Choose the content to read

• What is PTSD?
• What are the symptoms of PTSD?
• What causes PTSD?
• What are the complications of PTSD?
• How is PTSD diagnosed?
• How is PTSD treated?
• A note from MedPark's doctor

What is PTSD?

Post-traumatic stress disorder or PTSD is a mental health condition that occurs after exposure to severe traumas, impacting both body and mind. After the event, individuals with PTSD often feel as if they are reliving the traumatic experience repeatedly. They may suffer from intense stress, anxiety, guilt, or shame related to the event. These individuals might also have recurring nightmares about the incident and tend to avoid places or conversations about it. The distress from PTSD can be so overwhelming that it disrupts daily life.

Traumatic events that cause psychological wounds are usually intense and life-threatening situations. Individuals may be directly involved in or witnessing such events. Examples include car accidents, the loss of a loved one, long-term physical and emotional abuse, severe injury or illness, war, and natural disasters such as fires or earthquakes.

What are the types of PTSD?

• Acute Stress Disorder (ASD): This condition usually arises within the first month following a traumatic event. If the symptoms persist beyond one month, it may progress into PTSD.
• Complex PTSD (CPTSD): This form of PTSD results from prolonged and recurring traumatic experiences, such as war or physical or sexual abuse during childhood over an extended period. Individuals with CPTSD often exhibit the symptoms of PTSD alongside additional emotional, psychological, and interpersonal difficulties.

What are the symptoms of PTSD?

• Intrusive thoughts: These include nightmares and haunting memories of the traumatic event. Individuals may experience flashbacks, feeling as though they are reliving the event all over again.
• Avoidance: This involves steering clear of anything that might trigger memories of the traumatic event. Individuals with PTSD often avoid talking about the event or their feelings associated with it.
• Alterations in cognition and moods: Individuals may be unable to recall key details of the traumatic event, harbor negative thoughts, blame themselves, and feel fearful, angry, or easily irritated. They might lose interest in activities they once enjoyed, withdraw from social interactions, and experience a pervasive sense of unhappiness.
• Changes in arousal and reactivity: Symptoms include irritability, being easily startled, heightened anxiety, hypervigilance, difficulty concentrating, and sleep disturbances.

Individuals who have experienced traumatic events will often exhibit the symptoms above. However, those with PTSD endure these symptoms for longer than one month, and the severity of their condition significantly disrupts daily life. PTSD can lead to depression and memory problems and may drive individuals to substance abuse as a means to escape and numb their reality.

What causes PTSD?

Approximately 61-80% of the population experience a traumatic event in their lifetime, and about 5-10% of these individuals will develop PTSD. The reasons why people respond differently to traumatic events remain unclear. However, studies indicate that individuals with PTSD exhibit abnormal levels of hormones and neurotransmitters, leading to changes in the brain.

Changes in neurotransmitters and hormones

When faced with stress, individuals with PTSD exhibit low levels of cortisol, the stress hormone, and elevated levels of corticotropin-releasing factor (CRF). CRF stimulates the release of norepinephrine, which activates the sympathetic nervous system, preparing the body for a fight-or-flight response, which results in an increased heart rate and higher blood pressure, affecting the bodily reaction to frightening events. Additionally, there is an alteration in the functioning of neurotransmitters such as gamma-aminobutyric acid (GABA), glutamate, and serotonin in individuals with PTSD.

Changes in the brain

• The hippocampus, which regulates motivation, emotions, learning, and memory, becomes smaller.
• The amygdala, which is crucial for processing emotions and triggering fear reactions, is hyperactive.
• The medial prefrontal cortex, responsible for regulating the emotional responses of the amygdala, shrinks in size and becomes less responsive.

Symptoms of PTSD in children

Children may have difficulty expressing their emotions or recounting what happened. After traumatic experiences, they often display signs like anxiety, restlessness, and hyperactivity - symptoms that can be mistaken for Attention Deficit Hyperactivity Disorder (ADHD). For proper diagnosis and treatment, it is crucial to consult a child psychiatrist with expertise in PTSD.

Severity of PTSD Symptoms

When confronted with triggers that remind them of their trauma, such as the screeching sound of car brakes or news about sexual assault, individuals with PTSD may relive the traumatic event, which can exacerbate their symptoms and lead to a significant increase in distress.

What are the complications of PTSD?

• Mood swings
• Anxiety
• Neurological disorders, such as memory loss
• Substance abuse, including alcohol dependency
• Suicidal thoughts or attempts

When should you see a doctor for PTSD symptoms?

If individuals with PTSD relive their traumatic events for more than a month and it interferes with their ability to return to regular daily life, seek advice from a psychiatrist. Receiving appropriate and timely treatment can help prevent the symptoms from worsening.

How is PTSD diagnosed?

The diagnostic process for PTSD involves taking a detailed medical history and conducting a physical examination. The physician will then assess the patient's psychological state using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed with PTSD, a patient must meet the following criteria:

• Has personally experienced a traumatic event
• Has witnessed a traumatic event occurring to others
• Has repeatedly encountered the aftermath of traumatic events (e.g., as a first responder to such events)
• Have you lost a loved one due to a traumatic event or been aware that a loved one faced such an event?

Patients with PTSD typically exhibit symptoms for more than one month, and these symptoms significantly impact their daily lives.

How is PTSD treated?

Psychotherapy, particularly Cognitive Behavioral Therapy (CBT), is the cornerstone of PTSD treatment.

• Cognitive Processing Therapy (CPT): A specific type of CBT for PTSD patients, CPT focuses on altering negative emotions such as shame or guilt, allowing them to confront and process distressing memories.
• Eye Movement Desensitization and Reprocessing (EMDR) Therapy: This therapy involves specific eye movement exercises while the brain processes traumatic events. It is a relatively new treatment, but evidence suggests it is effective and yields faster healing than other methods.
• Group Therapy: Provides an opportunity for patients to meet others who have experienced similar events, encouraging them to open up and discuss their experiences and feelings without fear of judgment. Moreover, family therapy can help patients and their families better understand their situation and struggles, fostering family support and accelerating the recovery.
• Prolonged Exposure Therapy: This therapy helps patients confront past events and cope with symptoms in a safe environment. Patients to control and manage their fear responses.
• Trauma-focused CBT: This approach helps patients understand their bodily response to stress and traumatic events. It allows patients to identify issues and learn how to manage their symptoms effectively.

Additionally, doctors may prescribe anti-anxiety or antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs), to alleviate symptoms.

Can PTSD be prevented?

While we cannot always avoid encountering traumatic events, we can take steps to protect ourselves from PTSD afterward. For instance:

• Talk to friends or family about the event that affected you emotionally. Opening up and sharing feelings can help reduce stress and foster better understanding within the family.
• Learning to behave and respond to frightening events can help you cope and survive unexpected situations.
•  Helping others who have experienced similar situations, such as volunteering to assist disaster victims, can aid emotional healing and foster a positive self-perception.

How to live with PTSD

• Follow regular treatment advised by healthcare professionals, as it takes time to see results. Educate yourself with additional information about PTSD to enhance your understanding of the condition.
• Maintain good physical health through adequate rest and a balanced diet. Avoid caffeine and nicotine, which can exacerbate anxiety. 
• Avoid alcohol and recreational drugs to cope with or forget about traumatic events.
• Engage in hobbies or relaxing activities to alleviate stress and anxiety.

What to do when your loved ones have PTSD

When a loved one has PTSD, you may notice significant changes in their behavior and emotional state. They might become easily irritated, prone to outbursts, or descend into depression. Supporting someone with PTSD can be emotionally and physically taxing, and learning about their traumatic experiences can be distressing. You may avoid talking about the traumatic event, feel helpless, or blame yourself for not preventing it.

However, educating yourself about PTSD can improve your understanding of your loved one's experience. Being a supportive listener and avoiding pressure to discuss the event before they are ready can be beneficial. Encouraging them to seek treatment from a PTSD specialist can help prevent the worsening of symptoms. It is essential to monitor their condition, especially if they begin to withdraw from social interactions.

Moreover, families and caregivers must prioritize their well-being when supporting someone with PTSD. Taking breaks, seeking support from friends, or attending counseling sessions can help manage stress effectively.

Preparations before doctor appointments

• Document the symptoms and duration and list all medications and dietary supplements.
• Prepare questions for your doctor, such as:
  
  • What are the underlying causes of my PTSD symptoms?
  • Is this stress response to traumatic events temporary or chronic?
  • What treatment options do you recommend?
  • When can I expect to see improvement in my symptoms?
  • How might PTSD affect my overall mental health?
  • What lifestyle changes could help alleviate my symptoms?
  • Should I inform colleagues or others in my social circle about my condition?
• Prepare answers to the questions your doctor may ask.
  
  • When did you first notice your symptoms?
  • Have you experienced or witnessed any traumatic events?
  • Do you frequently think about certain events or have nightmares?
  • Are you avoiding any specific activities, people, or places? If so, why?
  • Are you having difficulties at school or work?
  • Have you had thoughts of harming yourself or others?
  • Do you consume alcohol or use drugs? If so, how often?
  • Have you previously received treatment for mental health issues or psychiatric disorders? If yes, what treatments were effective?

A note from MedPark's doctor

Post-traumatic stress disorder (PTSD) is a treatable condition. Consulting experienced psychologists and therapists, using prescribed medications, and participating in therapeutic activities can help individuals in their journey to recovery, helping them regain a sense of normalcy and happiness.