Post-Traumatic Stress Disorder

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after experiencing or witnessing a traumatic event. The event may be life-threatening — combat, a natural disaster, a road traffic accident, or sexual assault. But it doesn't have to be life-threatening; the sudden, unexpected death of a loved one can also cause PTSD.

It is normal to feel afraid during and after a traumatic situation. Fear triggers the body's "fight-or-flight" response — a release of hormones and increased alertness, blood pressure, heart rate, and breathing.

Most people recover from this naturally over time. But people with PTSD continue to feel stressed and frightened long after the trauma is over. Sometimes symptoms start later and may come and go.

What causes PTSD?

Researchers do not fully understand why some people develop PTSD and others don't. Genetics, neurobiology, and personal factors may affect it.

Who is more likely to develop PTSD?

PTSD can occur at any age. Several risk factors play a part, including:

• Your sex — women are more likely to develop PTSD
• Childhood trauma
• Feelings of horror, helplessness, or extreme fear during the event
• A traumatic event that lasted a long time
• Little or no social support afterwards
• Additional stress after the event — such as loss of a loved one, pain and injury, or loss of a job or home
• A history of mental illness or substance use

What are the symptoms of PTSD?

There are four types of PTSD symptoms, though each person experiences them differently:

• Re-experiencing symptoms — flashbacks (feeling like you are going through the event again), nightmares, or frightening intrusive thoughts.
• Avoidance symptoms — staying away from places, events, or objects that remind you of the trauma; or avoiding thoughts and feelings about what happened (for example, keeping very busy to avoid thinking about it).
• Arousal and reactivity symptoms — being easily startled, feeling tense or "on edge," trouble sleeping, angry outbursts.
• Cognition and mood symptoms — trouble remembering important parts of the event, negative thoughts about yourself or the world, feelings of blame and guilt, loss of interest in things you enjoyed, trouble concentrating.

Symptoms usually start soon after the traumatic event but sometimes don't appear until months or years later, and may come and go.

If your symptoms last longer than four weeks, cause great distress, or interfere with work or home life, you may have PTSD.

How is PTSD diagnosed?

A doctor or mental health professional who has experience with mental health conditions can diagnose PTSD. They will do a mental health screening and may also do a physical examination. To be diagnosed with PTSD, you need to have all of these symptoms 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

What are the treatments for PTSD?

The main treatments for PTSD are talk therapy, medicines, or both. PTSD affects people differently, so a treatment that works for one person may not work for another. Work with a mental health professional to find what works for you:

• Talk therapy (psychotherapy) can help you identify your triggers and learn to manage them. Several types are used for PTSD — including trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR).
• Medicines can help symptoms. Antidepressants may help with sadness, worry, anger, and emotional numbing; other medicines can help with sleep problems and nightmares.

Can PTSD be prevented?

Certain resilience factors can reduce the risk of developing PTSD:

• Seeking support from other people — friends, family, or a support group
• Learning to feel good about your actions in the face of danger
• Developing a coping strategy — a way of getting through the difficult event and learning from it
• Being able to act and respond effectively despite feeling fear