Post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after a single traumatic event or multiple events. It causes people to relive the trauma in their minds, and they may have nightmares or flashbacks of past events. Read our article and find out – what are the symptoms of PTSD, what are the types of PTSD and what are the treatments?
Post-traumatic stress disorder – what is PTSD ?
PTSD is an anxiety disorder characterized by a multitude of symptoms that enable normal functioning. Symptoms usually do not develop immediately after the trauma, only after some time. In the case of PTSD, symptoms persist 6 weeks after the traumatic event. First of all, the person experiences intrusive memories (flashbacks, nightmares or disturbing thoughts about the traumatic event). Often the experience is accompanied by emotional numbness: avoidance of activities and people that remind one of the trauma, apathy and lack of interest in life. Excessive agitation: irritability, outbursts of anger, difficulty sleeping.
A severe stress reaction occurs as a result of a traumatic event that exceeds mental resources. A traumatic event is one that can lead to death, severe injury or a threat to one’s sense of physical security. These events usually include, most often, tragic car accidents, violent crimes such as rape and assault. Post-traumatic stress syndrome can also arise after natural disasters such as tsunamis, earthquakes, fires, floods or volcanic eruptions, other events such as war or terrorist attacks.
The disorder was first recognized in the 1980s, when soldiers began returning from Vietnam, with symptoms such as flashbacks to past events, nightmares and hyper-vigilance.
Post-traumatic stress disorder can be triggered by childhood abuse or neglect. Childhood traumas include physical and sexual abuse, children are one of the most affected groups that can experience PTSD. Their vulnerability and dependence, and lack of sufficient resources to cope with the stressor, make them a high-risk group.
Post-traumatic stress disorder – symptoms of PTSD
PTSD symptoms are often severe enough to interfere with daily activities. PTSD sufferers may experience repeated reliving of traumatic events for weeks or months, either in nightmares, disturbing daydreams or intrusive imagery known as intrusions. Some people react to memories of trauma with bodily sensations e.g. rapid heartbeat, shortness of breath, muscle tension.
A person who has experienced life-threatening stressful events may develop PTSD, resulting in somatic symptoms and persistent symptoms. Avoiding situations that are reminiscent of traumatic events is one way to cope with complex post-traumatic stress disorder
Additional, most common symptoms include:
Avoidance. Most PTSD sufferers take steps to avoid frightening stimuli associated with the trauma – they don’t want to watch videos or read descriptions of the event that they associate with the trauma.
Negativism. Patients suffering from PTSD begin to adopt pessimistic visions of themselves and the world. They experience gloomy thoughts about themselves: “I am helpless, weak, out of control” and the world: “the world is a dangerous place, I can’t trust anyone.”
Indifference. Individuals lose interest in their own activities, goals, passions, and feel indifference to other people.
Overstimulation. Patients experience symptoms of over-stimulation, sensitivity, excessive breathlessness, problems with concentration or insomnia.
Diagnosis of post-traumatic stress disorder
For the diagnosis of PTSD, the duration of symptoms is important, which – to meet diagnostic criteria – should last for more than a month. The patient_ experiences distress, has difficulties in professional, school, social or personal functioning.
A person experiencing PTSD, has a sense of reliving traumatic events. He or she tries to avoid unpleasant thoughts and emotions. Often, patients with PTSD indicate negative feelings such as guilt or personal responsibility, such as “I should have prevented it.”
A diagnosis of PTSD excludes stressful experiences from daily life, such as bereavement, divorce, serious illness, social exclusion. Watching TV, images of a disaster is not considered a sufficient stressor, unless watching disasters or traumatic events is related to a person’s work, in which case we can presume that there is vicarious, secondary trauma.
Post-traumatic stress disorder is often co-occurring with mood disorders, anxiety disorders and substance abuse disorders.
Additional factors that increase the risk of PTSD. Causes of post-traumatic stress disorder
In addition to the traumatic event itself, other factors may play a role in the development of PTSD. Individual factors include a person’s personality structure and genetic endowment. In addition, intelligence and education levels are positively correlated with PTSD.
Environmental factors, including socioeconomic status and membership in a racial, sexual or ethnic minority, affect the risk of developing PTSD.
Age and gender are important factors. Older people are less likely to develop symptoms than younger people, and women tend to have a slightly higher incidence than men.
The duration of the trauma is important, i.e. whether it was a single event or a certain period of the patient’s life dominated by horrific experiences. In general, the more prolonged the experience of trauma, the greater the likelihood of developing the disorder will be.
Subtypes of PTSD
There are two types of PTSD. The simple subtype of PTSD relates to a single event experienced, including a car accident or flood, usually experienced in adulthood.
Complex PTSD will develop as a result of repeated events, often lasting for an extended period of time, such as domestic violence or the experience of war. A person suffering from complex PTSD has a wider range of symptoms and presents with more risk behaviors, e.g. self-harm, suicide attempts, dissociation, memory impairment.
Flashback vs. psychology
The term flashback is used to refer to a mental image of a past event that appears without warning, intruding into the patient’s reality in an intrusive way. The term “flashback” itself comes from the verb “flash” – “to flash” (to come out suddenly and briefly) with the temporal element “-back” – “return to”. Thus, “flashback” means “to return suddenly and briefly”.
Flashback can be triggered by an event in the present that is associated in some way with a traumatic event from the past, or it can occur without any connection to what is happening in the present. The person feels as if he or she is back in the traumatic moment. The memory can last from a few seconds to a few minutes. Retrospectives can involve sight, smell or hearing. A flashback is often described as a movie playing in the head. When experiencing flashbacks, there is always a negative affect, or negative emotional experience.
PTSD in a relationship
Is it possible to experience trauma in a relationship? Of course. Physical abuse and sexual violence can result in post-traumatic stress disorder PTSD.
Physical violence in a relationship is a form of abuse that can have long-term effects on those who experience it. Sexual violence includes unwanted touching or kissing, forced sex (rape) or attempts to coerce the victim into sexual activity. Marital violence, an interpersonal trauma, is a serious problem with devastating consequences for those who experience it. Long-term experience of violence can lead to mental disorders such as depression, chronic fatigue syndrome, anxiety, and post-traumatic stress disorder.
Post-traumatic stress syndrome is associated with many emotions of shame. People who have experienced trauma feel that they should be able to cope with these difficult events on their own, and that talking about it will make them look weak or vulnerable. But this type of belief can be dangerous and make people isolate themselves from those around them.
To combat this isolation, it is important for people who have experienced or are experiencing trauma to find support outside of their relationships. It’s a good idea to talk to friends or family members, join a local support group and, most importantly, go to a center that helps victims of violence to receive specialized legal and psychological help.
Combat stress syndrome
Combat stress syndrome is a psychological trauma that can be caused by exposure to combat. It is a condition that can affect both soldiers and civilians. Experiencing the negative consequences of war can happen to anyone who faces the sights of war, regardless of age or military rank. It can cause physical and emotional reactions such as anxiety, depression, anger, irritability and sleep disturbances. Combat stress syndrome is a disorder that anyone who is surrounded by war can suffer from. It is usually caused by the traumatic experience of being in combat. Symptoms of PTSD include flashbacks, nightmares, and prolonged anxiety.
Trauma after an accident
Although there has been a decrease in the number of traffic accidents over the past few years, there are still a great many patients who are injured and develop post-traumatic stress disorder as a result of accidents. They may be passengers, pedestrians, cyclists. In addition to the health consequences, they also experience extreme insecurity and lack of control. The experience of PTSD after a severe accident is also compounded by physical injuries, somatic pain and often a lengthy rehabilitation process.
PTSD treatment
Post-traumatic stress disorder is a serious disorder. It is important for patients to speak out about what is happening to them and seek help for PTSD symptoms. People with post-traumatic stress disorder, may experience sleep problems, have nightmares, feel detached or numb, avoid thoughts of what happened, have flashbacks and feel irritable or nervous.
Severe stress and a traumatic experience can put an individual at risk of developing PTSD, which manifests itself in persistent physical and psychological symptoms. In the treatment of post-traumatic stress disorder, a therapist can help the patient feel better through appropriate therapeutic methods and prevent the development of PTSD by controlling symptoms that persist for a long time
The most common treatment for PTSD is psychotherapy often with the inclusion of pharmacotherapy, especially when there is a co-occurring disorder. Pharmacological treatments used to treat PTSD in adults include antidepressants (usually selective serotonin reuptake inhibitors such as sertraline, e.g. Zoloft), citalopram (e.g. Celexa) or escitalopram (e.g. Blue Fish), and anti-anxiety med ications (usually benzodiazepines such as diazepam).
Therapy, PTSD – treatment
Psychotherapy includes cognitive-behavioral therapy (CBT), prolonged exposure therapy, desensitization therapy and eye movement reprocessing (EMDR).
Prolonged exposure method
The prolonged exposure method is a type of cognitive-behavioral therapy that has proven effective in treating PTSD. It is based on exposure techniques(in imagination and in vivo), but the mechanism of change is seen not so much in the process of habituation, i.e. getting used to the stimulus (which of course is the case), but is linked to the emotional and cognitive processing of the traumatic experience.
Cognitive-behavioral therapy CBT, Trauma-focused cognitive-behavioral therapy TF-CBT
Specialists working in the CBT stream emphasize that the mere apprehension and recall of the traumatic event is a pretext for modifying dysfunctional beliefs and attitudes revealed during the exposure. The authors of the cognitive model of PTSD emphasize that the primary factor responsible for the persistence of PTSD is an ongoing sense of threat and maladaptive beliefs about oneself and the world that are formed as a result of the traumatic event.
The work of changing the way of understanding involves looking at how the patient_ understands what happened to her, and assessing whether this perspective is fair or helpful – whether it serves her/him. The working method of these therapies is to change the way people think about trauma and its effects. Research on trauma has shown that if we can change our understanding of trauma, we can change how we feel and how we experience it. The work is also related to reducing avoidance strategies, which helps challenge incorrect beliefs and focuses on working through memories of the traumatic event and the meaning the patient_has given to it.
Regardless of the methodology, the most important thing is to face the memories. Psychologists believe that facing the problem allows one to look at different aspects of the experience in a different way, discover new elements of gaining a new perspective, and, above all, freeing oneself from the role of victim.
PTSD-treatment. What aspects to diagnose and treat?
There are several key areas necessary to work through the trauma in the process of psychotherapy.
Shame
A person with PTSD experiences shame, which is associated with secrets and secrecy, which in turn can affect increased responsibility for what happened. Letting go of the secret and starting a conversation is the first step in combating shame.
Relationships
Traumatic experiences reinforce the tendency to step into the role of victim, isolation and distrust in close relationships. Patients/patients are observed to have a distorted view of others, perpetuating negative judgments, such as a frequent preoccupation with their own relationship with the perpetrator, or a belief that the perpetrator still has full power. Therapeutic work is aimed at strengthening belief in some people around them and developing the ability to enter into good, safe relationships.
Beliefs
Beliefs about one’s own self and about what happened, what happened to the patient_ can compound helplessness, feelings of guilt, feelings of hurt. In therapeutic work, we begin to process these events in a different way, looking for alternative views, perspectives on the trauma and the self/self. It is worthwhile for people with PTSD to remember that they are not to blame for the violence, they do not deserve it. They are strong despite these difficult experiences.
Health
Therapeutic work focuses on taking care of health and the body. Interventions are primarily aimed at lowering tension in the body, breathing training, visualization techniques, and muscle relaxation. Work on minimizing symptoms related to sleep or eating disorders.
Emotions
PTSD therapy supports the development of healthy adaptive coping skills to deal with feelings. It includes working to minimize vacillation and variability between feelings of numbness and loss of control.
Psychotherapy can help you break free from symptoms and find ways to better cope with life. If you are experiencing symptoms of post-traumatic stress disorder, contact us for cognitive behavioral therapy.