Post-Traumatic Stress Disorder

Military troops who served in Vietnam and the Gulf Wars; rescue workers involved in the aftermath 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 South Dakota floods, and hurricanes Hugo and Andrew; and people who witness traumatic events are among the people who develop PTSD. Families of victims can also develop the disorder.

Fortunately, through research supported by the National Institute of Mental Health (NIMH) and the Department of Veterans Affairs (VA), effective treatments have been developed to help people with PTSD. Research is also helping scientists better understand the condition and how it affects the brain and the rest of the body.

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. PTSD is diagnosed when symptoms last more than one month.

How Common Is PTSD?

At least 3.6% of U.S. adults (5.2 million Americans) have PTSD during the course of a year. About 30 percent of the men and women who have spent time in war zones experience PTSD. One million war veterans developed PTSD after serving in Vietnam. PTSD has also been detected among veterans of the Persian Gulf War, with some estimates running as high as 8 percent.

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.

What Treatments Are Available for PTSD?

Research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma. Medications have also been shown to help ease the symptoms of depression and anxiety and help promote sleep. Scientists are attempting to determine which treatments work best for which type of trauma.

Do Other Physical or Emotional Illnesses Tend to Accompany PTSD?

Depression, alcohol or other substance abuse, or anxiety disorders are not uncommon, co-occurrences for people with PTSD. The likelihood of treatment success is increased when these other conditions are appropriately diagnosed and treated as well.

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are also common. Often, doctors treat the symptoms without being aware that they stem from PTSD. NIMH, through its education program, is encouraging primary care providers to ask patients about experiences with violence, recent losses, and traumatic events, especially if symptoms are recurring. When PTSD is diagnosed, referral to a mental health professional who has had experience treating people with the disorder is recommended.

Who Is Most Likely to Develop PTSD?

People who have been abused as children or who have had other previous traumatic experiences are more likely to develop the disorder. Research is continuing to pinpoint other factors that may lead to PTSD.

What Are Scientists Learning From Research?

NIMH and the VA sponsor a wide range of basic, clinical, and genetic studies of PTSD. In addition, NIMH has a special funding mechanism, called RAPID Grants, which allows researchers to immediately visit the scenes of disasters, such as plane crashes or floods and hurricanes, to study the acute effects of the event and the effectiveness of early intervention.

Research has shown that PTSD clearly alters a number of fundamental brain mechanisms. Because of this, abnormalities have been detected in brain chemicals that mediate coping behavior, learning, and memory among people with the disorder. Recent brain imaging studies have detected altered metabolism and blood flow as well as anatomical changes in people with PTSD.

The following are also recent research findings:

Some studies show that debriefing people 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 two years later than those who did not.
People with PTSD tend to have abnormal levels of key hormones involved in response to stress. Cortisol levels are lower than normal and epinephrine and norepinephrine are higher than normal. Scientists have also found that people with this condition have alterations in the function of the thyroid and in neurotransmitter activity involving serotonin and opiates.
When people are in danger, they produce high levels of natural opiates, which can temporarily mask pain. Scientists have found that people with PTSD continue to produce those higher levels even after the danger has passed; this may lead to the blunted emotions associated with the condition.
It used to be believed that people who tend to dissociate themselves from a trauma were showing a healthy response, but now some researchers suspect that people who experience dissociation may be more prone to PTSD.
Animal studies show that the hippocampus -- a part of the brain critical to emotion-laden memories -- appears to be smaller in cases of PTSD. Brain imaging studies indicate similar findings in humans. Scientists are investigating whether this is related to short-term memory problems. Changes in the hippocampus are thought to be responsible for intrusive memories and flashbacks that occur in people with this disorder.
Research to understand the neurotransmitter system involved in memories of emotionally charged events may lead to discovery of drugs that, if given early, could block the development of PTSD symptoms.
Levels of CRF, or corticotropin releasing factor -- the ignition switch in the human stress response -- seem to be elevated in people with PTSD, which may account for the tendency to be easily startled. Because of this finding, scientists now want to determine whether drugs that reduce CRF activity are useful in treating the disorder.

The content of this fact sheet was adapted from material published by the National Institute of Mental Health.

For additional resources, please call 1-800-969-NMHA.

NMHA's Campaign for America's Mental Health works to raise awareness that mental illnesses are common, real and treatable illnesses and ensure that those most at-risk receive proper, timely and effective treatment.

Adapted from http://www.thebrookhospitals.com/Resources/AnxietyDisorders/traumatic-stress.stml

Mayo Clinic PTSD Description

PTSD Awareness: Symptoms

NIH Article

PTSD it is in your skull but NOT in your head!

By Susan Ferris on Thursday, May 15, 2014 at 6:21am

How many times have we heard - “Just get over it”, “Suck it up”, “It is all in your head”, “If you really wanted to you could ______” or the like?

Signs and symptoms of post-traumatic stress disorder (PTSD)

The symptoms of post-traumatic stress disorder (PTSD) can arise suddenly, gradually, or come and go over time. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell. While everyone experiences PTSD differently, there are three main types of symptoms:

Re-experiencing the traumatic event

Avoiding reminders of the trauma

Increased anxiety and emotional arousal

Symptoms of PTSD: Re-experiencing the traumatic event

Intrusive, upsetting memories of the event

Flashbacks (acting or feeling like the event is happening again)

Nightmares (either of the event or of other frightening things)

Feelings of intense distress when reminded of the trauma

Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

Symptoms of PTSD: Avoidance and numbing

Avoiding activities, places, thoughts, or feelings that remind you of the trauma

Inability to remember important aspects of the trauma

Loss of interest in activities and life in general

Feeling detached from others and emotionally numb

Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Symptoms of PTSD: Increased anxiety and emotional arousal

Difficulty falling or staying asleep

Irritability or outbursts of anger

Difficulty concentrating

Hypervigilance (on constant “red alert”)

Feeling jumpy and easily startled

Other common symptoms of post-traumatic stress disorder (PTSD)

Anger and irritability

Guilt, shame, or self-blame

Substance abuse

Feelings of mistrust and betrayal

Depression and hopelessness

Suicidal thoughts and feelings

Feeling alienated and alone

Physical aches and pains

Post-traumatic stress disorder: the neurobiological impact of psychological trauma

A brilliant site explaining alot of what we go through

Originally written for Veteran's PTSD Project Support Forum and related forums on Facebook.

© Susan Ferris 2014 This document may be used by anyone for not for profit reasons as long as the copyright is included and the document is used in it's entirety. This document may not be used for profit in any way shape or form.

Nebraska Description

NMHA

Symptoms according to the Mayo Clinic

Post-traumatic stress disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.

PTSD symptoms are generally grouped into four types:

Intrusive Memories, Avoidance, Negative changes in thinking and mood, or Changes in emotional reactions.

Intrusive memories =

Recurrent, unwanted distressing memories of the traumatic event
Reliving the traumatic event as if it were happening again (flashbacks)
Upsetting dreams about the traumatic event
Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance =
Trying to avoid thinking or talking about the traumatic event
Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood =
Negative feelings about yourself or other people
Inability to experience positive emotions
Feeling emotionally numb
Lack of interest in activities you once enjoyed
Hopelessness about the future
Memory problems, including not remembering important aspects of the traumatic event
Difficulty maintaining close relationships

Changes in emotional reactions =
Irritability, angry outbursts or aggressive behavior
Always being on guard for danger
Overwhelming guilt or shame
Self-destructive behavior, such as drinking too much or driving too fast
Trouble concentrating
Trouble sleeping
Being easily startled or frightened

Intensity of symptoms

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you run into reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

When to see a doctor

If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your health care professional. Get treatment as soon as possible to help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts

If you or someone you know is having suicidal thoughts, get help right away through one or more of these resources:

Reach out to a close friend or loved one.
Contact a minister, a spiritual leader or someone in your faith community.
Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at

800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
Make an appointment with your doctor, mental health provider or other health care professional.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.