Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) – formerly known as “shell shock” or “battle fatigue” – is a debilitating condition that develops after a terrifying physical or emotional event. It causes the person who survived the event to have persistent, frightening thoughts and memories (flashbacks) of the ordeal. The flashback can be triggered by images, sounds, smells or feelings and cause the affected person to believe that the traumatic event is occurring again.

Persons with PTSD often feel chronically, emotionally numb. Up to one third of men and women who have spent time in war zones experience PTSD, according to the National Institute of Mental Health, and approximately 7.7 million Americans have PTSD at any given time.

PTSD can occur at any age, including childhood, and may be accompanied by other mental health issues such as anxiety, depression and substance abuse.

Causes of PTSD

Stressful events that can cause or trigger PTSD vary and are not limited to military situations. The following are among the more common causes of PTSD:

  • Abuse in childhood
  • Serious accidents (such as a car, train or plane crash)
  • Natural disasters (for example, floods or earthquakes)
  • Man-made tragedies (such as bombings)
  • Violent personal attacks (for example, mugging, being held captive or kidnapping)
  • Military combat

Symptoms of PTSD

The symptoms of PTSD are extreme emotional, mental or physical distress caused by exposure to situations that remind the individual of the traumatic event. Generally, the signs and symptoms of PTSD fall into three categories: re-experiencing symptoms, avoidance symptoms and hyperarousal symptoms. PTSD may lead to nightmares and sleep problems and disturbing recollections of the traumatic event during the day. Common symptoms of PTSD include:

  • Depression, guilt or worry
  • Loss of interest in things that were formerly enjoyable
  • Feelings of detachment or numbness
  • Loss of touch with reality
  • Trouble feeling affectionate
  • Difficulty working or socializing
  • Feeling jittery or "on guard" or being easily startled
  • Feeling irritable, more aggressive than before or even violent
  • Avoidance of certain places or situations that trigger the traumatic memories
  • Flashbacks or intrusive images, including reenacting the event for seconds, hours or, very rarely, days

Diagnosing PTSD

A diagnosis of PTSD is considered only in persons whose symptoms persist for more than one month. In the typical patient with PTSD, symptoms usually occur within three months of the traumatic event although they can also first appear months or even years later.

Your doctor will perform a thorough physical exam and obtain a complete medical and social history. You will also be asked to complete a PTSD screening questionnaire, which will help your doctor understand your signs and symptoms. Because PTSD often occurs in tandem with one or more additional psychiatric disorders such as depression, substance abuse or anxiety disorders, you will be asked questions that will help diagnose those disorders as well.

Treating PTSD

PTSD is often difficult to treat and may require long-term intervention to change the behavior and thought patterns. Some people recover within a few months, whereas others have symptoms that last for years or much longer.

Specific treatment for PTSD will be determined by your individual circumstances:

  • Your age, overall health and medical history
  • The severity and extent of your disease
  • Your tolerance for specific medications, procedures, or therapies
  • Your expectations for the course of the disease
  • Your opinion or preference

Treatment is critical and typically includes medication (antidepressants and/or antianxiety drugs) and/or psychological treatment, such as cognitive-behavioral, or talk therapy; exposure therapy; or eye movement desensitization and reprocessing, known as EMDR. For more information on PTSD, visit the National Center For PTSD.