Post-Traumatic Stress Disorder

Overview

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that is triggered by experiencing or witnessing a terrifying event. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. The disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a trauma- and stressor-related disorder.

A person sitting alone in a dimly lit room, their face obscured by shadow. They appear to be deep in thought or distress.

Symptoms

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.

Intrusive Memories

Symptoms of intrusive memories may include:

Recurrent, unwanted distressing memories of the traumatic event
Flashbacks to the traumatic event
Upsetting dreams or nightmares about the traumatic event
Severe emotional distress or physical reactions to something that reminds one of the traumatic event

Avoidance

Symptoms of avoidance may include:

Trying to avoid thinking or talking about the traumatic event
Avoiding places, activities or people that remind one of the traumatic event

Negative Changes in Thinking and Mood

Symptoms of negative changes in thinking and mood may include:

Negative feelings about oneself or other people
Inability to experience positive emotions
Feeling emotionally numb
Lack of interest in activities one once enjoyed
Hopelessness about the future
Memory problems, including not remembering important aspects of the traumatic event
Difficulty maintaining close relationships

Changes in Physical and Emotional Reactions

Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

Being easily startled or frightened
Always being on guard for danger
Self-destructive behavior, such as drinking too much or driving too fast
Trouble sleeping
Trouble concentrating
Irritability, angry outbursts or aggressive behavior
Overwhelming guilt or shame

Causes

PTSD is caused by experiencing, witnessing, or learning about an event involving actual or threatened death, serious injury, or sexual violation. The traumatic event can be a single occurrence, or an enduring or repeating event or events. Certain aspects of the traumatic event and some biological factors may make some people more likely to develop PTSD.

Diagnosis

Diagnosis of PTSD requires exposure to an event that involved death, threat of death, serious injury, or sexual violence. This exposure can occur in various ways. The DSM-5 lists four symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. The sixth criterion concerns duration of symptoms; the seventh assesses functioning; and, the eighth criterion clarifies symptoms as not attributable to a substance or co-occurring medical condition.

Treatment

Treatment for PTSD typically begins with a detailed evaluation, and development of a treatment plan that meets the unique needs of the survivor. Generally, PTSD treatment involves psychotherapy, medication, or both. Most people with PTSD undergo a combination of psychotherapy and medication.