Post-Traumatic Stress Disorder
PTSD is a disorder that can affect both your mental and your physical health. It can be caused by a single trauma or by many traumatic events. PTSD can result from being exposed in some way to death or potential death, serious physical injury, or sexual assault, directed at you or at someone else.
Each person’s response to a traumatic event is unique and two people living through the same event may process it differently. This response depends on factors like life histories, current situations and emotional characteristics.
Being traumatized by witnessing or experiencing something horrific is not a sign of weakness or fragility.
A healthcare provider may diagnose your family member or friend with PTSD if the person shows symptoms in each of the following four categories for more than one month:
- Re-experiencing the feelings and sensations felt at the time of the trauma
- Avoiding reminders of the trauma
- Negative thoughts or feelings about themselves, those around them, or a situation or location
- Feeling on edge or reactive, either physically or emotionally, without reason (also known as hyper-arousal)
PTSD can emerge from any number of traumatic situations. These may include:
- Military service in a conflict zone
- Witnessing atrocities while on deployment
- Incidents during service in uniform, such as domestic operations or Aid to the Civil Power
- Experiencing a natural disaster and providing rescue or relief support afterwards
- Terrorism or mass violence
- Domestic abuse, intimate partner or family violence
- Gender, race, or culture-based attacks or stress
- Sexual violence
In addition to these traumatic situations, emerging evidence shows that oppression – such as discrimination and attacks based on a person’s gender, sexual orientation, race and culture – may lead to PTSD.
Experiencing moral injury can also increase your family member or friend’s risk for developing PTSD. Moral injury refers to the psychological, social and spiritual impact of events in which a person performs, witnesses, or fails to prevent acts that conflict with one’s own deeply held moral beliefs and values. To learn more about moral injury, visit this webpage.
Everyone experiences PTSD differently. Some symptoms even contradict other symptoms. You may experience some of these, but not others. Not everyone who experiences or sees trauma develops PTSD.
Here are some examples of what you might experience if you have PTSD:
- I feel upset out of the blue
- I have thoughts and memories that are hard to cope with.
- I feel panicky – my heart is racing and I feel sweaty and frightened.
- I’m having a flashback – it’s like I’m right back in the situation that caused the trauma.
- I have trouble sleeping peacefully – I have nightmares and anxious dreams regularly.
- I have difficulty paying attention because of intrusive thoughts or images.
- I don’t want to go out in case I get triggered.
- I can’t let myself think about what I experienced when the trauma happened – it’s too painful and I’m afraid I’m going to lose control.
- As hard as I try, I can’t feel anything about the trauma that happened. It’s like it happened to someone else. I know the feelings are inside of me, but I can’t reach them.
- I’m drinking, smoking up, or using drugs to help me keep my feelings under control.
- I spend a lot of time on my own, even though it leaves me feeling lonely and isolated.
- I have no interest in going out to do things or to see people.
- I keep myself very busy so that I don’t have to remember my trauma or feel my emotions.
- I find it hard to feel positive about my life today and in the future.
- I find it hard to trust other people.
- I blame myself for causing the trauma, or for not being able to stop it.
- I know in my head that I love the people in my life, but I have trouble actually feeling it. I feel separate from them and distant.
- I have a difficult feelings like anger, aggression and fear. Other times, I feel guilty, ashamed and horrified at what I’ve seen or done.
- Much of the time I have difficulty feeling happy, optimistic or content. I often feel little interest in my life or in things that used to matter to me.
- I have a quick temper and get irritated easily.
- I find myself feeling road rage more often.
- I feel like I’m waiting for the next trauma or attack – I’m suspicious and on guard looking for possible risks or threats.
- I need to sit with my back to the wall in public places.
- I need to know where my loved ones are at all times.
- I often feel distracted and have trouble concentrating.
- I will do things that are risky or reckless.
These reactions are a natural response to trauma. It is not a sign of weakness if you develop PTSD when someone else in a similar situation does not. Your experiences and feelings are valid.
Asking for help is not a sign of weakness either. There are proven treatments for PTSD and many qualified people ready to help you.
Diagnosis and therapy
Getting a diagnosis will not change your symptoms, but it is an important step to get the right treatment. A diagnosis of PTSD can be made by a qualified service provider, like a psychiatrist or psychologist. To do so, service providers will explore:
- The presence of a traumatic experience, such as those listed under “What causes PTSD?” above
- Your symptoms in the four categories listed in “What are the symptoms of PTSD?” above
Even when diagnosed, PTSD does not usually go away on its own. Without support, symptoms may even get worse. Getting therapy might help you to:
- Feel more productive and positive
- Return to work
- Heal or strengthen relationships
- Stop symptoms from getting worse
- Get better control of your feelings and your life
- Learn skills and tools to manage your symptoms
- Feel better in your everyday life (mind, body, and spirit)
“I finally realized it didn’t have to be so hard . . . ”
Hear the strong voices of those who are living in Veteran Families with post-traumatic stress.
“The hope I want is the ability to enjoy life again . . .”
Listen to a Veteran talk about life after service and rebuilding after a diagnosis of PTSD. Treatment really can work. Healing is possible.
When you get support, your care provider should tell you about trauma in general, and about the specific plan for your therapy. You should decide together if you are ready to start, and you should be able to ask as many questions as you want about your therapy and progress at any time.
The most frequently recommended therapies for PTSD are called Trauma-Focused Psychotherapies. These types of therapies help you work through the memories of the trauma and/or what they mean in your life. It is not always easy to do, but by working with a trusted professional, and with the support of family or friends, it can produce very good results.
The five most highly recommended Trauma-Focused Psychotherapies are
(These options are intended for informational purposes. This information is not a substitute for medical care or advice from a provider. Only qualified, licensed professionals can diagnose PTSD. Atlas Institute does not provide direct clinical care).
Deciding on a treatment
Individual characteristics and experiences play an important role in understanding and shaping treatment. Demographics, the nature of the trauma, symptoms and other mental and physical health conditions all factor into your individual treatment plan.
While people with PTSD may have some characteristics in common, all individuals have their own particular needs and goals. When choosing the best treatment, you and your service provider should consider your personal characteristics, values, and preferences, the research evidence about treatments for PTSD, and clinical expertise. This fit may also change over time, as you change, and as new research and treatments emerge.
Treating PTSD alongside other conditions
It is common for people with PTSD to have other mental or physical health conditions as well.
These can include:
- Chronic pain
- Suicidal thoughts
- Substance-use disorder
Depending on your circumstances, your service provider may recommend starting with PTSD therapy. They may also recommend treating another condition first so that the PTSD treatment is as effective as it can be. Your characteristics, experiences, and therapy goals will influence this decision. Work with your doctor, therapist or other service provider to make the best decision for you.