Post-traumatic stress disorder (PTSD) is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. Symptoms can include reexperiencing phenomena such as nightmares and flashbacks, emotional detachment or numbing of feelings (emotional self-mortification) combined with regular hyperarousal and possibly sleep abnormalities (insomnia), avoidance of reminders and extreme distress when exposed to the reminders ("triggers"), with irritability and excessive startle.
Experiences likely to induce the condition include childhood physical/emotional or sexual abuse, adult's experiences of rape, war and combat exposure, violent attacks, natural catastrophes, and life-threatening complications at childbirth (and perhaps its accompanying exhaustion). For most people, the emotional effects of traumatic events will tend to subside after several months. If they last longer than that then consideration should be given to diagnosing a psychiatric disorder. Most people who experience traumatic events will not develop PTSD. PTSD is primarily an anxiety disorder and should not be confused with normal grief and adjustment after traumatic events. There is also the possibility of simultaneous suffering of other psychiatric disorders (i.e. co-morbidity).
PTSD may have a delayed onset of years or even decades and may be triggered by even a specific body movement (if the trauma was stored in the procedural memory mainly), or by another stressful event such as the death of a family member or someone else close, or by the diagnosis of a life-threatening medical condition. Once PTSD reaches the criteria for diagnosis the untreated course is generally for some worsening and then stability of the level of symptomatology over many years.
Symptoms of Post Traumatic Stress Disorder
Symptoms can include general restlessness, insomnia, aggressiveness, depression, dissociation with reality, emotional detachment, or nightmares. Amplification of other underlying psychological conditions may also occur. Young children suffering from PTSD will often enact aspects of the trauma through their play, and may often have nightmares that lack any recognizable content.
One patho-psychological way of explaining PTSD is characterized by viewing the condition as secondary to deficient emotional or cognitive processing of a trauma (Cordova 2001). This view also helps to explain the three symptom clusters of the disorder (Shalev 2001).
Intrusion. Since the person cannot process the difficult emotions in a normal way, he/she is plagued by recurrent nightmares, or daytime flashbacks, while he/she realistically reexperiences the trauma. These reexperiences are characterized by high anxiety levels, and make up one part of the PTSD symptom cluster triad called intrusive symptoms.
Hyperarousal. PTSD is also characterized by a state of nervousness with the organism being prepared for “fight or flight”. The typical hyperactive startle reaction characterized by “jumpiness” in connection with high sounds or fast motions is typical for another part of the PTSD cluster called hyperarousal symptoms, and could also be secondary to an incomplete processing.
Avoidance. The hyperarousal and the intrusive symptoms are eventually so distressing that the individual strives to avoid contact with everything, and everyone, even her own thoughts, that can arouse memories of the trauma and thus cause the intrusive and hyperarousal states to go on. He/She isolates him/herself, being detached in his/her feelings with a restricted range of emotional response, and can experience so-called emotional numbing. This avoiding behavior is the third and most important part of the symptom triad that makes up the PTSD criteria. The avoidance behavior could also be explained by a feeling of being different due to both the exclusiveness of the trauma and the strange and painful symptoms of intrusion and hyperarousal causing depersonalization.
Lisa Angelettie, M.S.W., is a psychotherapist, author, and an online advice expert. She has been helping people make smarter life choices since 1998. Visit her for Advice & Counseling, or take a free Depression Screening today.
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