What is post-traumatic stress disorder and how is it treated?
Post-traumatic stress disorder (PTSD) is a debilitating condition that follows a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people to whom they were once close.
War veterans first brought PTSD, once referred to as shell shock or battle fatigue, to the public’s attention, but it can result from any number of traumatic incidents. These include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as a mugging, rape, torture, or being held captive. The event that triggers it may be something that threatened the person’s life or the life of someone close to her or him. Or it could be something witnessed, such as mass destruction after a plane crash or a terrorist incident.
Whatever the source of the problem, some people with PTSD repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feeling detached or numb, or being easily startled. They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent. Seeing things that remind them of the incident may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often very difficult.
PTSD can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety. Symptoms may be mild or severe — people may become easily irritated or have violent outbursts. In severe cases, they may have trouble working or socializing. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person — such as a rape, as opposed to a flood.
Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and reenact the event for a period of seconds or hours, or very rarely, days. A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.
Not every traumatized person gets full-blown PTSD, or experiences PTSD at all. Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure, but the symptoms generally decrease over time and eventually disappear. However, about 8 percent of men and 20 percent of women go on to develop PTSD, and roughly 30 percent of these individuals develop a chronic form that persists throughout their lifetimes. PTSD is diagnosed only if the symptoms last more than a month.
Some people recover within 6 months, others have symptoms that last much longer. In some cases, the condition may be chronic. Occasionally, the illness doesn’t show up until years after the traumatic event.
Antidepressants and anxiety-reducing medications can ease the symptoms of depression and sleep problems; and psychotherapy, including cognitive-behavioral therapy, is an integral part of treatment. Being exposed to a reminder of the trauma as part of therapy – such as returning to the scene of a rape – sometimes helps. And support from family and friends can help speed recovery.