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Understanding Posttraumatic Stress Disorder

When we encounter a situation that is perceived as threatening (e.g., being cut-off by another car in traffic), our “fight or flight” system is instantaneously activated. Adrenaline is released in our bodies so that we can see, hear, and smell better as well as  move faster and stronger in order to either defend against the threat or get away from the threat as quickly as possible. So in the case of the traffic example, this response system allows you to quickly slam on your brakes or swerve out of the way to avoid a crash. Once we are free from danger, our bodies deactivate or “turn-off” this system so that we can return to a natural relaxed state. For those who have Posttraumatic Stress Disorder (PTSD), the “fight or flight” system appears to be activated all the time, leaving people feeling anxious and stressed or frightened even when there is no danger.

Posttraumatic Stress Disorder develops after exposure to a terrifying ordeal that could have resulted in death or bodily harm to self or others. Exposure includes:

  • Directly experiencing the traumatic event
  • Personally witnessing the event(s) as it occurs to others
  • Learning that a loved one was involved in a violent or accidental trauma
  • Repeatedly being exposed to the harsh details of a traumatic event usually associated with a person’s career or employment

Any event that is perceived as life threatening can lead to PTSD. Some of the most common traumas seen in PTSD include:

  • Combat exposure
  • Childhood neglect and abuse
  • Physical assault
  • Sexual molestation or rape
  • Being threatened with a weapon

Signs and Symptoms of PTSD:

  • Recurrent and intrusive memories of the traumatic event
  • Flashbacks, which involves reliving the event for minutes or even days at a time and is usually associated with dissociation or “losing time”
  • Recurrent nightmares about the traumatic event
  • Difficulty remembering details about the traumatic event
  • An exaggerated startle response (e.g., jumping at the slightest noise)
  • Feeling tense and on edge
  • Irritability and/or aggression
  • Reckless or self-destructive behaviors
  • Persistent feelings of guilt, shame, anger, fear, or horror
  • Persistent inability to experience positive emotions (e.g., happiness, satisfaction, affection for others)
  • Avoidance of situations, people, or things that trigger memories of the trauma
  • Feelings of detachment
  • Problems with sleep

It is normal to experience some of these symptoms after a traumatic experience that can persist for several weeks. However, when these symptoms are severe and last longer than a few weeks, it might be PTSD. In some cases, PTSD symptoms do not appear until months or even years after the trauma event.

Not everyone who is exposed to trauma develops PTSD. The reason for this is not known but researchers suggest genetic components associated with individual brain anatomy and biochemical function, early childhood abuse and trauma, a personal history of mental illness, and family history of mental illness or PTSD as contributing factors. Women are more likely to develop PTSD than men.

How is PTSD Treated?

The most common treatment for PTSD is a combination of psychotherapy and medication management. Some of the common types of psychotherapy used include Cognitive Behavior Therapy (CBT), EMDR, and animal-assisted therapy (AAT). Medications are prescribed to treat specific symptoms related to mood, anxiety, and sleep.

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