Lifting the Veil on PTSD

Post-traumatic stress disorder, or PTSD, is a mental health disorder that can develop after you experience or witness a traumatic or terrifying event. The triggering event may be a natural disaster, serious accident, terrorist act, wartime combat, sexual or physical assault, domestic abuse, even the sudden, unexpected death of a loved one.

While the event is happening, you may believe your life or the life of someone you love is in imminent danger.

Whenever we’re confronted by a traumatic situation, our bodies initiate the “fight or flight” stress response. Our heart rate, blood pressure and breathing increases to prepare us to defend against danger or avoid it. Most people return to normal function once the threat is gone. But if you continue to feel stressed when you’re no longer in danger, you may have PTSD.

Most people who experience a traumatic event don’t develop PTSD, but a small percentage do. According to the National Alliance on Mental Illness (NAMI), PTSD affects 3.6 percent of the adult population in the US – about 9 million individuals.

PTSD is more common in women than men. About 10 of every 100 women (10 percent) develop PTSD sometime in their lives compared to about 4 of every 100 men (4 percent). Why? Women are more likely to experience sexual assault and are more likely to blame themselves for a traumatic event than men.

But PTSD affects children and teens as well. Studies show that about 15 to 43 percent of girls and 14 to 43 percent of boys go through at least one trauma. Of those children and teens who’ve experienced a trauma, 3 to 15 percent of girls and 1 to 6 percent of boys develop PTSD.

Symptoms of PTSD most often begin within three months of the event, but sometimes, they don’t appear until years later. The diagnosis of PTSD should be made by a qualified mental health professional using the criteria set forth in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

According to the DSM-5, to be diagnosed with PTSD, you must have been exposed to death or threatened death, serious injury or sexual violence either directly, through witnessing it, by it happening to a loved one, or during your professional duties.

You must also experience one or more intrusion symptoms, one or more avoidance symptoms, two or more symptoms that affect mood and thinking, and two or more arousal and reactivity symptoms for more than one month.

Intrusion symptoms include nightmares and flashbacks. In addition, you may have vivid, unpleasant memories of the event or feel intense distress when you think about the event. Avoidance symptoms including refusing to discuss the event and avoiding situations that remind you of the event. Arousal and reactivity symptoms include difficulty sleeping, irritability, angry outbursts, being easily startled, and feeling tense and anxious.

Symptoms that affect mood and thinking include an inability to remember key details of the event, feelings of guilt and anger, feeling detached from others and emotionally and mentally numb, having a reduced interest in things you used to enjoy, difficulty concentrating, and experiencing other mental health disorders such as depression and anxiety.

You may experience physical symptoms as well that are not listed in the DSM-5. These include sweating, shaking, headaches, dizziness, upset stomach, various aches and pains, and chest pain. Your immune system is weakened by the stress of PTSD, so you may experience more frequent infections as well. And problems sleeping can cause tiredness that can impair your daily functioning.

Symptoms that are common in children ages 6 and younger include bedwetting after being toilet trained, not being able to speak, acting out the event during play and being clinging with an adult. Children between the ages of 5 and 12 may experience flashbacks. They may have difficulty remembering parts of the event or remember it in a different order. They may have nightmares and be irritable.

Children between the ages of 12 and 18 may display disruptive or disrespectful, impulsive or aggressive behavior. They may feel guilty for not behaving differently during the event and may think about getting revenge for what happened.

The goal of treatment for PTSD is trifold: It aims to reduce the emotional and physical symptoms of PTSD, improve your daily functioning and help you better cope with your triggering event. PTSD treatment generally involves medication, psychotherapy or both. It’s important that you seek treatment from a mental health provider who is experienced in treating PTSD.

Physicians often prescribe antidepressant medications to treat PTSD. Two antidepressants are FDA-approved to treat PTSD: sertraline (Zoloft) and paroxetine (Paxil). These medications are selective serotonin reuptake inhibitors (SSRIs). SSRIs block the resorption of the neurotransmitter serotonin, which stabilizes your mood, feelings of happiness and wellbeing.

Psychotherapy, also called “talk therapy,” is a staple of PTSD treatment. During psychotherapy, the therapist helps you understand your disorder and work through your fears associated with the traumatic event. Psychotherapy teaches skills for managing your symptoms and coping with your disorder. Psychotherapy may be conducted one-on-one, with the family or in a group setting.

Living a healthy lifestyle can also help you cope with your PTSD symptoms, so eat a healthy diet, exercise regularly, get enough sleep and avoid situations that increase stress or anxiety. Also, consider joining a support group. Sharing your feelings with others who understand where you’re coming from can help you feel less alone and isolated.

Recovery from PTSD is a continual process. Generally, symptoms don’t disappear completely, but treatment can help you learn how to manage them more effectively. Often, treatment can result in fewer and less intense symptoms, leading to a better quality of life.