What Is PTSD?
Although the idea of trauma is widely known today, it did not appear in medical literature until the 1900s after World War I. The term “shell shock” was used to describe the after-effects that combatants displayed after harsh battle experiences. During World War II, “combat neurosis” was commonly used to describe personality disturbances stemming from the stress of war.
It was not until 1980 that the American Psychiatric Association introduced the diagnosis of posttraumatic stress disorder (PTSD). Researchers recognized the emotional battle scars of veterans from the Vietnam War, which led to the medical diagnosis we know today. We now diagnose PTSD not just in people who have fought in wars, and know that anxiety isn’t the only symptom.
PTSD occurs in people who demonstrate significant distress and impairment in multiple areas after experiencing or witnessing trauma. Trauma can include a natural disaster (like hurricanes or tornadoes), serious accident, terrorist act, combat or sexual assault. It can be applied to those who have been threatened with serious injury or illness, sexual violence or death.
About 7% to 8% of people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genetic factors may make some people more likely to develop PTSD than others, according to the National Center for PTSD.
People with PTSD have intense, distressing and unwanted thoughts and feelings related to their experience that last long after the traumatic event has ended. Some relive the event through memories, nightmares and flashbacks. They often carry feelings of sadness, fear, anger and guilt or shame; however, they can also complain of feeling numb as well. Many feel isolated or estranged from other people.
PTSD sufferers may avoid situations, people, places and conversations that remind them of trauma. Some bury themselves into productive activities, like work, to avoid facing trauma. While these eases symptoms in the moment, avoidance tends to maintain and strengthen symptoms over time.
PTSD can lead to physical symptoms such as increased blood pressure and heart rate, rapid breathing and muscle tension. People with PTSD may have strong negative reactions to harmless situations such as a loud noise or an accidental touch. This makes them “jumpy” or easily startled by everyday instances.
Diagnosis and Treatment
Not everyone who encounters trauma develops PTSD. After a tragic event, it is common to experience the above symptoms and these symptoms may get better as a person approaches the event and seeks support. Those who tend to avoid facing trauma and symptoms are more likely to develop PTSD.
A diagnosis of PTSD is not assigned until the symptoms have been present for more than one month and cause significant interference with relationships, work or other aspects of daily life. Sometimes people have experienced symptoms that have persisted for months and sometimes years. PTSD often occurs with other related conditions such as depression, substance use, memory problems and other physical and mental health problems.
The National Institute of Mental Health reports that the course of PTSD varies. Some people recover within six months, while others have symptoms that last much longer. When people adapt to their symptoms, then the condition can become long-lasting. For instance, a person may say they prefer to watch movies at home rather than at the theater because they have learned to avoid dark and crowded places. While this sounds like it could be a preference, the behavior is really due to the trauma rather than the person’s values.
Not everyone who develops PTSD requires treatment. Some people can overcome their symptoms with assistance from family, friends, clergy members or others. Those who have more intense or disabling symptoms are recommended to seek professional help. Professional help typically involves a referral to a psychiatrist, psychologist or other mental health professional. Providers who treat PTSD have specific interview and assessment tools to evaluate those suspected of having PTSD.
The American Psychological Association created clinical practice guidelines for the treatment of PTSD based on current scientific evidence. Treatment can include medications and psychotherapy (talk therapy), and psychotherapy is strongly recommended as an integral component of recovery.
With psychotherapy, a patient is taught skills aimed at managing symptoms and developing coping mechanisms. Treatments such as cognitive therapy, cognitive processing therapy and prolonged exposure have been proven to be effective for PTSD. Treatments such as eye movement desensitization and reprocessing therapy, brief eclectic psychotherapy and narrative exposure therapy can also be helpful.
The clinical practice guidelines indicate the strongest evidence for treatment with medications promotes the “selective serotonin reuptake inhibitors” such as Prozac, Paxil, and Prozac, as well as the “selective serotonin-norepinephrine reuptake inhibitor” Effexor. Only Zoloft and Paxil are approved by the FDA for PTSD at this time.
Now, more than ever
It is important for those who may be experiencing PTSD to reach out for help, even though doing so may seem difficult – especially during these current difficult times.
The world has been exposed to a significant level of shock with the COVID-19 pandemic. Research from 2021 revealed that around 30% of patients with severe COVID-19 infection experienced PTSD symptoms. Even those who have not contracted COVID-19 may have been exposed to serious illness and death in loved ones due to the virus. The pandemic has led to increased vulnerability to psychological distress due to illness, grief, job loss or changes, social isolation, uncertainty and other stressors.
For those living on the Gulf Coast, there have been additional stressors and trauma due to hurricanes and storms. Many people are dealing with continued consequences and triggers from these events in addition to the pandemic and have not yet sought support or treatment.
The good news is that help is available. As mentioned before, there are multiple treatments that have been proven to be effective in resolving PTSD. Many people have successfully learned to live by their values and desires, rather than living life based on past trauma.
See a behavioral health specialist from the comfort of your own home with an Ochsner Anywhere Care virtual visit.