PTSD - Post Traumatic Stress Disorder

Post Traumatic Stress Disorder


What is Post-Traumatic Stress Disorder (PTSD)?

PTSD is a form of anxiety that develops following a person or a close friend or relative was exposed to a life threatening or traumatic event. PTSD can develop from a wide range of experiences such as car accidents, bush fires, experiencing or witnessing violence, war, sexual assault and traumatic child birth. While it is normal to be sad or anxious after a traumatic event PTSD is when those feeling continue for more than a month and intrude on your life. About 4% of the population has PTSD.

How do I know if I have it?

People who experience PTSD may have flashbacks or be hypervigilant in situations that may triggered by noises, smells, sights or sounds like the traumatic experience. The may find that the memory of the event is always intruding in on their thoughts and that they are always on guard. Nightmares are very common, and the person can be angry or emotional. Others can become emotionally numb, avoid people and situations similar to the traumatic event.

The diagnosis of PTSD is complex and should be completed by someone with experience in such diagnosis. As seen below there are many differing items required.

In order to be diagnosed with PTSD according to the DSM-5, you need to meet the following:

  • Criterion A
  • One symptom (or more) from Criterion B
  • One symptom (or more) from Criterion C
  • Three symptoms (or more) from Criterion D
  • Three symptoms (or more) from Criterion E
  • Criteria F through H

Criterion A

You were exposed to one or more event(s) that involved death or threatened death, actual or threatened serious injury, or threatened sexual violation. In addition, these events were experienced in one or more of the following ways:

  • You experienced the event
  • You witnessed the event as it occurred to someone else
  • You learned about an event where a close relative or friend experienced an actual or threatened violent or accidental death
  • You experienced repeated exposure to distressing details of an event, such as a police officer repeatedly hearing details about child sexual abuse

Criterion B

You experience at least one of the following intrusive symptoms associated with the traumatic event:

  • Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic event
  • Repeated upsetting dreams where the content of the dreams is related to the traumatic event
  • The experience of some type of dissociation (for example, flashbacks) where you feel as though the traumatic event is happening again
  • Strong and persistent distress upon exposure to cues that are either inside or outside of your body that are connected to your traumatic event
  • Strong bodily reactions (for example, increased heart rate) upon exposure to a reminder of the traumatic event

Criterion C

  • Frequent avoidance of reminders associated with the traumatic event, as demonstrated by one of the following:
  • Avoidance of thoughts, feelings, or physical sensations that bring up memories of the traumatic event
  • Avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event

Criterion D

At least two of the following negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event:

  • The inability to remember an important aspect of the traumatic event
  • Persistent and elevated negative evaluations about yourself, others, or the world (for example, “I am unlovable,” or “The world is an evil place”)
  • Elevated self-blame or blame of others about the cause or consequence of a traumatic event
  • A negative emotional state (for example, shame, anger, or fear) that is pervasive
  • Loss of interest in activities that you used to enjoy
  • Feeling detached from others
  • The inability to experience positive emotions (for example, happiness, love, joy)

Criterion E

At least two of the following changes in arousal that started or worsened following the experience of a traumatic event:

  • Irritability or aggressive behaviour
  • Impulsive or self-destructive behaviour
  • Feeling constantly “on guard” or like danger is lurking around every corner (or hypervigilance)
  • Heightened startle response
  • Difficulty concentrating
  • Problems sleeping

Criterion F

The above symptoms last for more than one month.

Criterion G

The symptoms bring about considerable distress and/or interfere greatly with a number of different areas of your life.

Criterion H

The symptoms are not due to a medical condition or some form of substance use.

How does this happen?

Scientists are not sure why some people develop PTSD and others don’t. There may be a relationship to previous experiences, coping mechanisms and other mental health disorders. There is some evidence that use of morphine and cannabis can increase the risk of PTSD, though there is developing evidence that cannabis may be useful in treatment.

What is Pathophysiology?

This is an area under study. There is evidence that there are physical changes to aspects of the brain and changes to the neurotransmitters in the brain as well. There may be a genetic component to the development of PTSD and the environment a person is in may also play a role.

How do I fix it?

While PTSD cannot be diagnosed for one month following a traumatic event, early intervention to deal with the stress and anxiety following a traumatic event can be helpful. Having support systems in place may also reduce the chance of developing PTSD.

Trauma-focused cognitive behavioural therapy (CBT): a psychologist will help guide you work with the emotions and sensations that you experience with thinking about the trauma. They will assist you to desensitise to the trauma you have experienced.

Eye-movement desensitisation and reprocessing (EMDR): while reliving some of the memory’s you will be asked to move your eyes in a certain pattern. This is thought to assist with the memory formation and reduce the level of distressed you experience.

Medication: Several medications have been used to assist with PTSD. Antidepressants are the mainstay of treatment at the moment. Your GP or psychiatrist will be of assistance.

Where can I get more information?

The following websites can assist with further information or see your GP.