Whether you or someone you know has PTSD, you might be filled with questions and concern. Here’s what to know.
Post-traumatic stress disorder (PTSD) is a serious mental health condition that develops after someone experiences trauma.
Sometimes, PTSD is used as a descriptor or label affixed to you, so some people may not fully understand what the condition entails and how to support those who have it.
PTSD is a mental health condition that can occur after someone has experienced or witnessed a traumatic event. Some examples include:
- natural disasters
- serious accidents
- terrorist acts
- a combat tour during wartime
- life threatening situations
- sexual violence
- a serious injury
PTSD affects around 7 million U.S. adults every year. It’s not limited to soldiers or survivors of sexual assault, as the media portrays.
This condition can happen to anyone — regardless of age or socioeconomic status. But according to the American Psychiatric Association, women are twice as likely to be diagnosed with PTSD as men. Latinos, Black Americans, and Indigenous Americans also have disproportionately higher rates of PTSD.
Q: What does PTSD look like?
A: PTSD can look different for each person. You may feel panicked, dreadful, or have palpable reactions in the present moment to something traumatic from your past.
While many people experience trauma, not everyone develops PTSD.
The signs and symptoms of PTSD can be frequent, on-and-off, or rare, but can feel just as strong now as they did during the traumatic event.
Symptoms fall into four categories:
- Intrusion: Intrusive symptoms may include flashbacks, nightmares, or distressing memories of the events. These are unwanted and involuntary symptoms that can lead to physical effects like a rapid heartbeat or sweating.
- Avoidance: You may avoid places, people, and situations that might trigger panic or memories of the traumatic event. You might also stay away from anything related that reminds you of the trauma, like certain types of movies.
- Arousal and reactivity: Arousal symptoms are constant, rather than brought on by a trigger. This can include persistent stress or anger. Reactivity involves changes to how you react to certain situations. You might become easily started or feel edgy. Arousal and reactivity can both lead to sleep issues and harmful coping behaviors.
- Changes in thoughts and moods: The way you think and feel can change when you have PTSD. This could manifest as trust issues, new and negative self-perceptions, or feeling continually “on guard.”
Q: I’ve heard a new term: CPTSD. What’s the difference?
A: Experts have recognized for a while that some types of trauma may come with additional symptoms. Complex PTSD (CPTSD) is a longer lasting form of PTSD that usually develops from ongoing trauma (like experiencing childhood abuse).
CPTSD Is not in the American-based Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it is listed in the International Classification of Diseases, 11th Revision (ICD-11).
If you’re experiencing complex PTSD, you may be more likely to have memory lapses or feel detached from yourself (disassociation), along with the other PTSD symptoms.
You’re more likely to develop complex PTSD if:
- you experienced trauma at an early age
- the trauma lasted for a long time
- escape or rescue were unlikely or impossible
- you’ve experienced multiple traumas
- you were harmed by someone close to you
Q: How is PTSD diagnosed?
A: PTSD is diagnosed using very specific criteria because it often overlaps or is misdiagnosed for similar conditions.
In order to receive a PTSD diagnosis, a mental health professional will look for at least:
- 1 recurring symptom
- 1 avoidance symptom
- 2 arousal and reactivity symptoms
- 2 cognition and mood symptoms
The above need to be present for at least 1 month and severe enough to interfere with things in your life — like relationships or work.
Over the years, research has started investigating blood tests to more accurately diagnose PTSD.
Q: How long does PTSD last?
A: According to the National Institute of Mental Health, some folks recover within 6 months, while others have symptoms that last much longer.
Older research in 2003 states that the length of time someone has PTSD symptoms for can depend on someone’s:
- proximity to the trauma
- duration and intensity of the trauma
- subjective interpretation of that trauma
The research also suggests that for people receiving regular treatment, the average duration of symptoms was around 3 years. In people living undiagnosed or not actively seeking treatment, the symptoms persisted for closer to 5 1/2 years.
Q: What is it about these life or death events that causes PTSD in some and not others?
A: Out of people who survive trauma, 25–30% develop PTSD.
PTSD may occur for a few reasons, including:
Changes in the brain
The brain areas involved in PTSD are the amygdala, hippocampus, and prefrontal cortex. PTSD may cause lasting changes in these brain areas.
In people with PTSD, the hippocampus appears smaller, which may not leave adequate space for flashbacks and nightmares to be fully processed. Unprocessed memories may mean that anxiety stays fresh over time.
People with PTSD may also have increased levels of cortisol (the stress hormone).
Symptoms of PTSD can be the result of an innate survival mechanism that’s intended to help you survive potential trauma in the future.
Your brain might fixate on a past trauma event in detail, so you’re better prepared if it — or something similar — happens again.
Especially when it comes to arousal symptoms, edginess is the body’s way to create readiness — helping you react in another crisis.
Your body’s survival mechanism activates the sympathetic nervous system. It’s like a fire hydrant. It does its job to help put the fire out but needs a firefighter to provide the tools to turn it off.
The same can be said for therapy and PTSD treatments that help to transition your body to its relaxation response, activating the parasympathetic nervous system.
Anxiety or depression
If you’ve had depression or anxiety in the past, you’re more likely to develop PTSD after a traumatic event.
Q: Is it helpful for people with PTSD to talk about the trauma? Should I offer them a vent session?
A: Talk therapies are helpful for people with PTSD to discuss the trauma, their symptoms, and work through it, but this is done with a professional.
It’s not recommended that you try to pull the story out of someone you know or love. Let them open up however they feel comfortable.
There may be times someone you know will let you into their lived experience.
Perhaps they’re explaining a seemingly out-of-place behavior of theirs recently. Or maybe they’re being transparent about what’s on their mind when you ask what they were thinking about when they looked lost in thought.
Just remember: Unsolicited prodding can violate a person’s boundaries, increase PTSD symptoms, and spoil your sincere intentions to support them.
Q: So what’s the treatment for PTSD?
A: There are several options for managing PTSD.
Trauma-focused therapies, which usually last about 8–16 sessions, include:
- trauma-focused cognitive behavioral therapy (TF-CBT)
- eye movement desensitization and reprocessing (EMDR)
- prolonged exposure therapy
- cognitive restructuring
Your doctor may also recommend antidepressants for relieving some of your symptoms. Common types include:
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- selective serotonin reuptake inhibitors (SSRIs)
Anyone can develop PTSD — it starts with one or an ongoing traumatic event where someone was in real danger, perceived a threat to their life, or witnessed danger or violence.
Historical injustices, along with healthcare and economic inequities, may lead to higher rates of PTSD in some people. Preexisting mental health conditions and genetic components can also play a role.
Whether you or a loved one has PTSD (or CPTSD), there’s hope. Many therapies and treatment options are available.
Receiving a diagnosis of PTSD is an actionable first step to healing. Psychotherapy, medications to treat related symptoms, and a support system can all help you reduce your condition’s severity and duration.
You may want to seek support from friends, family members, your community, or peer support groups.