Post-Traumatic Stress Disorder (PTSD): Causes, Symptoms, and Treatments

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June is recognized as Post-Traumatic Stress Disorder (PTSD) Awareness Month. Here we’ll cover an overview of the causes, symptoms, and evidence-based treatments for PTSD.

What is trauma?

The American Psychological Association (APA) defines trauma as an emotional response to a “terrible event”. There are many types of events that could elicit a trauma response, but examples include exposure to actual or threatened death, serious injury, sexual violence, or a natural disaster. 

Besides directly experiencing or witnessing such an event, learning that a traumatic event has occurred to a loved one could also be experienced as traumatic. Further, repeatedly being exposed to the details of traumatic events can elicit trauma, so first responders and other professionals frequently encountering tragedies are also at risk of developing PTSD. 

What is PTSD?

The APA defines PTSD as an anxious reaction to experiencing a traumatic event. 

Symptoms of PTSD

This “anxious reaction” could look different from person to person, but PTSD is characterized by four cardinal symptom clusters:

  1. Re-experiencing symptoms: distressing memories or dreams of the event, flashbacks, feeling “triggered”, panic attacks.
  2. Avoidance of distressing memories, thoughts, feelings, people, places, conversations, activities, objects, or situations related to the event.
  3. Negative changes in thoughts and mood: memory loss related to the event, negative beliefs about oneself, others, or the world, blaming oneself or others for the event, persistent negative moods, loss of interest in activities, missing important events, feeling detached and withdrawn, inability to experience positive emotions.
  4. Significant changes in physiological arousal and reactivity: irritable behavior and angry outbursts, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, difficulty concentrating, sleep disturbances.

Symptoms from each cluster must be present in order for PTSD to be diagnosed. Short-term symptoms are common in the immediate aftermath of a traumatic event, so PTSD can only be diagnosed if the above symptoms persist for more than one month. Symptoms lasting less than one month may indicate Acute Stress Disorder (ASD). Further, the symptoms must cause clinically significant distress or impairment in the person’s functioning.

In some cases, the person may not experience all of these symptoms right away. In cases where the diagnostic criteria for PTSD are not met until at least 6 months after the event, the PTSD is considered to have a “delayed onset”. 

In some cases, the person may also experience either of the following dissociative symptoms: 

  1. Depersonalization: Often feeling detached from one’s mental processes or body. Those experiencing depersonalization might feel as if they were an outside observer of themselves, or as if they were in a dream, or that time is moving slowly, or a sense of “unreality”, as if they were not real. 
  2. Derealization: Frequent experiences of “unreality” of surroundings. For example, the person may feel as though their environment is not real, dreamlike, distorted, or distant.

Why do some people get PTSD and others don’t?

Not everyone who experiences trauma will develop PTSD. Research suggests that the person’s level of distress during the event is a predictor of future PTSD symptoms. That is, acute stress and fear experienced during the traumatic event as well as frightening memories of the event have been linked to the development of post-traumatic symptoms. 

Those with a history of other mental health problems like anxiety and/or depression may also be more likely to develop PTSD in the aftermath of trauma. Finally, the lack of a robust social support system is another risk factor for developing PTSD. 

Evidence-Based Treatments for PTSD

The APA recommends several evidence-based treatments for PTSD: 

  • Prolonged Exposure (PE): PE includes exposure to situations, places, people, memories, thoughts, and emotions related to the traumatic event the patient has been avoiding because of a fear response. Exposure is practiced until the fear response decreases. 
  • Cognitive Processing Therapy (CPT): A specific type of cognitive-behavioral therapy that helps patients learn how to modify and challenge unhelpful beliefs related to the trauma.
  • Trauma-focused Cognitive Behavioral Therapy (TF-CBT): Treatment for children and adolescents impacted by trauma and their parents or caregivers. It incorporates cognitive-behavioral, family, and humanistic principles and techniques. 
  • Eye Movement Desensitization and Repressing (EMDR): Sometimes called “tapping therapy”, EMDR involves the patient focusing on memories of the trauma while simultaneously experiencing bilateral stimulation (typically eye movements or tapping), which has been linked to a reduction in distress associated with trauma memories.

Getting Help for PTSD

Great Lakes Psychology Group connects you to online and in-person PTSD counseling. The GLPG network includes a wide variety of therapists who specialize in evidence-based treatments for trauma and PTSD.