Post-traumatic Stress Disorder: Symptoms, Treatment, Diagnosis
Post-traumatic stress disorder (PTSD) is a mental disorder that develops after a severe psychotraumatic event (violence, military action, disaster, etc.). The condition is characterized by the presence of vivid memories or dreams of an unpleasant event, which are perceived by a person as real, happening to him at a given moment in time.
This is accompanied by a corresponding reaction to fear: panic, trembling, or, on the contrary, aggression. In the period between attacks of memories, a person remains in a state of nervous tension and fear, which does not allow him to function fully. Because of this, problems arise in relationships, at work, in the family.
Constant post-traumatic stress often leads to the addition of other mental and somatic pathologies, which significantly worsens the quality of a person's life.
Note: This article is for patients with a disease diagnosed by a doctor. It does not replace a doctor's appointment and cannot be used for self-diagnosis.
What Is Post Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) is a mental disorder that occurs in some people after an incident that seriously affects their psyche (for example, physical or sexual abuse, natural or man-made disaster, etc.).
The syndrome manifests itself in the form of obsessive vivid memories of a traumatic event or dreams. These memories can arise involuntarily, but more often they are caused by various triggers associated with psychological trauma: people, things, smells, sounds, and others.
Due to the distortion of perception characteristic of this disorder, these memories are perceived as a real incident occurring at a given moment in time. In this regard, a person experiences extreme fear, horror, loses touch with reality, and reacts in the same way as he reacted during the traumatic event itself.
In the period between memories, such a person is constantly wary, anxious, which is expressed in increased fear reactions. He also avoids any triggers that can cause memories of psychological trauma.
Causes Of PTSD
The term PTSD (post-traumatic stress disorder) itself indicates that this syndrome occurs after some kind of trauma (mental or physical), accompanied by stress so strong that the brain is unable to comprehend it. As a result, various signs of the disorder appear.
According to statistics, PTSD occurs in approximately 13-50% of people who have experienced a traumatic event. This difference in numbers is due to the fact that intentional harm, as well as personal trauma in the form of sexual or physical violence, are much more likely to cause PTSD than natural disasters and accidents.
The development of the disorder also depends on the severity of the psychological trauma, the context of the situation, and the psychological and biological characteristics of the person.
People aged 60 and over are less likely to develop PTSD than younger people. Children develop PTSD less often than adults, especially children under 10. Boys are more likely to develop PTSD than girls, but this changes with age, and women develop PTSD 2.5 times more often than men.
PTSD can be caused by a situation that seriously traumatizes the psyche, causing severe stress, shock, fear, horror, hostility. At the same time, a person often has no usual experience of such a situation, and it can fundamentally diverge from his beliefs, moral principles, ideas about the world.
There is a genetic predisposition to PTSD. If someone in your immediate family has had a psychological disorder, this increases the chances that PTSD will develop in that person if they find themselves in a traumatic situation. The most common causes of PTSD are:
Violence (sexual, physical, psychological);
Kidnapping;
Being held captive, as a hostage;
Participation in military operations (wars, military actions);
Accidents;
Terrorist attacks;
Disasters (natural and man-made);
Life-threatening diseases (cancer, heart attack, stroke);
Miscarriage (especially recurrent miscarriage);
Unexpected or violent death of a loved one;
Evidence of violent, mass or sudden death of other people;
Some surgical procedures (eg, mastectomy);
Stay in the intensive care unit.
Moreover, a person with PTSD can be either a victim, a witness, or even a perpetrator of a traumatic event. PTSD syndrome, predisposition factors:
Young age;
Female gender;
Lack of work, family, support from relatives and friends;
Low income (poverty);
Low level of education;
Heredity (mental illness in relatives);
Dysfunctional childhood;
Previous disorders and psychological trauma.
It was also noted that in some cases, when the situation is not an emergency, for subjective reasons it can become a serious psychological trauma for a number of people.
Symptoms Of Post Traumatic Stress Disorder
PTSD is an anxiety disorder. Its symptoms last for a month or more and include persistent experiences and corresponding physiological reactions.
According to the International Classification of Diseases, 11th revision (ICD-11), PTSD is characterized by the following triad of main symptoms:
Re-experiencing a traumatic situation in the present in the form of vivid memories accompanied by horror, fear, nightmares, flashbacks.
Avoiding memories of the traumatic event and everything associated with it.
A feeling of constant threat, manifested by excessive alertness and a strong fear response.
If a patient experiences all three of the above symptoms over several weeks and they significantly impair functioning, a doctor may diagnose PTSD. Post-traumatic stress disorder symptoms:
Realistic Memories
Realistic memories (flashbacks) of psychological trauma are caused by a large number of details that took place at that moment: sounds, visual images, taste sensations, smells. In rare cases, the patient experiences only one type of flashback.
Psychological Trauma
The experience of psychological trauma is perceived by a person as reality, happening to him here and now. Depending on the severity of the disorder, people at this moment can lose touch with the real world, completely falling into the power of memories that frighten them.
Disturbing Memories
Disturbing memories are not subject to conscious control – just like the body’s defense reactions. The fear experienced in that situation returns in full, without taking into account new information.
At that moment, a person does not realize that he is alive and safe, but feels on the verge of death or a threat to his life and health. Such perception is associated with a violation in fixing memories during psychological trauma.
External Triggers
Typically, memories are triggered by external triggers that remind you of the event (sounds, objects, people, places). For example, post-traumatic stress disorder in military personnel often manifests itself as flashbacks in response to loud sounds reminiscent of gunfire or explosions.
In some cases, even the date of the incident or the same weather as on the day of the incident can trigger flashbacks.
State Of Stress
In the period between memories, a PTSD patient is constantly in a state of stress. He involuntarily begins to perceive each new situation as an analogue of the primary trauma. He unconsciously launches a defensive reaction at this moment, but it completely corresponds to what happened at the time of the main psychological trauma.
Because of this, his defensive reactions become irrelevant in new conditions. The constant activity of the emotional centers of the brain inhibits the work of the conscious part, which worsens control over emotions and prevents logical understanding of the situation. When remembering a traumatic event, a person may experience the following signs of PTSD:
Clenching fists;
Rigidity of the muscles of the arms and legs;
Loss of orientation in space;
Detached look;
Change of facial expression;
Change in behavior to one that is uncharacteristic for a given person;
Sudden, unexplained fear, panic, aggression, or desire to leave;
Shiver;
Tears;
Trance state;
Slurred speech, change in speaking pattern, or lack of speech;
Symptoms of nervous excitement.
Nightmarish Dreams
People with PTSD often have very realistic dreams about a traumatic event. Compared to flashbacks, they contain only part of the information about the incident and are more abstract, but they also cause intense fear, and the events in them can be mixed with those seen or experienced the day before.
Because of such dreams, the patient's sleep is disturbed, he is afraid to fall asleep so as not to see a nightmare again. Often, such dreams reproduce some details of the traumatic situation with photographic accuracy, in addition, they are distinguished by their brightness and plausibility, as if they were happening in reality.
When waking up from a nightmare, a person will be frightened by what he saw, he can scream, and even attack someone nearby. In addition, PTSD involves physical symptoms caused by constant nervous tension and anxiety. For example:
Heart pain,
Gastrointestinal dysfunction,
Headaches.
PTSD may also have other clinical signs, the appearance of which depends on various factors of the trauma itself and the person who experienced it. People with this disorder often feel like victims, feel helpless because they are unable to prevent the negative event that happened to them. They may experience the following symptoms and signs of PTSD:
Depression - develops against the background of depletion of the body's defenses due to constant worry;
Amnesia - the absence of memory of psychological trauma, which does not prevent the occurrence of flashbacks;
A feeling of dirt on oneself and a desire to constantly wash (usually observed after physical or sexual abuse);
Various phobias and addictions;
Suicide attempts;
Self-harming behavior;
Aggression, anger, irritability;
Distrust of people;
Panic attacks.
In mild cases of PTSD, a person can function normally, but in severe cases, they will not be able to care for themselves. As a result, many patients with PTSD experience difficulties in communication, work, study, family, and other areas of activity, which significantly worsens their quality of life.
Classification And Stages Of Development
Types of PTSD differ according to several criteria.
By Duration
Acute - symptoms last from one to three months,
Chronic - symptoms last more than three months,
Delayed - symptoms appear 3-6 months after the psychological trauma, before which post-traumatic syndrome does not manifest itself in any way.
By Severity
Mild form - characterized by infrequent, short-term attacks, while maintaining a person's functionality in various areas of life;
Severe form - frequent re-experiences, arising for any reason, in between which serious disturbances in the person's psyche and behavior are observed, which does not allow him to function normally.
Types Of PTSD With Specific Symptoms
Anxious - characterized by anxiety, irritability, tension, obsessive memories of psychological trauma, poor sleep with nightmares. The person tries to distract himself from this by doing some activity.
Asthenic - characterized by loss of interest in life, indifference, passivity, and resentment. Memories of psychological trauma are not vivid, but there is a feeling of inadequacy. Chronic drowsiness even with good, restful sleep.
Dysphoric - a person has a gloomy mood, irritability, discontent, aggression. Thoughts of personal revenge on offenders. Uncommunicative, withdrawn. Such people do not seek help, so it is important for their relatives to assist in their treatment.
Somatoform - often occurs with delayed PTSD. The patient complains of painful sensations in the heart, gastrointestinal tract, and head. These symptoms are a consequence of psychological trauma and are caused by excessive focus on one's physical sensations. The fear of somatic pain often exceeds the fear of the psychologically traumatic situation itself. Panic attacks and avoidance behavior are observed.
Hysterical - wants to attract attention to himself. He is characterized by increased self-hypnosis and suggestibility.
Depressive - accompanied by symptoms such as pessimism and bad mood.
Dissociative - a person perceives himself as a different personality, not connected with the psychological trauma or interprets reality as something unreal, which allows him to abstract from what happened. This is how post-traumatic personality disorder occurs.
Hypochondriacal - just like somatoform, it usually appears a significant time after psychological trauma and is characterized by excessive fear for one's own health.
Mixed - may include symptoms typical of different types of PTSD.
Stages Of Development Of PTSD:
The impact of psychological trauma on the psyche.
Anxious thoughts about a traumatic situation, rethinking those events with a sense of guilt, options for preventing this incident.
Avoiding any triggers associated with the traumatic event: people, places, things, etc.
Constant agitation, tension, anxiety, worry. These symptoms and signs of PTSD become chronic.
This behavior persists for more than one month. It worsens the patient's quality of life, creates problems in communication, work, study and other areas of life. The following stages of PTSD are also distinguished:
Acute stress reaction.
Occurs immediately or soon after psychological trauma, is characterized by shock, and can last for several days.
A long-term condition in which the core symptoms of PTSD are present along with features characteristic of a particular type of disorder. The severity of symptoms depends on the sense of detachment and the intensity of emotions experienced during the acute stress response phase.Recovery phase.
Disappearance or reduction in the intensity of PTSD symptoms. Recovery may be complete or partial.
Diagnosis of PTSD
The main diagnostic method is questioning the patient, during which complaints and situations that could have caused psychological trauma are identified. The ICD-11 specifies the following criteria for diagnosing PTSD, based on three key symptoms of the disorder:
The presence of a traumatic event.
Even if there is a predisposition to PTSD in the form of heredity or personality type, post-stress syndrome will not occur without a corresponding event that is extremely traumatic to the psyche of a specific individual. Such an event is usually sudden, unexpected, associated with the fear of death, receiving a dangerous injury.
A characteristic feature of such memories is their involuntary, uncontrolled emergence, repetition and perception by the patient as reality, happening to him at the moment. All this is accompanied by strong emotions and pronounced physical sensations. Patients with PTSD tend to avoid any memories of the traumatic event, be it conversations, people, things, places that are somehow connected or somehow remind them of the psychotraumatic incident.Perception of current heightened threat.
Characterized by heightened fear reactions, for example, to a loud sound. Constant alertness, a sense of threat to oneself personally or together with family and friends can be expressed in an excessive desire to control potentially dangerous places and situations.
For example, not to sit with your back to a door or window, constantly turn around, avoid nooks and crannies and dark places. In addition, a patient with PTSD may experience symptoms such as:
Dysphoria
Dissociation
Somatic disorders
Suicidal thoughts and behavior
Phobias
Speech disorders
Social isolation
Depression
Alcohol abuse
Drug abuse
Anxiety
Panic
Obsessions and compulsions.
To confirm the diagnosis, all these symptoms must manifest themselves over several weeks. At the same time, a person often experiences difficulties in functioning in various areas of life: family, work, study, communication with other people, which can also be a diagnostic criterion.
When And Why You Should See A Doctor?
If you have any symptoms of PTSD you should seek psychotherapeutic help as soon as possible. Only a doctor can make a diagnosis and prescribe the appropriate treatment for a specific patient.
If you or your loved ones have experienced a traumatic situation, it is advisable to visit a qualified specialist as soon as possible - a psychologist, psychotherapist, psychiatrist. Even if the symptoms of the disorder have not yet begun, the doctor's advice will help to recognize them in time and even prevent the development of complications that may arise without appropriate treatment.
If your loved one does not want to visit a doctor, seek help yourself, a specialist will tell you everything about PTSD: what it is, how it occurs, how it is treated, and will tell you how to act correctly in various situations with a person who has post-traumatic personality disorder.
Complications And Prognosis For Patients With PTSD
Complications of PTSD are often related to the neglect or severity of the current disorder. If left untreated, comorbidities may arise and existing symptoms may worsen. The complications are as follows:
Addition of other mental disorders;
Suicidal thoughts and behavior;
Addictions;
Deterioration of physical health;
Deterioration of social status as a result of refusal to communicate with people;
Deterioration of financial situation due to the inability to perform professional duties at the proper level;
Causing harm to oneself or another person as a result of an outburst of uncontrolled aggression;
Problems of a sexual nature (lack of desire, erectile dysfunction, or excessive sexual activity).
The prognosis for PTSD depends on the severity of the disorder, the physical, mental and personal qualities of the patient, the effectiveness and timeliness of the treatment. Practice shows that about half of patients with PTSD stop experiencing symptoms of the disorder three months after their onset.
At the same time, memories of the psychological trauma may still be painful, but without serious stressful situations they gradually lose their intensity.
If the dynamics of PTSD are unfavorable, some complications may persist even after the symptoms of the disorder disappear (for example, anxiety, depression, some phobias - such as fear of driving a car after an accident), mistrust of people, low self-esteem, and others.
Prevention: PTSD
Prevention of PTSD development is especially effective at the initial symptoms of the disorder or immediately after a psychological trauma - before they appear. At this time, support and help from family and friends are important, as well as timely seeking qualified help from a psychotherapist.
It is impossible to insure against future stress, but you can strengthen your physical and mental state so that if a psychotraumatic situation occurs, its consequences for health are minimal. A person's lifestyle is important for prevention. You should not abuse alcohol, nicotine, coffee, psychoactive substances. All of them only increase a person's anxiety level.
You can master relaxation and self-control techniques, such as auto-training, breathing exercises, and yoga. Maintaining good physical fitness also helps prevent various mental and somatic disorders.
People with PTSD must make an effort not to withdraw into themselves, to want to recover and return to a full life. In this, support from loved ones and relatives is of great help.
Treatment Of PTSD
How to treat PTSD? The main treatment for post-traumatic stress disorder is psychotherapy. But if there are certain symptoms of the disorder that significantly worsen the patient's condition and quality of life, the doctor can simultaneously conduct drug therapy.
Drug Treatment
Drug treatment usually includes:
Antidepressants;
Neuroleptics;
Anticonvulsants.
If nightmares are present, the doctor will also prescribe appropriate medications. These medications help improve overall well-being, stabilize the mental state, and allow the patient to better focus on psychotherapy.
Psychotherapy And Self-Help Methods
PTSD - in psychology means a violation of the mechanisms of mental processing of a stressful situation. If the brain itself is not able to process this information, it needs help. Therefore, treatment of PTSD without psychotherapy is impossible. If you simply ignore the disorder, it can worsen and provoke the emergence of other mental disorders.
Due to the high level of constantly recurring stress, post-traumatic personality disorder has a high comorbidity - the risk of developing concomitant mental disorders. Therefore, it is important to seek psychotherapeutic help in time.
First of all, a qualified doctor will establish a trusting relationship with the patient, which is an important criterion for quality treatment. After confirming the diagnosis of post-traumatic syndrome, the doctor selects treatment individually.
It includes psychotherapy methods that are suitable for this particular patient. The goal of psychotherapy is to change a person's views on psychological trauma, reduce its negative impact, gain self-control and correct behavior in a stressful situation.
This method of treatment is not fast, but it is effective not only for the current disorder, but also as a preventive measure for similar conditions in the future. Including cognitive therapy, the following methods of psychotherapy can be used in the treatment process:
Changing The Way Of Thinking And Behavior
It is aimed at changing the patient's way of thinking and behavior. It consists of tracking and identifying thoughts that provoke fear. For this, the patient is asked to keep a diary where he describes his condition and reactions to it. These records will help the doctor understand how exactly the psychotraumatic situation is reflected in the patient's thoughts and will help find ways to combat it.
The consequence of psychological trauma is often self-deprecation, which, in severe cases, can lead to deep depression and even suicide. During therapy, the doctor teaches the patient to transform negative thoughts about himself into more rational ones.
Under The Supervision Of A Psychotherapist
The patient mentally returns to the psychotraumatic situation, and the doctor teaches him to react to it correctly: without fear and panic. Over time, this method allows you to get rid of disturbing memories and return to normal life.
Memories of psychological trauma persist because the brain is unable to process them. This technique was developed to activate the process of processing stressful information, which is necessary for the treatment of PTSD. During the session, the patient must simultaneously think about the psychological traumatic event and, as instructed by the doctor, focus on various stimuli: sounds, following a certain pointer with the gaze, etc.
As a result, both hemispheres begin to work synchronously, which allows the brain to process unpleasant memories. After several sessions, the psychological traumatic event is perceived more calmly and stops disturbing with constant flashes of memories about it.
The following types of psychotherapy may also be used:
Group - consists of support from people who have experienced a similar situation. This makes it easier to share feelings, experience them, gain understanding and acceptance, develop communication skills and solve other problems.
Body-oriented - consists of paying attention to body sensations, allowing one to learn to experience psychological trauma not from the position of a victim, but as a person capable of acting. Also, participation in some types of creative activity allows one to gain freedom and eliminate the constraint caused by the disorder.
Physical exercise is also recommended for patients with PTSD. Moderate physical activity not only improves physical health, but also increases self-esteem, improves self-control, and helps distract from anxious thoughts.
Complex PTSD (post-traumatic stress disorder) usually requires longer-term treatment, and may require temporary inpatient placement if necessary.
How To Help Yourself?
Follow the doctor's recommendations, exercise, walk in the fresh air, find a hobby, eat well. Give up cigarettes, alcohol, coffee, which increase anxiety. Communicate more with people who can listen and support.
Final Words
Treatment of PTSD always leads, if not to a complete recovery, then to a significant improvement in the condition of the person who has experienced psychological trauma. In rare cases, some symptoms of the disease persist for a long time.
Full recovery consists of a significant reduction in anxiety, a decrease in other symptoms of the disorder: fear, shame, depression. A person shows interest in life, work, family, relationships, communication.
Memories of psychological trauma are less traumatic, do not cause strong emotions and physical reactions. These memories are perceived as part of the past, not interfering with a full life in the present.
Mental healthcare clinic in Mansfield TX Wholesome Mind Psychiatry provides specialized psychological assistance to people with any type of PTSD. Our psychologists, psychiatrists and psychotherapists have many years of successful practical experience in treating this disorder.
As therapy, our specialists use those methods of drug and psychotherapeutic treatment that have proven their effectiveness in practice. We guarantee complete confidentiality and quality of specialized assistance.
To make an appointment with a doctor, fill out the form on the website or call the phone number listed on the contacts page.
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