PTSD: 5 Things You Need to Know

distressed womanJune is Posttraumatic Stress Awareness Month. About 7% of the U.S. population has PTSD at any given time, according to the National Institute of Mental Health (NIMH). Living with PTSD is difficult for the person who has it and for those around him/her. Most people associate PTSD with war veterans, but anyone can experience it following a traumatic event in which actual or the potential for serious harm was present.

Some examples: victims of physical assault/violence; survivors of torture and systemic abuse; childhood abuse; rape survivors; people who have experienced natural disasters; those who have been in car accidents; and so on. What these people have in common is the experience of loss of control over their personal safety. The following highlights will give you more insight.

1. According to the DSM-5, the symptoms of PTSD include:

Intrusive thoughts, images, feelings, or behaviors related to the traumatic event.

  • Nightmares.
  • Repetitive intrusive thoughts.
  • Flashbacks or intrusive images.
  • Extreme emotional distress when reminded of the trauma.
  • Physical arousal or distress when reminded of the trauma.

Avoidance or reminders of the traumatic event.

  • Avoidance of trauma-related thoughts or feelings.
  • Avoidance of reminders of the traumatic event.

Changes in thinking or mood related to the traumatic event.

  • Inability to remember some aspects related to the traumatic event.
  • Persistent negative beliefs and expectations about oneself and the world.
  • Persistent distorted blame of oneself or others for the traumatic event.
  • Persistent negative trauma-related emotions.
  • Loss of interest in activities enjoyed before the trauma.
  • Feeling alienated from others since the traumatic event.
  • Inability to experience positive emotions.

Changes in arousal and reactivity related to the traumatic event.

  • Irritability, agitation, or aggressive behavior.
  • Self-destructive or reckless behavior.
  • Hypervigilance—being “on guard” most of the time.
  • Exaggerated startle response.
  • Difficulty concentrating.
  • Problems sleeping.

There are new subtypes of PTSD for children under age 6 and those who experience dissociation. One does not need to have all of these symptoms to meet the criteria for PTSD.

If you recognize some of these symptoms in yourself or a loved one after a traumatic event, and the symptoms do not decrease in frequency and intensity over a period of one month, it’s a good idea to discuss this with a medical or mental health provider. In fact, anyone who experiences a traumatic event would be wise to talk to a professional. There is often an immediate stress response called acute stress (ASD). ASD occurs within the first month after a trauma and places a person at risk for PTSD. However, not everyone who experiences a trauma will develop ASD or PTSD.

2. Triggering events

Triggers are situations, sensations or memories associated with the traumatic event that can cause the initial emotional and physical reactions to reoccur. These triggers may not be directly associated with the traumatic event. For example, one sexual abuse victim I worked with became physically ill and emotionally distressed when she saw hot dogs that she associated with male genitalia.

A more common situation involved a woman who had been in a car accident and became terrified to the point of panic when she had to ride in cars. One man I worked with who had been severely physically and emotionally abused as a child became triggered when he perceived anyone as threatening, as in through tone or volume of voice. A woman I worked with who had been robbed as a teller at a bank was unable to go near a bank without experiencing an acute stress reaction.

Determining what triggers precede a PTSD reaction help those who have the issue learn to identify and cope with them. This is a critical aspect of treatment.

3. Treatment for PTSD

There are two common therapies for PTSD: cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). There are several types of CBT for PTSD, primarily exposure therapy and cognitive restructuring.

  • Exposure therapy entails gradually introducing reminders of the traumatic event to desensitize the person with PTSD to those triggers, and help them work through their reactions.
  • Cognitive restructuring involves examining thoughts and memories, as well as one’s perceptions about the event, and then restructuring those that are problematic.
  • EMDR uses bilateral stimulation, such as moving the eyes from side to side or alternately tapping each knee, while following a sequence of of treatments.
  • Family therapy, medication, and self-help groups are also recommended for some people.

4. Self-help for PTSD

Support groups are one form of self-help. Support groups for people with PTSD are usually led by a professional facilitator. Other self-help strategies involve staying connected with people in your support network to decrease isolation. Service dogs and companion animals can also be helpful for people with PTSD and related issues. Just remember: none of these are a replacement for treatment by a qualified professional.

5. Recovery

Most people who experience PTSD after a traumatic event gradually get better. It is important to understand that the process of recovery takes time and follow-through. Although there may be times when you want to isolate yourself from others, connections with supportive people are critical to your recovery. Professional treatment with a therapist and medication management, if warranted, with a knowledgeable psychiatrist or medical prescriber will provide you with the best chances of recovery. Support groups and other self-help efforts will enhance your prognosis.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by LuAnn Pierce, LCSW, therapist in Denver, Colorado

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Christine M

    Christine M

    May 26th, 2014 at 8:24 AM

    Thank you so much for this insightful article about PTSD. I think that much of the time we think that those who have experienced something traumatic in their lives should be able to pick up and move on without realizing that for so many this is niot that easy. There will always be something for them that could take them right back to that event and they will experience the pain over and over again without ever learning that it has not been processed and resolved in a healthy way. It is up to the rest of us to be cognizant of that and to encourage them to get the help that they need when they are ready to work through some of these things so that they are no longer left in fear of them anymore.

  • Lorraine

    Lorraine

    May 27th, 2014 at 3:53 AM

    There is always so much misinformation out there about PTSD< what it is and things you can do to help that it is nice to know that the real truth is out there and you are committed to getting the word out.
    I think that there are many people who assume that this is just something that they will have to live with for the rest of their lives when clearly there is help to be had and progress that can be made by taking advantage of the may resources that are available to help those with these symptoms.
    It is critical that we spread the message that yes, you may have had something terrible happen to you but that does not have to be the end of the world. It will take work but there is light out there for you again if you are willing to seek it out.

  • Perry

    Perry

    May 27th, 2014 at 3:27 PM

    So I have been reading some about this and I am not sure that I understand how going through the memoties and the experience with your therapist would be any different than coming across those triggering events on your own.

    Is this supposed to help because you are doing it in a supposedly safer environment? Because either wya I think that for me it would be scary to re-live those things that are causing you the trauma to begin with.

  • jeri

    jeri

    May 28th, 2014 at 3:47 AM

    My uncle had PTSD that he never sought treatment for and I can’t tell you how much this damaged the whole family.

    Of course he hurt, he was the one reliving the events over and over in his mind. But his wofe and kids also had to experience this right along with him because he never got a grasp on how to process those memories and let them go.

    He finally lost everyone that was important to him in his life, not because they wanted to leave him but because even when you suffer like this it isn’t right to hurt your family over and over by not getting the treatment that you know that you need but are too proud to ask for it.

  • LuAnn

    LuAnn

    May 28th, 2014 at 8:59 AM

    Hi Perry –

    The purpose of identifying the triggering events with a therapist (as opposed to stumbling upon them unexpectedly) is to learn to recognize your triggers, learn how to respond when you are triggered and with EMDR, to disconnect those memories from the symptoms. Many people go through life without therapy, but the outcome can be devastating. While it is scary to address these issues with a therapist, it is easier than being haunted by the triggers and memories repeatedly with no help to manage the symptoms. However, you are right that it is still scary and you definitely need to work with a therapist you trust.

  • Perry

    Perry

    May 29th, 2014 at 3:46 AM

    Thanks LuAnn I appreciate the feedback. I can see that going through this alone would definitely be a terrifying thing for most of us. I guess that if you can begin to see what causes the pain and the flashbacks then you can then take steps to avoid the things that could cause them.

  • Sara Staggs, LICSW

    Sara Staggs, LICSW

    May 30th, 2014 at 11:53 AM

    As a licensed therapist trained in both EMDR and CBT, I wanted to mention a point of clarification: EMDR is not CBT plus bilateral stimulation. EMDR is a trauma therapy with its own 8 step protocol based on the Adaptive Information Processing model. They are completely separate from each other.

  • Paige

    Paige

    May 31st, 2014 at 7:14 AM

    Do you have any suggestions for how to get someone who I think that could use therapy for what I do believe could be PTSD to at least think about doing it?

    It has to be scary and I know that but I really think that this person could seriously use the help but I don’t even know how to approach this with her.

  • LuAnn

    LuAnn

    June 1st, 2014 at 3:34 PM

    Sara – Thanks for that clarification. I will make that change.

    Paige. You might offer to go with this person to the initial appt to find out more shout and give him/her some literature to read.

  • Jack R.

    Jack R.

    June 28th, 2014 at 8:52 AM

    I’d be interested to know if anyone else can recommend Primal Therapy for physical abuse post traumatic stress disorder, rather than the Charlatans’ Charter of CBT.

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