Post-Traumatic Stress Disorder (PTSD): Causes, Symptoms, and Coping Strategies

In today’s fast-paced world, the silent epidemic of Post-Traumatic Stress Disorder (PTSD) continues to affect millions globally. Rooted in distressing experiences, PTSD transcends mere psychological turmoil, infiltrating every facet of daily life. From debilitating flashbacks to crippling anxiety, its ramifications are profound. 

Understanding PTSD, its triggers, symptoms, and treatment modalities, is paramount for both those affected and the society at large. Let’s delve into this complex condition in this blog.

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD (post-traumatic stress disorder) is a mental health condition that arises in some individuals after experiencing or witnessing a traumatic event. This event may be life-threatening or significantly threaten one’s physical, emotional, or spiritual well-being. Every age group is susceptible to PTSD.

Individuals with PTSD experience intense and intrusive thoughts and feelings related to the trauma long after the event has passed. PTSD symptoms include:

• Depression, anxiety, or emotions of shame or guilt.
• Flashbacks or nightmares.
• Avoidance of situations, places, and activities associated with the traumatic event.

Significant anxiety and difficulties with day-to-day functioning are caused by these symptoms.

What are the types of PTSD?

PTSD can be broken down into subtypes based on symptoms, known as condition “specifiers,” to aid in diagnosis and treatment.

Acute Stress Disorder (ASD)

• Not PTSD, but involves symptoms like anxiety and avoidance within a month after trauma.
• Many with ASD develop PTSD.

Dissociative PTSD 

• Detachment from the trauma, feeling separated from the event or body.

Uncomplicated PTSD

• PTSD symptoms without other mental health issues, such as depression.
• Responds well to treatment.

Comorbid PTSD

• PTSD symptoms alongside another mental health disorder.
• Best treated by addressing both PTSD and other conditions.

With Derealization –

Emotional and physical detachment from surroundings.

With Delayed Expression-

PTSD criteria met at least six months post-event.

Complex PTSD

• Results from prolonged trauma, like abuse or trafficking.
• May cause severe psychological damage beyond single-event PTSD.
• Symptoms include uncontrollable feelings and negative self-perception.
• Increased risk factors include continued trauma.

Also read: Behavioural problems in children: symptoms, causes, and treatment

What are the Symptoms of PTSD?

To be diagnosed with PTSD, a person’s symptoms must be severe enough to interfere with everyday functioning or continue longer than a month. Four categories of PTSD symptoms exist:

Intrusion

• Intrusive thoughts, such as repeated, involuntary memories.
• Nightmares.
• Flashbacks of the traumatic event can be very vivid and feel real.

Avoidance

• Avoiding reminders of the traumatic event, like people, places, activities, things, and situations.
• Avoiding remembering or thinking about the traumatic event.
• Refraining from discussing the incident or your feelings towards it.

Changes in Thinking and Mood

• Ongoing fear, horror, anger, guilt, or shame.
• Forgetfulness of key details from the painful experience.
• Persistently unfavourable and skewed ideas and emotions toward oneself or other people.
• Incorrect self- or other-blaming beliefs result from distorted ideas about the event’s source or consequences.
• Feeling detached from others.
• No longer enjoying activities you once did.
• Being unable to experience positive emotions.

Changes in Arousal and Reactivity

• Irritability and angry outbursts.
• Reckless or self-destructive behaviour.
• Being overly watchful of your surroundings (hypervigilance).
• Being easily startled.
• Problems concentrating or sleeping.

Symptoms of PTSD in Children

• Difficulty expressing how they’re feeling.
• Experiencing trauma that might not be known.
• Restlessness, fidgetiness, or trouble paying attention and staying organised.

These symptoms can be confused with ADHD, so it’s important to consult a specialist experienced in diagnosing PTSD in children.

What are the Causes of PTSD?

Approximately 61% to 80% of people experience a traumatic event in their lives, with PTSD developing in about 5% to 10% of this population. The reasons for different responses to trauma are unclear, but studies indicate that people with PTSD show abnormal levels of certain neurotransmitters and hormones, and experience brain changes.

Neurotransmitter and Hormone Changes

• Cortisol, or the “stress hormone,” levels that are normal to low
• Elevated levels of corticotropin-releasing factor (CRF)
• Increased sympathetic nervous system response leading to:
• Higher heart rate
• Elevated blood pressure
• Increased awareness and startle response

Other Neurotransmitters

Altered functioning of:

• Gamma-aminobutyric acid (GABA)
• Glutamate
• Serotonin

Brain Changes

• Decreased hippocampus size (regulates motivation, emotion, learning, and memory)
• Overactive amygdala (processes emotions and fear responses)
• Smaller and less responsive medial prefrontal cortex (controls emotional reactivity of the amygdala)

What are the Complications of PTSD?

The following conditions are frequently observed in individuals with PTSD and can exacerbate its symptoms:

• Mood disorders
• Anxiety disorders
• Neurological conditions, including dementia
• Alcohol use disorders are examples of substance use disorders.

Additionally, people with PTSD face a higher risk of experiencing suicidal thoughts and attempts.

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How is PTSD Diagnosed?

Diagnosing PTSD involves a comprehensive evaluation by a healthcare provider, as there’s no single test for it. The process includes:

• Discussing your symptoms
• Reviewing your medical and mental health history
• Assessing your exposure to trauma

Diagnosis Criteria (DSM-5-TR)

• At least one intrusion symptom
• At least one avoidance symptom
• At least two thinking and mood symptoms
• At least two arousal and reactivity symptoms

It can be challenging to discuss the trauma. Bringing a loved one for support and additional details can be helpful. Additionally, your provider might conduct a physical exam and order tests to rule out other conditions.

What is the Treatment for PTSD?

Psychotherapy (talk therapy) is the main treatment for PTSD, especially forms of cognitive behavioural therapy (CBT). This therapy takes place with a trained, licensed mental health professional, such as a psychologist or psychiatrist. They provide support, education, and guidance to help you and your loved ones function better and increase well-being.

Specific forms of CBT for PTSD include:

• Cognitive Processing Therapy: Focuses on changing painful negative emotions (like shame and guilt) and beliefs due to the trauma, helping confront distressing memories and emotions.
• Eye Movement Desensitisation and Reprocessing (EMDR) Therapy: Involves specific eye movements while processing traumatic memories, helping heal from trauma faster than many other methods.
• Group Therapy: Encourages survivors of similar traumatic events to share experiences and feelings in a nonjudgmental setting. Family therapy may also be beneficial.
• Prolonged Exposure Therapy: Uses repeated, detailed imagining of the trauma or progressive exposures to symptom triggers in a safe, controlled way, helping face and gain control of fear.
• Trauma-Focused CBT: Involves learning about the body’s response to trauma and stress, identifying and reframing problematic thinking patterns, and learning symptom management skills, including exposure therapy.

Medication for PTSD

There are no FDA-approved medications specifically for PTSD, but healthcare providers may prescribe:

• Medications that treat depression, such as serotonin and norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs).
• Anti-anxiety medications.

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How can you Prevent PTSD?

While you can’t always prevent a traumatic event, research suggests that certain actions might help mitigate the development of PTSD afterwards. Known as “protective factors” these behaviours consist of:

• Seeking support from friends and family to create a sense of security.
• Joining a support group after experiencing trauma.
• Developing a positive perspective on your actions during the event.
• Utilising healthy coping strategies post-trauma.
• Maintaining the ability to act and respond effectively despite fear.
• Assisting others, especially in events that impact multiple people, such as natural disasters.

Conclusion

Understanding PTSD is crucial for providing effective support and treatment. By raising awareness and promoting empathy, we can help those affected lead healthier, more fulfilling lives. It is always advisable to seek medical help from a psychiatrist. Timely care and help can ensure an appropriate diagnosis and treatment of your condition. 

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult a psychiatrist, reach out to us, or book a direct appointment with psychiatry at the CK Birla Hospital. 

FAQs

Can PTSD Develop Years after the Traumatic Event?

Yes, PTSD can develop years after the traumatic event, often triggered by reminders or new stressors, reflecting the latent impact of unresolved trauma.

Is PTSD Only Experienced by Military Veterans?

PTSD is not exclusive to military veterans; it can affect anyone who has experienced or witnessed a traumatic event, such as accidents, assaults, disasters, or abuse.

Can Children Develop PTSD?

Children can develop PTSD after experiencing or witnessing traumatic events, such as abuse, natural disasters, or violence, impacting their emotional and psychological well-being.

Are there Any Long-Term Effects of Untreated PTSD?

Yes, untreated PTSD can lead to chronic mental health issues like depression, anxiety, substance abuse, relationship problems, and increased risk of physical health conditions.

How does PTSD Affect Relationships?

PTSD can strain relationships through symptoms like irritability, emotional numbness, and withdrawal, leading to misunderstandings, reduced intimacy, and difficulties in communication and trust.

Can PTSD be Completely Cured?

PTSD may not be completely cured, but effective treatments like therapy and medication can significantly reduce symptoms, helping individuals manage and lead fulfilling lives.

How Should I Proceed if I Think Someone may be Suffering from PTSD?

If you suspect someone has PTSD, encourage them to seek professional help, offer support and understanding, listen non-judgmentally, and help them connect with resources for treatment and support.