![Terrorist attacks, car accidents, abuse, rape, combat, and personal assaults are a few situations that may trigger PTSD.](https://images.emedicinehealth.com/images/newsletter/daily/june-2014/PTSD-posttraumatic-stress-disorder-graphic.jpg)
Post-traumatic Stress Disorder (PTSD) IQ
Think you know a lot about post-traumatic stress disorder, an anxiety disorder that may occur after one experiences a frightening ordeal? Test your PTSD IQ with our quiz.
Posttraumatic stress disorder (PTSD) is a trauma- or stressor-related disorder that can develop after exposure to actual or threatened death, serious injury, or sexual violence, according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
Traumatic events that may trigger PTSD include
What happens when you have PTSD?
PTSD is a disorder in which your brain continues to react with excessive fear and nervousness after you have experienced or witnessed trauma or terrifying event, even though the original trauma is over. Our brains can react by staying in overdrive and being hyper-alert to the next possible trauma.
What does a PTSD attack feel like?
People with PTSD will re-experience the trauma by having intrusive memories, flashbacks, or nightmares about the event, even though the trauma is in the past.
After a traumatic event, we can also become numb and shut down our feelings, and try to avoid situations that might cause us to remember the trauma. For other individuals, the effects on emotions and behavior can show up as depression, irritability, or risky behavior.
When you are afraid, your body activates the "fight or flight" response, a response common to other animals as well as our evolutionary ancestors.
With this response, the brain activates the sympathetic nervous system, including the release of adrenaline (epinephrine) in the body, which is responsible for increasing blood pressure, heart rate, and increasing glucose to muscles, readying the body for a physical response (fight or flight).
However, once the immediate danger (which may or may not have actually existed) is gone, the body begins a process of shutting down the stress response, and this process involves the release of another hormone known as cortisol.
If your body does not generate enough cortisol to shut down the flight or stress reaction, you may continue to feel the stress effects of the adrenaline.
Trauma victims who develop post-traumatic stress disorder often have higher levels of other stimulating hormones (catecholamines) under normal conditions in which the threat of trauma is not present as well as lower levels of cortisol. This combination of higher than normal arousal levels and lower than normal levels of the calming hormones of the changes creates the conditions for PTSD.
After a month in this heightened state with stress hormones elevated and cortisol levels lowered, you may develop further physical changes, such as heightened hearing. This cascade of physical changes, one triggering another, suggests that early intervention may be the key to heading off the effects of post-traumatic stress disorder.
Not everyone exposed to a traumatic event has an abnormal reaction and some who initially experience symptoms find that they resolve in a relatively short period of time. The presence of PTSD symptoms lasting one month or less after trauma is known as an acute stress disorder. Another area of research is to understand why some people are able to recover, while others develop the long-term difficulties of PTSD.
Specific brain regions are also associated with PTSD and the physical responses in the rest of the body.
After a trauma in which you think you might die, see someone die, or become seriously injured, and you feel intense fear, helplessness, or horror, it is very common to become distressed and anxious.
You may have trouble sleeping, have nightmares, think about the trauma a lot, try to avoid the site of the trauma, and/or try to avoid feelings at all and become more numb.
When these symptoms occur shortly after the trauma, and they are severe enough to impair functioning, acute stress disorder is diagnosed.
For most people, this distressing period passes within about four weeks. PTSD is diagnosed when these symptoms continue to interfere with daily life and persist more than a month after the initial trauma.
There are four main types of symptoms related to PTSD:
There are also other symptoms and diagnoses often associated with PTSD:
PTSD is often associated with other psychiatric and physical problems.
Children and adolescents also experience trauma and may develop PTSD. Children and teenagers still have the same four categories of symptoms. However, the physical, emotional, and anxiety symptoms of PTSD may be different than those seen in adults.
Following the trauma, children may initially show agitated or confused behavior. They also may show intense fear, helplessness, anger, sadness, horror, or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma.
In addition to these core symptoms of PTSD, children may also show the following symptoms:
PTSD is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and requires:
Specific diagnostic criteria from the DSM-5 are as follows:
PTSD is a clinical diagnosis; there are no laboratory tests or brain-imaging studies currently used in clinical practice to diagnose PTSD. Brain imaging studies are underway to learn more about the brain in the PTSD condition, but these are not used in everyday medical practice.
A physical exam and some blood tests may be necessary to rule out medical conditions that may mimic PTSD, such as hyperthyroidism, which can create an anxiety state.
Most people bounce back from traumatic events such as car crashes or assaults, including rape. Short term, most of us would experience some PTSD symptoms. A smaller percentage of people have symptoms that are bad enough to interfere with day-to-day function and are diagnosed with acute stress disorder.
Most of these people will also recover within the first month, but a subset of those with ASD will have symptoms lasting longer than a month and are diagnosed with PTSD. We know that some people recover from PTSD at later times—maybe six months, a year, or even longer. However, some people will have long-term or chronic PTSD symptoms.
At any time after the trauma, if any symptoms are serious enough to affect job performance or the ability to function in day-to-day life, you should consult a licensed mental health professional. Depending on how long the symptoms have caused problems, and which symptoms are worst, different treatments will be appropriate.
Although it may seem painful to remember your trauma, many studies show that avoiding it continues to cause problems. Talking about it with a professional is helpful to many people with PTSD.
As with most psychiatric disorders, there are both psychotherapy and medication (psychopharmacologic) ways of treating PTSD.
Either type of treatment can be effective for people with PTSD, but the best type of treatment for an individual should be determined by working with a mental health professional.
National Mental Health Association
2001 N Beauregard Street, 12th Floor
Alexandria, VA 22311
703-684-7722
National Institute of Mental Health (NIMH)
Public Information and Communications Branch
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
866-615-6464 (toll-free)
National Center for PTSD
802-296-6300
Email: [email protected]
Sidran Institute, Traumatic Stress Education & Advocacy
200 E Joppa Road, Suite 207
Towson, MD 21286
410-825-8888
National Institute of Mental Health, Post-Traumatic Stress Disorder (PTSD)
MedlinePlus, Post-Traumatic Stress Disorder
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Think you know a lot about post-traumatic stress disorder, an anxiety disorder that may occur after one experiences a frightening ordeal? Test your PTSD IQ with our quiz.