Symptoms
Post-Traumatic Stress Disorder (PTSD) is a debilitating condition
that follows a terrifying event. Often, people with PTSD have
persistent frightening thoughts and memories of their ordeal and
feel emotionally numb, especially with people they were once close
to. PTSD, once referred to as shell shock or battle fatigue, was
first brought to public attention by war veterans, but it can
result from any number of traumatic incidents. These include kidnapping,
serious accidents such as car or train wrecks, natural disasters
such as floods or earthquakes, violent attacks such as a mugging,
rape, or torture, or being held captive. The event that triggers
it may be something that threatened the person's life or the life
of someone close to him or her. Or it could be something witnessed,
such as mass destruction after a plane crash.
Whatever the source of the problem, some people with PTSD repeatedly
relive the trauma in the form of nightmares and disturbing recollections
during the day. They may also experience sleep problems, depression,
feeling detached or numb, or being easily startled. They may lose
interest in things they used to enjoy and have trouble feeling
affectionate. They may feel irritable, more aggressive than before,
or even violent. Seeing things that remind them of the incident
may be very distressing, which could lead them to avoid certain
places or situations that bring back those memories. Anniversaries
of the event are often very difficult.
PTSD can occur at any age, including childhood. The
disorder can be accompanied by depression, substance abuse, or
anxiety. Symptoms may be mild or severe--people may become easily
irritated or have violent outbursts. In severe cases they may
have trouble working or socializing. In general, the Symptoms
seem to be worse if the event that triggered them was initiated
by a person--such as a rape, as opposed to a flood.
Ordinary events can serve as reminders of the trauma
and trigger flashbacks or intrusive images. A flashback may make
the person lose touch with reality and reenact the event for a
period of seconds or hours or, very rarely, days. A person having
a flashback, which can come in the form of images, sounds, smells,
or feelings, usually believes that the traumatic event is happening
all over again.
Not every traumatized person gets full-blown PTSD,
or experiences PTSD at all. PTSD is diagnosed only if the Symptoms
last more than a month. In those who do have PTSD, Symptoms usually
begin within 3 months of the trauma, and the course of the illness
varies. Some people recover within 6 months, others have Symptoms
that last much longer. In some cases, the condition may be chronic.
Occasionally, the illness doesn't show up until years after the
traumatic event.
Specific Symptoms of this Disorder:
The person has been exposed to a traumatic event in which the
person experienced, witnessed, or was confronted with an event
or events that involved actual or threatened death or serious
injury, or a threat to the physical integrity of self or others
and the person's response involved intense fear, helplessness,
or horror.
The traumatic event is persistently reexperienced
in one (or more) of the following ways:
recurrent and intrusive distressing recollections of the event,
including images, thoughts, or perceptions.
recurrent distressing dreams of the event.
acting or feeling as if the traumatic event were recurring (includes
a sense of reliving the experience, illusions, hallucinations,
and dissociative flashback episodes, including those that occur
on awakening or when intoxicated).
intense psychological distress at exposure to internal or external
cues that symbolize or resemble an aspect of the traumatic event
physiological reactivity on exposure to internal or external cues
that symbolize or resemble an aspect of the traumatic event
The individual also has persistent avoidance of stimuli associated
with the trauma and numbing of general responsiveness (not present
before the trauma), as indicated by three (or more) of the following:
efforts to avoid thoughts, feelings, or conversations associated
with the trauma
efforts to avoid activities, places, or people that arouse recollections
of the trauma
inability to recall an important aspect of the trauma
markedly diminished interest or participation in significant activities
feeling of detachment or estrangement from others
restricted range of affect (e.g., unable to have loving feelings)
sense of a foreshortened future (e.g., does not expect to have
a career, marriage, children, or a normal life span)
Persistent Symptoms of increased arousal (not present before the
trauma), as indicated by two (or more) of the following:
difficulty falling or staying asleep
irritability or outbursts of anger
difficulty concentrating
hypervigilance
exaggerated startle response
The disturbance, which has lasted for at least a month, causes
clinically significant distress or impairment in social, occupational,
or other important areas of functioning.
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