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post-traumatic stress disorder Alternative Names
PTSD, shell-shocked, battle fatigue, posttraumatic stress syndrome, posttraumatic stress
Definition
Post-traumatic stress disorder, or PTSD, is a condition that follows a traumatic event outside the range of normal experience. Such an event might involve a serious life-threatening experience, for example, or seeing a loved one killed. Symptoms of PTSD include: - reliving the event
- feeling numb to one's surroundings
- startling easily
- having feelings of guilt
- developing loss of memory
- experiencing a variety of nerve dysfunctions that control automatic body functions, called autonomic dysfunctions and disorders of thinking, memory, or concentration, called cognitive dysfunctions
- experiencing feelings of dissatisfaction, depression and anxiety, called dysphoria
- experiencing difficulties with concentration and sleep
People with PTSD have feelings of intense fear, helplessness or horror in response to a past trauma event.
What is going on in the body?
There are three types of PTSD reactions: - acute: symptoms last less than 3 months
- chronic: symptoms last longer than 3 months
- delayed: symptoms start at least 6 months after the actual trauma occurs
What are the signs and symptoms of the condition?
Symptoms of a PTSD episode look similar to an acute anxiety reaction in which uncomfortable feelings of uneasiness or distress are felt or a panic reaction, in which excessive fear occurs.
Symptoms of PTSD fall into three main categories.
The first is reliving the event in one or more of the following ways: - memories of the event.
- recurrent dreams of the event.
- sensations that the event is reoccurring. These sensations can include: illusions or misinterpreting things you see or hear as something else, hallucinations, or seeing or hearing things that are not there, and flashbacks, or reliving events as if they are occurring now
- severe emotional upset at cues similar to experiences in the actual event.
- physical sensations that recall the event. This can occur after exposure to outside cues or after internal memories.
The second category of symptoms are connected to a tendency to avoid reminders of the event, which can result in: - guilt at surviving when others did not, which is known as survivor guilt.
- trouble making and keeping healthy family, social or job relationship.
- avoidance of thoughts, feelings, or talk about the event.
- avoidance of activities, places or people that might bring the event to mind.
- trouble recalling key parts of the event.
- loss of interest in daily activities.
- feelings of detachment or emotional distance from others. This could include trouble feeling love or affection.
- a sense of a shortened future. This might involve refusal to think or plan for the future.
The third category of symptoms is associated with a higher level of arousal and anxiety than before the trauma, and can result in: - problems sleeping. This can include trouble falling asleep or staying asleep or early morning waking.
- irritability and trouble managing anger.
- problems with memory and concentration.
- an exaggerated startle response, or being set off by surprising events.
- persistent anxiety.
- somatic or body symptoms. These may include headache, nausea, sweating, chest pain or dizziness.
- agitation, or feelings of restlessness.
- less ability to tolerate or control emotions.
- self-destructive behaviour. This may include alcohol and drug abuse, suicide attempts or acting out.
- feeling of being separate from yourself or from the world, called dissociative symptoms.
What are the causes and risks of the condition?
PTSD is caused by exposure to excessive stress or trauma. Events that spark the condition are not normally part of most people's life experience. Examples would include plane crashes, rape, torture, severe child abuse, combat, war imprisonment, natural disaster, combat, and severe assault. Not everyone exposed to such events will develop PTSD. It is not known why some individuals develop PTSD. However, having strong support systems lessens a person's risk of the disorder.
What can be done to prevent the condition?
Counselling after a traumatic event may cut down on the chances of developing PTSD. The earlier treatment is started, the better the chances for lessening or eliminating symptoms of the condition.
How is the condition diagnosed?
PTSD is diagnosed based on a person's symptoms. A major, extreme event must have taken place. A doctor will do a thorough examination to make sure symptoms do not stem from a medical source.
What are the long-term effects of the condition?
People with PTSD often have problems in their relationships with others. Marriage problems and high divorce rates are common. Job and legal problems also occur frequently in persons with the syndrome. Alcohol and drug abuse are significant among people with this disorder, as well.
What are the treatments for the condition?
Various treatments have been shown to be useful in treating PTSD. In particular, cognitive-behavioural therapy and eye movement desensitisation and reprocessing have demonstrated significant efficacy.
People with PTSD often need treatment for depression or substance abuse. This needs to occur before measures directed at decreasing symptoms of PTSD can be effective.
Antidepressant medications, such as sertraline, or fluoxetine, may help limit symptoms. Short term use of antianxiety drugs, such as lorazepam or alprazolam, are useful during periods of severe symptoms.
What are the side effects of the treatments?
Side effects may occur with some of the medications used. They differ according to which medications are used.
What happens after treatment for the condition?
Chronic PTSD often persists for years, but it usually becomes less intense and bothersome as time passes.
Author: Ann Reyes, Ph.D.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
