| Post-traumatic stress disorder (PTSD), once called shell shock or battle fatigue syndrome, is a serious condition that can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened. It is a lasting consequence of traumatic ordeals that cause intense fear, helplessness or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war or natural disaster. Military troops who served in the Vietnam and Gulf Wars; rescue workers involved in the aftermath of disasters like the terrorist attacks on New York City and Washington, D.C.; survivors of the Oklahoma City bombing; survivors of accidents, rape, physical and sexual abuse, and other crimes; immigrants fleeing violence in their countries; survivors of the 1994 California earthquake, the 1997 North and South Dakota floods, and hurricanes Hugo and Andrew; and people who witness traumatic events are among those at risk for developing PTSD. Families of victims can also develop the disorder. Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear and even guilt. These reactions are common; and for most people, they go away over time. For a person with PTSD, however, these feelings continue and even increase, becoming so strong that they keep the person from living a normal life. People with PTSD have symptoms for longer than one month and cannot function as well as before the event occurred. What Are the Symptoms of PTSD? Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. The Trauma Response and Symptoms of PTSD The physical and emotional reaction to trauma that later develops into PTSD in some people is really a way to survive during intense danger. The body produces chemical substances which prepare people to fight or run when they are under threat. They become very alert, but at the same time, they shut down emotionally. This is called numbing. It happens because emotions like love or sadness would only get in the way of physical survival. Many times people in the middle of danger seem extremely calm. They have disassociated from themselves, experiencing the event as if they were watching a movie of someone else experiencing what is happening around them. Long after the traumatic event has passed, some people continue to experience the trauma response. Professionals who study and treat PTSD separate the symptoms of the disorder into three categories that include: Intrusive Symptoms Things that cause a person to involuntarily re-experience the traumatic event. These include nightmares, flashbacks, and intrusive memories. Avoidance Symptoms The avoidance of anything that will trigger memories of the trauma, such as sights, smells and sounds associated with the trauma and even certain feelings. Often people with PTSD withdraw from activities they used to enjoy. Increased Arousal Symptoms Signs that the person is both emotionally and physically in a state of constant readiness in case the trauma happens again. Anger, the need to control everything in their lives and jumpiness are some of these signs. Symptoms of PTSD often are grouped into three main categories, including: Re-living: People with PTSD repeatedly re-live the ordeal through thoughts and memories of the trauma. These may include flashbacks, hallucinations and nightmares. They also may feel great distress when certain things remind them of the trauma, such as the anniversary date of the event. Avoiding: The person may avoid people, places, thoughts or situations that may remind him or her of the trauma. This can lead to feelings of detachment and isolation from family and friends, as well as a loss of interest in activities that the person once enjoyed. Increased arousal: These include excessive emotions; problems relating to others, including feeling or showing affection; difficulty falling or staying asleep; irritability; outbursts of anger; difficulty concentrating; and being "jumpy" or easily startled. The person may also suffer physical symptoms, such as increased blood pressure and heart rate, rapid breathing, muscle tension, nausea and diarrhea. Young children with PTSD may suffer from delayed development in areas such as toilet training, motor skills and language. When Does PTSD First Occur? PTSD can develop at any age, including in childhood. Symptoms typically begin within 3 months of a traumatic event, although occasionally they do not begin until years later. Once PTSD occurs, the severity and duration of the illness varies. Some people recover within 6 months, while others suffer much longer. Who Gets PTSD? Everyone reacts to traumatic events differently. Each person is unique in his or her ability to manage fear and stress, and to cope with the threat posed by a traumatic event or situation. For that reason, not everyone who experiences or witnesses a trauma will develop PTSD. Further, the type of help and support a person receives from friends, family members and professionals following the trauma may influence the development of PTSD or the severity of symptoms. PTSD was first brought to the attention of the medical community by war veterans, hence the names shell shock and battle fatigue syndrome. However, PTSD can occur in anyone who has experienced a traumatic event. People who have been abused as children or who have been repeatedly exposed to life-threatening situations are at greater risk for developing PTSD. Victims of trauma related to physical and sexual assault face the greatest risk for PTSD. How Common Is PTSD? About 3.6% of adult Americans -- about 5.2 million people -- suffer from PTSD during the course of a year, and an estimated 7.8 million Americans will experience PTSD at some point in their lives. PTSD can develop at any age, including childhood. Women are more likely to develop PTSD than are men. This may be due to the fact that women are more likely to be victims of domestic violence, abuse and rape. Do Other Illnesses Tend to Accompany PTSD? Co-occurring depression, alcohol or other substance abuse, or another anxiety disorder are not uncommon. The likelihood of treatment success is increased when these other conditions are appropriately identified and treated as well. Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common. Often, doctors treat the symptoms without being aware that they stem from PTSD. NIMH encourages primary care providers to ask patients about experiences with violence, recent losses, and traumatic events, especially if symptoms keep recurring. When PTSD is diagnosed, referral to a mental health professional who has had experience treating people with the disorder is recommended. How Is PTSD Diagnosed? If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose PTSD, the doctor may use various tests to rule out physical illness as the cause of the symptoms. If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder. The doctor bases his or her diagnosis of PTSD on reported symptoms, including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate PTSD. PTSD is diagnosed if the person has symptoms of PTSD that last for more than one month. How Is PTSD Treated? Research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient gradually and repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help promote sleep. Scientists are attempting to determine which treatments work best for which type of trauma. Some studies show that giving people an opportunity to talk about their experiences very soon after a catastrophic event may reduce some of the symptoms of PTSD. A study of 12,000 schoolchildren who lived through a hurricane in Hawaii found that those who got counseling early on were doing much better 2 years later than those who did not. The goal of treatment is to reduce the emotional and physical symptoms associated with PTSD, to improve daily functioning and to help the person better cope with the event that triggered the disorder. Treatment for PTSD may involve psychotherapy (a type of counseling), medication or both. Medication The only drug currently approved to treat PTSD is the antidepressant, Paxil. Doctors may use other antidepressant medications to control the feelings of anxiety and its associated symptoms, including: Desyrel, Celexa, Luvox, Prozac and Zoloft. Tranquilizers such as Ativan or Klonopin may also be prescribed to reduce anxiety symptoms. Psychotherapy Psychotherapy involves helping the person learn skills to manage symptoms and develop ways of coping. Therapy also aims to teach the person and his or her family about the disorder, and help the person work through the fears associated with the traumatic event. A variety of psychotherapy approaches are used to treat people with PTSD, including: Cognitive-behavior therapy, which involves learning to recognize and change thought patterns that lead to troublesome emotions, feelings and behavior. Exposure therapy, a type of cognitive-behavior therapy that involves having the person re-live the traumatic experience, or exposing the person to objects or situations that cause anxiety. This is done in a well-controlled and safe environment. Exposure therapy helps the person confront the fear and gradually become more comfortable with situations that are frightening and cause anxiety. Psychodynamic therapy focuses on helping the person examine personal values and the emotional conflicts caused by the traumatic event. Family therapy may be useful because the behavior of the person with PTSD can have an affect on other family members. Group therapy may be helpful by allowing the person to share thoughts, fears and feelings with other people who have experienced traumatic events. What Is the Outlook for People With PTSD? Recovery from PTSD is a gradual and ongoing process. Symptoms of PTSD seldom disappear completely, but treatment can help sufferers learn to cope more effectively. Treatment can lead to fewer and less intense symptoms, as well as a greater ability to cope by managing feelings related to the trauma. Research is ongoing into the factors that lead to PTSD and into finding new treatments. Can PTSD Be Prevented? Some studies suggest that early intervention with people who have suffered a trauma may reduce some of the symptoms of PTSD or prevent it all together. |
| PTSD and You |
| Post Traumatic Stress Disorder: What is it, Why do I have it, and What can I do about it? |
| There are several aspects of PTSD. Not all survivors experience the same symptoms. Some survivors never experience them and some do much later after their assault. Many survivors experience triggers, reminders of their assault. Triggers can occur through sight, sound or smell. Sometimes it is easy to identify the trigger. One may associate the color hair or build of a person to their attacker. Other times, triggers are not as easily identified and may leave a survivor questioning why they have increased anxiety and discomfort. These triggers may set off a panic attack. Survivors may feel overall anxiety or nausea during this time. It is possible to work through triggers by desensitizing yourself to them.Making a list of things which trigger us is a good first step towards desensitization. Working with a trained professional is a good beginning. Although there are other symptoms of PTSD, it is important to remember is that what you are experiencing is common as a result of experiencing such a trauma as sexual assault. These symptoms are caused through NO fault of your own. They are a direct result of what happened TO you. It may take some time, but it is possible to resolve these issues with the assistance of a counselor & other support systems you have developed. |
| What are Triggers? |
| Nightmares |
| Nightmares are a common symptom of PTSD. They can sometimes occur immediately after the trauma. Other times they may begin when a new memory has been recovered.In many cases, unfortunately, nightmares will continue for years after the trauma.While there is no sure cure for night terrors I can tell you that they do get more handleable over time.In a way sometimes repeated nightmares also act as a desensitization tool: even though while we are dreaming the feelings are immediate and intense, eventually you do get used to them.As a personal example,after a "cease-fire" of almost a year,in building this website I have begun my personal cycle of night terrors all over again.By now they are so familiar that upon waking I can tell myself,"ho-hum, not THAT again" and not let it control me.Desensitizing myself to the nightmares came a little at a time,and it is indeed an ongoing process. |
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