PTSD / Trauma

Post-traumatic stress disorder, more commonly styled as PTSD, is a mental health condition in which a person has recurring memories of frightening events or has negative emotional responses to external stimuli arising from trauma. These reactions are generally considered to be uncontrollable by those who experience them, and the reactions often have adverse impacts on the lives of those who suffer through the episodes.

PTSD is a recognized diagnosis on the DSM-5. It can be helpful to learn about the symptoms of PTSD, sources of trouble, what happens to the body, and how you may be able to address your situation.

Symptoms of PTSD

Behaviors related to post-traumatic stress disorder tend to break up into two very general categories. First, there are the ones where a person’s internal world circulates around reliving traumas. Second, there are the ones where outside occurrences trigger responses or emotions.

In terms of the internal mental issues that are often associated with the condition, signs of trouble can include:

  • Mentally reliving the events that led to the trauma
  • Experiencing nightmares
  • Showing outbursts of anger when presented with tense situations
  • Feeling anxiety when talking or thinking about similar scenarios
  • Playacting through events
  • Having flashbacks where people feel the events are happening right now

Common reactions to episodes include:

  • Sudden reactions to loud noises
  • Emotional outbursts, such as crying, when subjected to stress
  • Withdrawal and isolation during high-intensity situations, including socialization
  • Extreme mismatches between responses and sources of difficulty
  • Generalized guilt and shame

Physically, PTSD is frequently manifested in the form of sleeplessness, challenges with concentration, headaches, and nausea. Sweating is also very common. Some individuals who have been through trauma experience eye movement desensitization, which leads to what’s sometimes interpreted as staring into the distance.

Symptoms of this condition typically begin to appear within one to six months of the inciting events. People who have coped well with trauma, however, may not exhibit symptoms until years afterward. These less-likely cases are usually prompted by additional traumatic events or strong reminders of the initial incident.

People who have suffered through difficult events may stop leading normal lives, especially if they feel like they don’t have a positive outlook for the future. Some people overtly avoid individuals or places that remind them of certain happenings, and it’s also common for them to avoid talking about feelings that are similar to the ones they felt at the time of a traumatic event.

The way someone talks about his or her situation often provides clues to whether he or she might have a disorder. For example, a person may express his or her concerns by saying things like:

  • “It won’t get out of my head.”
  • “I can’t talk about it.”
  • “I feel dead inside.”
  • “It’s like it just keeps happening again and again.”
  • “Nothing feels normal.”
  • “I’m having anxiety attacks.”

It’s also common for people with PTSD to insist upon the necessity of arming themselves or becoming trained in combat.

Bear in mind that no single symptom satisfies the diagnostic criteria for PTSD. There should be evidence that several of the items from the above lists we’ve provided are present before you begin trying to narrow issues down to anything that can be called a post-traumatic stress disorder.

One key problem to keep an eye out for is what is called “hyperarousal.” In cases of hyperarousal, people can stay awake through entire nights without explanation. Extreme cases include people who refuse to turn the lights off as they stay up through the night. They often display fight-or-flight responses when presented with minor confrontations or stressors. It’s common for people in these conditions to begin self-medicating with drugs or alcohol. Many also disconnect from friends and family members because they’re not sure how to be normal in common social situations.

Another issue to watch out for is what’s considered a “startle response.” This is when people scream, shake, run, or quickly overreact to even small inputs. Such inputs include being touched, sudden visual changes like flashing lights, loud noises, and complex conversations.

Comorbidity between PTSD and other disorders is common. For example, those who have eating disorders like bulimia or binge eating often also exhibit signs of post-traumatic stress disorder. As you might imagine, a negative shift in one’s nutrition intake that is concurrent with PTSD is likely to make the situation worse. Suicidal thoughts, acts of violence, and anti-social behavior are also frequently tied to PTSD. In many cases, suicidal ideation and suicide attempts have been documented.

Potential Sources

When we think of post-traumatic stress disorder, we tend to stereotype it as a mental illness experienced by soldiers who have been in combat, children who have been abused, and those who have been sexually assaulted or raped. However, this disorder can follow from a number of other events. These include:

  • Extremely violent events, such as being present during an assault or a homicide
  • Prolonged environmental stress, especially in childhood and the teens
  • Going through the events of a natural disaster
  • Being diagnosed with a life-threatening disease
  • The sudden death of a family member or a friend

It is estimated that about one out of three people who go through a major trauma will experience PTSD.

Notably, most clinicians will not label an event that’s just upsetting as a trauma. For example, a prolonged divorce is unlikely to be considered the source of PTSD, especially in isolation. On the other hand, someone who was the victim of persistent domestic violence in childhood and then ended up going through a difficult divorce in adulthood might find himself or herself triggered by a sudden flood of emotions during the proceedings.

What’s Going On?

For very strong survival reasons, the human body is rigged to flush itself with a number of chemicals during stressful situations. In particular, the body tends to get slammed with a great deal of adrenaline, a neurotransmitter that allows a person to switch quickly from a resting state into a condition of high alertness. Under these circumstances, you may notice that your:

  • Muscles feel tense
  • Heart is beating quickly
  • Breathing pace has accelerated

The goal of all of these changes is to ensure that as an emergency occurs, you’ll be able to act quickly and aggressively to meet the situation head-on.

People also tend to experience issues with two key areas of their brains when they go through trauma. The hippocampus is a structure that’s buried deep in your temporal lobe. It handles many memory-related functions. However, many kinds of stimuli can damage it.

The amygdala is a neighbor of the hippocampus, and it handles the processing of emotions like fear, especially the forms of fear that we become conditioned to dealing with. When you feel like you have to freeze in a bad situation or that your heart rate is suddenly kicking up, there’s a good chance that the amygdala is being triggered.

The proximity of these two structures to the cortex of your brain means that there’s essentially a triangle of memory, fear responses, and thoughts that your thoughts are being cycled through. In most cases, these conditioned responses are highly helpful. A police officer, for example, needs to be able to kick his or her body into gear at the sound of gunfire.

Constant stimulation of these structures, however, can adversely impact the brain. By one estimate,  8 percent of Americans will experience a post-traumatic stress disorder at some point in their lives.

If stresses occur in childhood, when brain development is consuming a significant amount of the body’s resources, damage or underdevelopment can occur. Massive shocks in adulthood can yield similar outcomes. Also concerning is that some physical events, such as a head trauma, may lead to damage of the internal structures of the brain, making the regulation of fear responses, stress, and memory harder.

It’s normal, too, for the body to cut down the release of neurotransmitters following stressful events. This means that chemicals like serotonin and dopamine may be less present. Studies of a wide range of disorders have tied altered serotonin and dopamine levels to a variety of negative outcomes, including depression, anxiety, and addiction.

Addressing the Situation

First, it’s wise to not narrow in on PTSD as the one and only possible cause of the trouble you might be experiencing. PTSD-like symptoms often follow from traumatic events due to other mental health issues, brain damage, and specific coping mechanisms. Only a medical professional can diagnose you with post-traumatic stress disorder and then prescribe a course of treatment.

One of the most common options for addressing PTSD is having a person undergo Cognitive Behavioral Therapy. The idea behind CBT is to help people unlearn patterns in which cognition of situations creates a disconnect with socially acceptable responses. Put more simply, the objective is for a patient to learn that everyday stimuli are not indicators of impending stressful situations that have to be immediately dealt with.

For example, one study of young men who had grown up in Liberia during either or both of the country’s recent civil wars tested how CBT might help them. Individuals were selected on the basis of continuing participation in anti-social behaviors, especially rioting and political violence. Many had been mobilized to participate in the civil wars, even if they were minors. The goal of the study was to establish whether cash or CBT would produce the best possible outcome, and it was found that therapy was the best option.

Selective serotonin reuptake inhibitors (SSRIs) are also sometimes prescribed. This class of drugs includes recognizable brand names like:

  • Celexa
  • Paxil
  • Zoloft
  • Prozac

Some antidepressant medications, especially tricyclic ones, are also prescribed to individuals who experience PTSD.

It should be noted that post-traumatic stress disorder symptoms almost never clear up completely. To some extent, this is to be expected. After all, even a person who has been through trauma still needs to maintain a degree of alertness to deal with emergencies. It would never be healthy for a medical professional to try to shut down these responses entirely, and you absolutely should not expect this sort of outcome from treatment.

When you feel it’s time to get help, there are a few things you can do. It may be beneficial to recruit close friends or family members to help you with some basic needs, especially if you’re having trouble doing things like driving in traffic or using public transportation. These people can also be sounding boards for when you want some outside input regarding symptoms you suspect are present. Getting such information may allow you to provide a fuller picture when talking with a practitioner, especially if you’ve experienced memory lapses.

Once you have a sense of what your situation is, it’s worthwhile to seek medical advice. You can begin with your general practitioner or go to a psychologist for guidance. There are treatment programs that are aimed at people with PTSD, and you may also want to get some information about the ones at locations nearest to you

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