Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after living through or witnessing a traumatic event. The event may be life-threatening — combat, a natural disaster, a car crash or sexual assault — but it need not be dangerous: the sudden, unexpected death of someone close can also lead to PTSD.
When normal fear does not fade
Feeling afraid during and after a traumatic event is normal. Fear sets off the fight-or-flight response, the body’s way of protecting itself: hormones are released, and alertness, blood pressure, heart rate and breathing all rise. Most people recover from this on their own over time. People with PTSD do not — they keep feeling stressed and frightened long after the danger has passed. Sometimes symptoms begin later, and they can come and go.
Why some people develop it
Researchers do not know why some people get PTSD and others do not. Genes, brain biology, risk factors and personal characteristics may all play a part. PTSD can develop at any age. Risk is higher for people who:
- are women
- experienced trauma in childhood
- felt horror, helplessness or extreme fear during the event
- went through a long-lasting trauma
- had little or no support afterward
- faced extra stress afterward, such as losing a loved one, pain or injury, or losing a job or home
- have a history of mental illness or substance use
Four kinds of symptoms
Symptoms differ from person to person, but fall into four groups:
| Type | What it looks like |
|---|---|
| Re-experiencing | Flashbacks that feel like reliving the event, nightmares, frightening thoughts — often set off by a reminder |
| Avoidance | Staying away from places, events or objects that bring back the trauma (someone in a car crash may stop driving); keeping very busy to avoid thinking about it |
| Arousal and reactivity | Being easily startled, feeling tense or on edge, trouble sleeping, angry outbursts |
| Cognition and mood | Trouble remembering key parts of the event, negative thoughts about oneself or the world, blame and guilt, losing interest in things once enjoyed, trouble concentrating |
Symptoms usually start soon after the event, but can appear months or years later and come and go over many years. Symptoms that last longer than four weeks, cause great distress or get in the way of work or home life may be PTSD.
Diagnosis
A health care provider experienced in mental illness can diagnose PTSD after a mental health screening, and sometimes a physical exam. The diagnosis requires, for at least one month:
- at least one re-experiencing symptom
- at least one avoidance symptom
- at least two arousal and reactivity symptoms
- at least two cognition and mood symptoms
Treatment
The main treatments are talk therapy, medicine or both. Because PTSD affects people differently, what helps one person may not help another, so treatment is worked out with a mental health professional.
- Talk therapy (psychotherapy) explains the symptoms and teaches people to recognize their triggers and manage them. There are several kinds.
- Medicines: antidepressants can ease sadness, worry, anger and feeling numb; other medicines can help with sleep problems and nightmares.
Protective factors
Some resilience factors can lower the risk of PTSD:
- seeking support from friends, family or a support group
- learning to feel good about how one acted in the face of danger
- having a way of coping — getting through the event and learning from it
- being able to act effectively despite feeling afraid
If you are struggling, you can call or text 988, or chat at 988lifeline.org, to reach the 988 Suicide & Crisis Lifeline.
Sources
Based on "Post-Traumatic Stress Disorder," MedlinePlus, U.S. National Library of Medicine, drawing on the National Institute of Mental Health; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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