Post- traumatic stress disorder (PTSD) is a mental health condition that develops in response to experiencing or witnessing a distressing event involving the threat of death or extreme bodily harm. Examples of traumatic events that can trigger PTSD include sexual assault , physical violence, and military combat. PTSD can also occur in the wake of a motor vehicle accident, a natural disaster (e.g., fire, earthquake, flood), a medical emergency (e.g., having an anaphylactic reaction), or any sudden, disruptive incident.
What Is Post-Traumatic Stress Disorder?
PTSD has likely existed throughout human history. During World War I, it was known as “shell shock” and was first thought to affect only soldiers. PTSD was officially recognized as a mental health disorder in 1980. Researchers believe that the changes to body and mind that occur in PTSD reflect an attempt of the system to protect the person from further experiences of danger.
Anyone who has survived a deeply disturbing experience of any kind can develop PTSD symptoms. PTSD is characterized by vivid, intrusive memories of the precipitating event, hypervigilance and hyper-reactivity to possible threats, nightmares, and mood disturbances. Those suffering from PTSD often report feeling anxious or scared even in the absence of danger, as if it could strike at any time.
The condition may manifest in anxiety -like symptoms, emotional numbness or dysphoria, anger and aggression , or some combination of those states. It can feel like the normal stress response is locked into permanent overdrive, and those with PTSD often find it difficult to function normally in everyday life.
Many people experience a traumatic event at some point in their lives, although only a small proportion of them develop PTSD. In the United States, about 3.5 percent of people may have the disorder, including children. For some, the stimulus is not one distressing incident but a series of incidents occurring over a period of time, as may be the case with sexual or physical abuse during childhood . The prevalence of the disorder is higher among veterans of combat, ranging from 10 to 30 percent. About half of those with PTSD recover within three months, but for many others, the condition becomes chronic.
Research shows that some people are at higher risk than others for PTSD. Most vulnerable are persons who have a history of multiple adverse experiences or mental difficulties. Having little social support or recurrent ongoing life stress are also risk factors. Physical impairment and job loss add to the risk.
Experiencing distress, fear , anxiety, shock, and other negative emotions is normal in the immediate aftermath of a disturbing incident. A diagnosis of PTSD is generally considered if such symptoms persist for at least a month and interfere with daily functioning. PTSD symptoms can last anywhere from months to years following the originating trauma and can be exacerbated by exposure to more trauma.
What Are the Symptoms of PTSD?
Those with PTSD suffer from classic anxiety symptoms, such as insomnia and worry. They are hypervigilant and constantly alert to possible dangers. Typically, they have an exaggerated startle response. Unexpected sound or movement can provoke a strong, violent reaction, as if the precipitating danger were happening again that instant. That original traumatic event is often recalled spontaneously in flashbacks of memory so vivid and intense that the person feels as if they are living through the situation again in the present. They may even feel the same panic, dread, and terror that were originally evoked.
Anxiety is not the only form of distress sufferers experience. Disrupted mood is common, and people often feel the guilt and shame typical of depression . Some people with PTSD may experience apathy or detachment from others. They may also regard others with suspicion and display hostility. Those with PTSD may find it difficult to trust anyone.
In an attempt to feel safe, many with PTSD withdraw from the normal activities of life altogether as a way to avoid reminders of the trauma, which tend to occur randomly. Some seek relief by consuming alcohol or other drugs. There is no guarantee that PTSD symptoms will go away on their own or lessen with time, but there are resources that can help people regain a good quality of life.
For more information on symptoms, causes, and treatment of PTSD, see our Diagnosis Dictionary .
Consultation with a mental health professional, who conducts an assessment of symptoms, is essential for someone concerned about having post-traumatic stress disorder. PTSD is a clinical diagnosis, meaning that PTSD is diagnosed by observing a person’s symptoms. Anyone who has been exposed to trauma and who finds that the experience interferes with daily functioning for more than a month may be diagnosed with PTSD.
One of the most common myths about PTSD is that everyone who goes through trauma will develop post-traumatic stress disorder. While it’s completely normal to experience PTSD-like symptoms immediately following a traumatic event, these usually resolve within a month, especially if the individual receives strong emotional support. PTSD symptoms often overlap with acute stress disorder (ASD), an intense but brief psychological reaction to a traumatic or life-altering event that doesn’t persist after 30 days.
PTSD and the Human Brain
Researchers are intensely investigating what trauma does to the brain, in the hope of developing effective treatments for PTSD. Scientists know that in PTSD, the stress circuitry in the brain goes awry, disrupting communication between several brain centers. These include the amygdala, which normally monitors incoming perceptions and red-flags threats, putting systems on high alert and setting off the stress response; the prefrontal cortex, or executive control center of the brain, which normally senses when a threat is over and dampens amygdala activity; and the hippocampus, where memories are stored and retrieved.
Scientists find that in PTSD, the prefrontal cortex is underactivated, and the amygdala is overactivated. There is evidence that a core problem lies in the connections between individual nerve cells, or synapses; there is a deficit in connectivity, limiting communication between nerve cells. As a result, individuals with PTSD lose psychological flexibility: They stay stuck in an over-the-top response pattern, and their memories resist the modification that normally occurs over time.
PTSD is a whole-brain disorder that involves the brain circuits of fear, stress, and anxiety . The amygdala (which sets off the fight-or-flight response) becomes hyperactive . Meanwhile, the prefrontal cortex (the CEO, or executive functioning center of the brain) grows sluggish or lacks sufficient neural connections with the amygdala to calm down the fear response. In people with PTSD, the hippocampus (the verbal memory center) tends to be smaller than normal and yet more active in response to perceived threats.
In response to an overactive amygdala and underactive prefrontal cortex, the brain releases large amounts of norepinephrine in the presence of perceived danger. This can affect brain functioning in several ways, leading to hyperarousal, hypervigilance, and increased wakefulness and disrupted sleep. PTSD sufferers may also find that when they are emotionally aroused, they have little control over their reactive anger and impulsive behaviors. The weight of negative emotions such as fear and anger can diminish positive feelings and create problems at work and in personal relationships.
Yes, the brain scans of people with PTSD are different than those without this condition. For starters, the hippocampus (the center of memories and emotions in the brain) shows reduced volume, and heightened activity appears in the amygdala (which is involved in the body’s fear response). However, it’s important to note that PTSD is not diagnosed from brain scans. Only a medical professional can diagnose post-traumatic stress disorder based on a patient’s clinical symptoms.
Treatment for PTSD usually centers around talk therapy, Psychotherapy , particularly cognitive behavioral therapy, has proven to be one of the most reliable treatments for PTSD. It consists of several parts: exposure therapy, stress inoculation training, and cognitive reappraisal. One major goal is to restore cognitive flexibility so that sufferers can talk about their bad experiences and modify the emotional force of the memory. Underlying such improvements are increases in nerve-cell connectivity, a hallmark of all effective therapies.
Frequently Asked Questions
What exactly is post-traumatic stress disorder?
Post- traumatic stress disorder (PTSD) is a mental health condition that develops in response to experiencing or witnessing a distressing event involving the threat of death or extreme bodily harm. Examples of traumatic events that can trigger PTSD include sexual assault , physical violence, and military combat. PTSD can also occur in the wake of a motor vehicle accident, a natural disaster (e.g.,
What are the signs of post-traumatic stress disorder?
Those with PTSD suffer from classic anxiety symptoms, such as insomnia and worry. They are hypervigilant and constantly alert to possible dangers. Typically, they have an exaggerated startle response. Unexpected sound or movement can provoke a strong, violent reaction, as if the precipitating danger were happening again that instant. That original traumatic event is often recalled spontaneously in
Is post-traumatic stress disorder a serious condition?
Post-Traumatic Stress Disorder exists on a spectrum. While mild forms are a normal part of life, persistent or severe post-traumatic stress disorder can significantly impact daily functioning and quality of life. It's important to seek professional support if post-traumatic stress disorder is interfering with work, relationships, or wellbeing.
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