin Neurosci. 2011;13(3):301-309
Cahill SP, Pontoski K. Post-traumatic stress disorder and acute stress disorder I: their nature and assessment considerations. Psychiatry (Edgmont). 2005;2(4):14-25.
Post-traumatic stress disorder can lead to the development of a number of concomitant conditions and disorders. Among them can be depression, generalized anxiety disorder, panic attacks, addictions, suicidal behavior, aggressiveness. If you suspect that you or a loved one has PTSD, consult a doctor, do not self-medicate.
Clinical symptoms of PTSD can persist for a long time, from a month to several years. We recommend consulting a doctor to have an accurate diagnosis done.
