What is PTSD?
Following a traumatic event, is it very common for people to experience emotional distress. As time passes, the intensity of that distress typically decreases. For Post-Traumatic Stress Disorder (PTSD) sufferers, however, symptoms persist long after the trauma. People with PTSD continue to re-experience the traumatic event, often through flashbacks, leading to a high degree of distress and ongoing life impairment. Fortunately, effective treatments have been developed.
How common is PTSD?
It is important to note that most people who have a traumatic experience will not develop Post-Traumatic Stress Disorder. Anyone can develop PTSD at any age. Overall, PTSD affects 3.5% of the U.S. adult population, about 8 million Americans. Women are diagnosed with PTSD at approximately twice the rate of men—1 out of 9 women.
How do we define a traumatic event?
The human condition is full of diverse and meaningful experiences. Unfortunately, some of those experiences will be emotionally painful. The Diagnostic and Statistical Manual, Fifth Edition (DSM-5) defines that a traumatic event involves a threat to a person’s life or witnessing such threats to loved ones. Using this definition, as many as 70% of adults in the U.S. have experienced a traumatic event. These events are typically sudden and unexpected and could be anything from seeing a death, being in a car accident, sexual assault, combat, or a natural disaster. They are capable of creating a moment of extreme, sheer panic in which one fears for one’s life or the life of a loved one.
To be diagnosed with PTSD, an adult must experience all of the following for at least 1 month:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two cognition and mood symptoms
- At least two arousal and reactivity symptoms
Types of PTSD
Basic symptom criteria are the same across the broad diagnosis of PTSD; however, remember that anyone can develop it at any age. As a result, PTSD may present in a variety of different ways. The identified types of PTSD defined by the DSM-5 include:
- Delayed onset/expression
The most recent edition of the DSM-5 included a new specifier for PTSD symptoms in children six years or younger. Symptoms of PTSD in children may appear differently than for adults. Children with PTSD may experience nightmares (which do not need to contain content related directly to the traumatic event), and they also may express distress through play.
Why do some people develop PTSD?
Not everyone who lives through a traumatic event develops PTSD. Numerous factors present before, during, and after the trauma play a role.
Risk factors that may increase the likelihood of developing the disorder include:
- Exposure to dangerous events or traumas.
- Getting hurt or seeing people hurt or killed.
- Childhood trauma.
- Feeling horror, helplessness, or extreme fear.
- Having little or no social support after the event.
- Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.
- Having a personal history or family history of mental illness or substance use.
Resilience factors that may reduce the likelihood of developing PTSD include:
- Seeking out support from friends, family, or support groups.
- Learning to feel okay with one’s actions in response to a traumatic event.
- Having a coping strategy for getting through and learning from a traumatic event.
- Being prepared and able to respond to upsetting events as they occur, despite feeling fear.
Myths vs. Facts
Myth: Only war veterans develop PTSD. / Fact: Anyone can develop PTSD at any time.
Myth: A trauma is any difficult event in life. / Fact: There are many things in life that cause feelings of upset, but not just any upsetting event can cause PTSD. For instance, a breakup, losing a job, or the death of a pet cannot in themselves lead to PTSD.
Myth: Only weak people get PTSD. / Fact: PTSD is not determined by strength or weakness. There are many different risk factors that contribute to developing PTSD.
Myth: PTSD is not a treatable condition. / Fact: There are currently several well-researched, effective PTSD treatments.
Effective Treatment Methods
The symptoms of PTSD can be debilitating if left untreated, so it is important to seek help. There are several known effective PTSD treatments. The recommended treatment programs for PTSD are “trauma-focused” psychotherapies. and are most often treated at an outpatient level of care. These treatments focus on the memory of the traumatic event or its meaning. They use different techniques to help you process the trauma including visualizing, talking or thinking about it. Cognitive Behavioral Therapy approaches focus on changing unhelpful beliefs about the trauma. Sometimes these psychotherapeutic approaches are undertaken in combination with medication.
Prolonged Exposure (PE)
Prolonged Exposure (PE) is a specific type of Cognitive Behavioral Therapy which focuses on exposure. PE teaches the sufferer to gradually approach trauma-related memories, feelings, and situations that they have been avoiding since the traumatic event. Research has shown that this approach has been highly effectively in decreasing the symptoms of PTSD. Learn more about PE by watching the video below.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is another specific type of Cognitive Behavioral Therapy. CPT builds from the idea that if you change your thoughts, you can change the way you feel. CPT teaches sufferers to evaluate and change the upsetting thoughts they have experienced since their trauma.
After a trauma, the way you think about yourself and the world can change. You may not trust that the world is a safe place, and/or blame yourself for what happened. These perspectives may keep you stuck in your PTSD symptoms and cause you to miss out on pleasure in life. CPT teaches skills to handle upsetting, recurring thoughts. You will learn how to decide whether the facts support your thought or do not support your thought. It helps you to ask yourself: “Is my current perspective useful, or can I think about things differently?”
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a psychotherapy that can help you process upsetting memories, thoughts, and feelings related to the traumatic event. Processing these experiences leads to relief from PTSD symptoms.
After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps you process the trauma, which can allow you to start to heal. While processing, you pay attention to a back-and-forth movement or sound while you call to mind the upsetting memory. You continue to do a bilateral stimulation while focusing on your target until shifts occur in the way that you experience that memory and information from the past.
OCD & PTSD
Post-Traumatic Stress Disorder (PTSD) and Obsessive-Compulsive Disorder (OCD) can co-occur in people with a history of trauma. Research shows that the likelihood of a person diagnosed with PTSD developing OCD within a year is about 30%. At MSAM, Harold Kirby (LCSW/BCD) specializes in the treatment of both OCD and PTSD.
If you or someone you know is struggling to cope with trauma, it may be time to contact a mental health provider for support. No one should face PTSD alone; help is available. A professional evaluation can help determine the most appropriate treatment and level of care including medication management, outpatient or even residential treatment if indicated. Contact Harold Kirby at 610-517-3127 for a consultation or simply to learn more about treatment for PTSD.