What is post-traumatic stress disorder?
Post-traumatic stress disorder (PTSD) is an anxiety disorder that a person can develop after experiencing or witnessing—either directly or indirectly—a traumatic event or life-threatening situation. A traumatic event involves exposure to death, threatened death, actual or serious injury, or actual or threatened sexual violence. Specific examples include physical assault, combat exposure, and serious accidents.
What are the symptoms of post-traumatic stress disorder?
People who have PTSD may have the following symptoms:
- repeated, intrusive memories of the traumatic event
- a vivid sense that the traumatic event is happening again (also called a “flashback”)
- nightmares about the event
- intense distress after being reminded of the event
- physical symptoms of anxiety, such as nervousness, being startled easily, an inability to concentrate, and insomnia
- persistent negative emotions about the event, such as guilt, shame, fear, or anger
- avoiding reminders of the traumatic event
- amnesia for all or part of the event
- decreased interest in things that were once important
- feeling hopeless about the future
If these symptoms last longer than a month and interfere with the person's social life, work, or relationships, they may represent PTSD. Most symptoms of PTSD usually occur within three months of the traumatic event, but can emerge years later. Not everyone who experiences a traumatic event will have PTSD.
Who develops post-traumatic stress disorder?
In the United States, approximately 7-8% of the population will develop PTSD at some point in their lives. It is not known why some people suffer from PTSD after a traumatic event and others do not. However, researchers have identified specific factors that increase risk for PTSD:
- experiencing trauma caused by other people, such as rape or assault;
- exposure to long-term or repeated traumas;
- personal history of mental health problems, especially anxiety disorders;
- lack of support from family and friends after a trauma.
What types of treatment are available for post-traumatic stress disorder?
There are several different types of treatment for PTSD. There is no one treatment that works for everyone. If you feel that you may have PTSD, talk with your doctor or mental health provider to determine what treatment options are best for you.
Cognitive-behavioral treatments, either individually or in a group format, are regarded as the most effective treatment for PTSD:
- Prolonged exposure: People who have experienced trauma fear and avoid the thoughts, feelings, and situations that remind them of it. The goal of exposure therapy is to eventually have less fear about your memories, and to learn to control your thoughts and feelings about the traumatic event. Prolonged exposure is a specific therapy that includes four components:
- education about PTSD and treatment;
- breathing retraining to help manage anxiety;
- practice with approaching real-life situations that are related to the trauma; and,
- talking through the trauma experience.
- Cognitive processing therapy: This therapy helps with managing upsetting thoughts and feelings, and with gaining a better understanding of the trauma and its effects. Therapy steps include:
- education about PTSD and treatment;
- monitoring thoughts and feelings, and understanding how the traumatic event altered your views of yourself, others, and the world;
- developing skills to change dysfunctional thoughts or “stuck points”; and,
- shifting beliefs affected by the trauma, such as safety, trust in yourself and others, and self-esteem.
- Cognitive-restructuring therapy: This therapy approach helps people identify and transform dysfunctional thought patterns and beliefs related to the trauma experience. The treatment uses daily diaries to track thoughts and feelings. With the help of your doctor, you will learn to replace those thoughts with more accurate and less upsetting thoughts. Your doctor will also teach you ways to cope with feelings such as anger, guilt, and fear. As you learn how to recognize and change your perceptions about the trauma, symptoms often improve.
- Eye movement desensitization and reprocessing: Eye movement desensitization and reprocessing is a treatment that includes components of exposure and cognitive therapies. The idea is to use the brain’s information processing to resolve trauma reactions. Treatment sessions involve thinking about the trauma, identifying negative trauma-related thoughts, generating positive aspects, and engaging in rapid side-to-side eye movements while focusing on the target trauma. Sounds, tapping, and other methods that activate stimulation of both halves of the brain have proven equally effective and are routinely used.
Medications for post-traumatic stress disorder
A class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) has shown benefit in treating PTSD. Some commonly prescribed SSRIs are citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Zoloft and Paxil have been approved by the Food and Drug Administration (FDA) for the long-term treatment of PTSD.
Overall, the evidence of treatment effectiveness suggests that therapy interventions have a greater impact than medications. However, some people may prefer medications, or may benefit from a combination of therapy and medication.
Where can I get more information?
National Suicide Prevention Lifeline
If you or someone you know is in a crisis and threatening to hurt or kill himself or herself, immediately call 9-1-1 or the National Suicide Prevention Lifeline: 800.273.TALK (8255)
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/20/2015...#9545