Identifying PTSD

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after an individual has experienced or witnessed a major trauma. PTSD distinct from Traumatic Stress, which has less intensity and duration, and combat stress reaction, which is transitory. In the past, PTSD has been recognized as shell shock, battle fatigue, traumatic war neurosis, or post-traumatic stress syndrome. PTSD is a severe and ongoing emotional reaction to an extreme psychological trauma. This stressor may involve some one's actual death; a threat to the client's or someone else's life; being in, or seeing, a serious car accident; being sexually assaulted/raped, experiencing long-term sexual or physical abuse; undergoing major surgery (bone marrow transplant, extensive hospitalization, severe burns); experiencing or witnessing natural disasters (earthquakes, hurricanes, floods, fire); experiencing torture, a terrorist attack, or being a prisoner of war; experiencing or witnessing a violent crime (kidnapping, physical assault, assault or murder of a loved one); being involved in a war or witnessing violence or death during wartime or threat to physical or psychological integrity, overwhelming psychological defenses. In some cases it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.

There is no one type of trauma that can lead to PTSD. Rather, there are several different kinds of traumatic situations that can do this, all of which have certain common elements: The trauma was life threatening or it led to an actual or potentially serious injury; The individual reacted to the trauma with intense fear, helplessness, or horror; You can develop PTSD if you have been directly involved in a serious traumatic event, or if you witnessed a traumatic event. There are many different types of symptoms that someone can have after a trauma, but PTSD symptoms fall into 3 categories: (1) Reliving or re-experiencing the trauma; (2) Attempts to avoid thoughts, situations, or people that are reminders of the trauma; (3) Increased anxiety or arousal, including being constantly on guard for danger, and being easily startled. People with PTSD will have at least one or more symptoms of each of these categories. The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as: (A.) Exposure to a traumatic event (B.) Persistent re experience (e.g. flashbacks, nightmares) (C.) Persistent avoidance of stimuli associated with the trauma (e.g. inability to talk about things even related to the experience, avoidance of things and discussions that trigger flashbacks and re experiencing symptoms fear of losing control) (D.) Persistent symptoms of increased arousal (e.g. difficulty falling or staying asleep, anger and hyper vigilance) (E.) Duration of symptoms more than 1 month (F.) Significant impairment in social, occupational, or other important areas of functioning (e.g. problems with work and relationships.) Notably, criterion A (the "stressor") consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that "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." The second (A2) requires that "the person’s response involved intense fear, helplessness, or horror." The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience." Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%. Various scales exist to measure the severity and frequency of PTSD symptoms.

Possibility of PTSD cannot be ruled out, if you are currently experiencing at least one symptom from each of the following three categories. Although most people with PTSD develop symptoms within three months of the traumatic event, some people don't notice any symptoms until years after it occurred. A major increase in stress, or exposure to a reminder of the trauma, can trigger symptoms to appear months or years later.

1. Symptoms of reliving or "re-experiencing" the trauma

Upsetting memories about the event. This usually involves having vivid images about the trauma come up again and again even when you do not want to have them. For example, if you were physically attacked, you might keep remembering your attacker's face. Or, if you were in a car accident, you might have strong memories about the sound of the crash or a vivid picture of blood all over yourself or someone else involved.

Nightmares about the trauma. People with PTSD will often have very vivid nightmares of either the trauma or themes surrounding the trauma. For example, if you were in a car accident, you might have frequent nightmares about being in the accident yourself, or about other people being involved in accidents. Some people with PTSD who were assaulted will have nightmares of being chased, and the person chasing them in the dream might not be the person who assaulted them.

Acting as if the trauma were happening again ("reliving the trauma"). This is also called "dissociation", where an individual loses touch with the present, and feels as if they are living through the trauma again. Some people with this symptom might speak and act as if they are physically in the traumatic situation, whereas others might appear to simply stare off into space for a period of time. Some people with PTSD will also have "flashbacks", which are very vivid images of the trauma they experienced. Flashbacks can seem very real, and some people describe it as a picture or movie that they can see clearly in their minds.

Anxiety or distress when reminded of the trauma. Some people with PTSD become extremely upset or feel very anxious whenever they are confronted with a person, place, situation, or conversation that reminds them of the trauma. This can include becoming very upset when hearing tires squeal if you were in a car accident, or feeling anxious when watching violence on TV if you were assaulted.

2. Symptoms of avoidance

Avoiding reminders of the trauma. Many people with PTSD will try very hard to avoid anything that is associated with, or reminds them of, the traumatic event they experienced. Reminders can include - Circumstances (e.g., the actual date of the event, clothes worn, place where the event occurred, etc.); Things associated with the trauma (e.g. being in a car if the trauma was a car accident); General signs of danger (e.g. TV shows about violence, news programs, police or fire department sirens, fire alarms, etc.); Avoiding thoughts, feelings, or memories related to the trauma. Although many people with PTSD will avoid any reminders of their traumatic experience, it is also common for people to avoid even thinking about what happened. For example, you might avoid talking to anyone about the trauma, and if you have thoughts or memories about what happened, you might try to push them out of your head.

Not able to recall parts of the trauma. It is not uncommon for people who have lived through a trauma to have difficulty remembering parts of it, or the entire trauma, or to be confused about the timeline of events.

Reduced interest in previously enjoyed activities. For example, after a trauma, you might stop wanting to spend time with friends and family, or you might stop all activities that you used to enjoy (such as sports or hobbies).

Feeling detached/estranged from others. People with this symptom describe feeling cut off from others, even though they might have family and/or friends around them.

Feeling numb/unable to experience feelings. Some people with PTSD will say that they generally feel numb, and don't experience loving feelings anymore (such as love, joy, or happiness). People with this symptom might have a hard time even describing how they feel, and are not able to recognize when they are happy, sad, or angry.

Feeling of foreshortened future. It is not uncommon for people with PTSD to say that they have a feeling of "impending doom"; that is, they say that they don't expect to live long, that something bad is likely to happen again soon, or that they feel hopeless about the future.

3. Symptoms of increased anxiety or "hyper arousal"

Sleep difficulties. Some people with PTSD will have trouble falling asleep or staying asleep. This often happens when you feel quite anxious throughout the day.

Anger outbursts or irritability. It is not uncommon for people with PTSD to feel more irritable and angry. If you have this symptom, you might find yourself snapping at people, or getting extremely angry in a situation that reminds you of your trauma. For example, if you were in a car accident, and while driving someone cuts you off, you might get very angry and even yell or act inappropriately.

Concentration difficulties. Many people with PTSD report that they have a hard time paying attention or concentrating while completing daily tasks. This is often the result of being very anxious; it is not a sign that there is something wrong with your memory.

Hyper vigilance. Often, people with PTSD feel as if they are "on guard" or "on alert" all the time. People with this symptom will be very easily startled, and will jump at the slightest sound (for example, the telephone ringing, someone tapping you on the shoulder).

Self-help and/or treatment portion of this article is posted elsewhere

This is a Compiled Article 

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