Post-traumatic stress disorder (PTSD)

Find a doctor

It can be hard to talk about PTSD, or post-traumatic stress disorder. At Atrium Health Floyd and Harbin Clinic, we teach people helpful ways to react to the events that trigger PTSD symptoms. Our goal is to help people process their emotions and learn the skills to manage them.

What is PTSD?

PTSD is characterized by sudden surges of anxiety or depression caused by burnout from hypervigilance. It’s characterized by emotional dysregulation, avoidant behavior, increased arousal or alertness, or persistent negative emotion.

What causes PTSD?

PTSD occurs in people who have experienced a specific traumatizing event, such as being the victim of a crime, abuse, accident or disaster. It’s also common in people who’ve experienced prolonged exposure to stressful environments or circumstances, such as soldiers or those who live in war zones.

Not every traumatized person develops long-term (chronic) or short-term (acute) PTSD. And not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD.

What are the symptoms of PTSD?

PTSD symptoms usually begin early, within three months of a traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.

Symptoms of avoidance in PTSD

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change their routines. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

Other symptoms of avoidance include:

Avoiding thoughts or feelings related to the traumatic event
Staying away from places, events or objects that are traumatic reminders

Symptoms of hyperarousal and reactivity in PTSD

When arousal is constant, instead of being occasional, a person can feel stressed and angry. This can make daily tasks – sleeping, eating or concentrating – difficult.

Hyperarousal and reactivity symptoms include:

Being easily startled
Feeling tense or on edge
Having angry outbursts
Having difficulty sleeping

Symptoms of PTSD that affect cognition and mood

Cognition and mood symptoms can begin or worsen after a traumatic event. These symptoms can make a person feel alienated or detached from friends and family members.

Cognition and mood symptoms include:

Distorted feelings like guilt or blame
Loss of interest in enjoyable activities
Negative thoughts about oneself or the world
Trouble remembering key features of the traumatic event

Symptoms of PTSD in children

Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults.

In children younger than 6, these symptoms can include:

Acting out the scary event during playtime
Being unusually clingy with a parent or other adult
Forgetting how to or being unable to talk
Wetting the bed after having learned to use the toilet

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful or destructive behaviors. Older children and teens may feel guilty for not preventing injuries or deaths. They may also experience thoughts of revenge.

PTSD diagnosis

Some people with PTSD don’t have any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse or other anxiety disorders. A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least one month:

At least one avoidant experience
At least two arousal and reactivity experiences
At least two cognition and mood related experiences
At least one case of reexperiencing symptoms

Reexperiencing symptoms entails reexperiencing the trauma. This can happen in several ways such as dreams, frightening thoughts or flashbacks.

PTSD risk factors

According to the National Center for PTSD, about seven or eight of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others. Anyone can develop PTSD at any age.

Common risk factors include:

Living through dangerous events and traumas
Getting hurt
Seeing another person hurt or seeing a dead body
Childhood trauma
Feeling horror, helplessness or extreme fear
Having little or no social support after a traumatic event
Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
Having a history of mental illness or substance abuse

Resilience factors may reduce the risk of PTSD

There are several things that can lessen the risk of PTSD, including:

Seeking out support from other people, such as friends and family
Finding a support group after a traumatic event
Learning to feel good about one’s own actions in the face of danger
Having a positive coping strategy, or a way of getting through the bad event and learning from it
Being able to act and respond effectively despite feeling fear

Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.

PTSD treatment

The main treatments for people with PTSD are medication, therapy or both. It’s important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.

Therapy can teach people helpful ways to react to the events that trigger PTSD symptoms. Based on this goal, different types of therapy may:

Teach about trauma and its effects
Use relaxation and anger-control skills
Provide tips for better sleep, diet and exercise habits
Help people identify and deal with guilt, shame and other feelings about the event
Focus on changing how people react to their PTSD symptoms

Psychotherapy involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. This treatment for PTSD usually lasts six to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.

Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.

Effective psychotherapies tend to emphasize a few key components, including education about symptoms plus teaching skills to help identify the triggers of symptoms and skills to manage the symptoms.

Exposure therapy helps people face and control their fear by gradually exposing them to the trauma they experienced – in a safe way. It includes imagining, writing about or visiting the place where the traumatizing event happened. The therapist uses these tools to help people with PTSD cope with their feelings.

Cognitive restructuring helps people make sense of bad memories. Sometimes people remember a traumatic event differently than how it happened. They may feel guilt or shame about something that’s not their fault. A therapist can help a person with PTSD look at what happened in a realistic way.

PTSD recovery

Finding the right health care professional for treatment is the first step. Recovery happens after or between treatment sessions and requires focus and dedication. Certain things are essential to recovery:

Talk with your doctor about treatment options.
Engage in mild physical activity or exercise to help reduce stress.
Set realistic goals for yourself.
Expect your symptoms to improve gradually, not immediately.
Identify and seek out comforting situations, places and people.
Break up large tasks into small ones, set some priorities and do what you can.
Try to spend time with other people and confide in a trusted friend or relative.
Tell others about things that may trigger symptoms.
Care for yourself and others.