Post-Traumatic Stress Disorder (PTSD)
WHAT IS PTSD?
Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by witnessing or experiencing a traumatic event. Although often associated with military personnel who have served in active combat situations, PTSD can be triggered by any serious trauma.
Non-military situations that can lead to PTSD include living through a natural disaster, witnessing or experiencing domestic violence, bullying, being involved in a serious accident, or being a victim of rape or sexual assault. PTSD can also be caused by conditions of sustained stress, such as working in a highly stressful or toxic workplace environment.
PTSD is characterized by intense, disturbing thoughts that are related to the traumatic experience. These recurring thoughts last long after the occurrence of the traumatic event, even when the person experiencing PTSD is now in a safe environment. The traumatic event is often relived through flashbacks or nightmares. These unwelcome flashbacks and intrusive thoughts can be triggered by common situations such as loud noises, seeing a person that reminds them of their traumatic event, or being in an environment reminiscent of their traumatic event.
PTSD can be a debilitating condition. People experiencing PTSD often engage in avoidance behavior to prevent negative thoughts or flashbacks, which can cause disruption to everyday activities. For example, avoidance behavior can cause them to shun friends and family, avoid social gatherings, and limit career opportunities.
About 1 in 3 people who experience severe trauma will develop PTSD. Source
What Causes PTSD?
Research has still not determined exactly why people develop PTSD, but a number of theories have been proposed.
PTSD as a Survival Mechanism
PTSD may be the result of an instinctive mechanism intended to serve as a protection against further traumatic experiences. The flashbacks characteristic of PTSD may be the brain’s attempt to process the traumatic event in detail, so you’re better prepared for a similar situation in the future. The hypervigilance associated with PTSD is theorized as an attempt to help you react more quickly in a future crisis situation.
Although these responses may be rooted in a survival instinct, they are counterproductive to recovery. Rather than allowing the brain to process the trauma and move on, PTSD traps the person indefinitely in the traumatic experience without relief.
Adrenaline and PTSD
Studies have shown that people with PTSD have higher levels of stress hormones. In traumatic situations, the body releases stress hormones, including adrenaline, in the well-known “flight or fight” response. In people with PTSD, the body continues to produce high levels of stress hormones even when there is no present danger. The continuously elevated level of stress hormones is thought to cause the numbed emotions and hyperarousal that many people experience with PTSD.
Changes in the Brain from PTSD
In people with PTSD, parts of the brain associated with emotional processing show abnormal activity in brain scans. The hippocampus – the part of the brain responsible for memory and emotions – appears smaller in patients with PTSD. The changes in the hippocampus may be the cause of the loss of memory, heightened anxiety, and flashbacks associated with PTSD.
What are the Symptoms of PTSD?
There is not a uniform set of symptoms experienced by those suffering from PTSD. The disorder is highly variable and some people with PTSD will have multiple symptoms while others may only have one symptom characteristic of PTSD. The severity of symptoms will also vary from person to person.
In general, most people with PTSD will experience symptoms in at least one of four major symptom classifications. Symptoms include hyperarousal and hypervigilance, intrusive thoughts, avoidance behavior, and negative moods and cognitive behavior. Source
Hyperarousal and Hypervigilance
Hyperarousal is an increased physical and mental alertness, in which the body and mind are always on edge, ready to respond to outside stimuli. Individuals with PTSD who experience hyperarousal may be easily startled, have a disproportionate response when startled (such as reverting to combat responses, for example), or feel like they are always primed for action or constantly on edge. The hyperarousal may interfere with sleeping or cause frequent irritability or outbursts of anger.
Hypervigilance is a specific manifestation of hyperarousal where individuals are constantly monitoring for potential threats. Even in ordinary situations, such as eating at a restaurant, someone experiencing hypervigilance will constantly monitor exits, scan each person entering the restaurant, and frequently look out the window to check for external threats. This constant state of hypervigilance is extremely taxing, both mentally and physically, preventing any type of true relaxation or down time.
Popular culture portrayals of PTSD often feature individuals experiencing flashbacks. While the flashbacks may not be as dramatic as those portrayed by Hollywood, individuals with PTSD often do experience intrusive thoughts, memories, or nightmares related to the traumatic event.
Flashbacks are a vivid form of intrusive thoughts, where individuals feel as if they are reliving the traumatic event. These intrusive thoughts can cause further distress themselves, by constantly reminding the individual of the traumatic event. Individuals experiencing intrusive thoughts may also react in a disproportionate or embarrassing way, causing additional emotional harm.
Avoidance behavior involves changing one’s environment in an active attempt to avoid places, people, activities, or situations that could trigger a memory of the traumatic event and bring up a host of negative emotions. While avoidance behavior is a protective mechanism, it can actually interfere with daily life and relationships, making it difficult to hold down a job, maintain relationships with friends and family members, or engage in travel or social situations. This pattern of avoidance behavior makes it more difficult for the person suffering from PTSD to move beyond their traumatic experience and find healing.
Negative Mood and Cognitive Symptoms
People suffering from PTSD may habitually feel strong negative emotions such as fear, guilt, shame, anger, or sadness. Survivor’s guilt, for example, can trouble those who survived a traumatic situation where others did not. These strong negative emotions can supersede any positive emotions and lead to depression, hopelessness, and isolation. These negative emotions are often expressed as outbursts of anger or self-loathing.
PTSD can also cause cognitive issues, such as memory loss or difficulty concentrating. These cognitive difficulties can have a significant impact on the person’s career and personal relationships.
What Treatments Work for PTSD?
While there is not currently a cure for PTSD, there are several treatments which are effective at alleviating symptoms and making the disorder much more manageable. With treatment, those suffering from PTSD can reduce or eliminate the negative symptoms they experience, allowing them to live a normal life.
Common Treatments for PTSD
Cognitive Behavioral Therapy (CBT) is commonly recommended for PTSD and often one of the first treatments attempted. CBT seeks to help a patient process their past trauma, thus enabling them to move beyond the traumatic experience. A qualified mental health professional can help those with PTSD regain control of their thought patterns to eliminate intrusive thoughts, identify healthy coping strategies, and reduce outbursts associated with PTSD
Antidepressants are also used to help alleviate the symptoms of PTSD. People who suffer from PTSD often suffer from depression, too. Taking antidepressants as prescribed can help alleviate symptoms of both PTSD and depression. To receive a prescription for antidepressant medication, schedule an appointment with a psychiatrist or psychiatric mental health nurse practitioner (PMHNP) who can assess your symptoms and prescribe the right medication for you.
TMS is a safe, effective treatment delivered in a psychiatrist’s office that treats mental disorders, such as PTSD. TMS produces a stimulus/response effect in the brain, prompting the brain to develop new, healthy pathways that produce healthy brain function once again.
For military members and veterans, TMS is an especially effective option for treating PTSD. The treatment is a covered benefit under Tricare, the military health insurance, providing military members access to a highly effective PTSD treatment.
To be evaluated for TMS treatment, schedule an appointment with an Ampelis Health psychiatrist or PMHNP.
Which treatment is best for PTSD?
The best treatment for PTSD depends on several factors, such as the type of symptoms and the severity of symptoms, the patient’s own wishes, and the patient’s ability to adhere to a care plan. All these questions should be discussed with a qualified mental health professional, such as an Ampelis Health Utah-based psychiatrist or PMHNP.