Post-Traumatic Stress Disorder

Condition Basics

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a mental health problem that can result from traumatic events. It can make you feel scared, confused, or angry. And you may have nightmares or flashbacks. PTSD can cause a lot of distress and can affect your daily life. But many people get better with treatment.

What causes it?

Anyone who has gone through or witnessed a traumatic event can get PTSD. These events can include combat, sexual or physical violence, serious accidents, and being in the intensive care unit (ICU). Many people who go through a traumatic event don't get PTSD. It isn't clear why some people get PTSD and others don't.

What are the symptoms?

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. Symptoms include feeling upset by reminders of what happened, having flashbacks, being depressed, feeling that you're always in danger, and having trouble sleeping or keeping your mind focused. Children may have other symptoms.

How is it diagnosed?

There's no medical test that can diagnose PTSD. Your doctor will ask about your symptoms, how long you've had them, and how much they affect your daily activities. Your doctor may also ask about the event or events that led to your symptoms and check to see if you have other health problems like depression.

How is PTSD treated?

Treatment for PTSD includes cognitive behavioral therapy (CBT) and antidepressant medicines. There are many types of CBT. You may need to try different types of treatment before you find the one that helps you. Treatment can help you to feel more in control of your emotions, have fewer symptoms, and enjoy life again.

Cause

Anyone who has gone through or witnessed a traumatic event can get PTSD.

Examples of events include:

• Combat or being sent to a combat zone.
• Military sexual trauma.
• Terrorist attacks.
• Physical or sexual violence.
• Serious accidents, like a car wreck.
• Natural disasters, like a fire or tornado.
• Serious illnesses, like cancer.
• Staying in the hospital, especially in the intensive care unit (ICU).
• Living in or near a conflict, like war.

Many people who go through a traumatic event don't get PTSD. How likely you are to get PTSD depends on many things, including:

• How intense the trauma was.
• If you lost a loved one or were hurt.
• How close you were to the event.
• How strong your reaction was.
• How much you felt in control of events.
• How much help and support you got after the event.

Having a history of mental health problems, substance use disorder, or childhood trauma may also increase your risk.

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Symptoms

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years.

After going through a traumatic event, you may:

• Feel upset by things that remind you of what happened.
• Have nightmares, vivid memories, or flashbacks of the event. You may feel like it's happening all over again.
• Avoid places or things that remind you of what happened. You may even avoid talking or thinking about the event.
• Often feel bad about yourself and the world.
• Feel numb or lose interest in things you used to care about.
• Feel that you're always in danger, or worry that something bad is about to happen.
• Feel anxious, jittery, or irritated.
• Have trouble sleeping or keeping your mind on one thing.

PTSD symptoms can change your behavior and how you live your life. You may pull away from other people, work all the time, or use drugs, marijuana, or alcohol. You may find it hard to be in relationships. And you may have problems with your spouse and family.

Children can have PTSD too. They may have the symptoms listed above and symptoms that depend on how old they are. As children get older their symptoms are more like those of adults.

• Children who are younger than 6 may act out the details of the trauma through play. Or they may have upsetting dreams and nightmares that may not be related to the details of the trauma. Parents may also notice behavioral and emotional changes, like extreme temper tantrums or avoiding people, places, and activities that remind them of the trauma.
• Older children and teens may view themselves in a negative way and engage in risky behaviors. And they may have behavioral problems that affect their performance at school and their relationships with friends.

If you think you or your child has PTSD, talk to your doctor or a counselor. Treatment can help.

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What Happens

PTSD can make it hard to do daily activities like work or school. It can also affect your relationships with those who are closest to you like your partner, friends, or family. You may also develop unhealthy behaviors to cope with your symptoms, like drinking too much, lashing out, or avoiding others.

Problems that often occur with PTSD

PTSD doesn't always occur alone. Other medical conditions often occur with it, such as substance use disorder, depression, panic attacks, and physical health problems. Suicide is a risk for some people who have PTSD.

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When to Call a Doctor

Call 911 anytime you think you may need emergency care. For example, call if:

• You feel you cannot stop from hurting yourself or someone else.
• You feel hopeless or think of hurting or killing yourself.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Watch closely for changes in your health, and be sure to contact your doctor if:

• Your PTSD symptoms are getting worse.
• You have new or worse symptoms of anxiety or depression.
• You are not getting better as expected.

Check your symptoms

Exams and Tests

There is no medical test that can diagnose PTSD. Your doctor will ask you about your symptoms, how long you've had them, and how much they affect your daily activities.

Your doctor may also ask about:

• The event or events that led to your symptoms.
• Traumatic events in your past, including those from childhood.
• Whether anyone in your family has had a mental health problem.
• Whether you have any suicidal thoughts or thoughts of harming others.

You may also have a physical exam or lab tests to check for signs of injury or other medical problems that may be causing your symptoms. Your doctor will also check to see if you have other mental health problems like depression or substance use disorder.

Your doctor may want your spouse, partner, or close family member to come with you. This person can help your doctor understand what you've been going through.

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Treatment Overview

Medicines and counseling are used to treat PTSD. Treatment can help you to feel more in control of your emotions, have fewer symptoms, and enjoy life again.

• Counseling. There are many types of therapy that focus on the trauma to help you get better. Most therapies use cognitive-behavioral therapy (CBT) techniques to help you understand your thoughts and learn ways to cope with your feelings.
  • In prolonged exposure therapy, you talk about the traumatic event as if it were happening again. You may also be exposed to places or things that are related to the event. You do these things until you have less fear.
  • With cognitive processing therapy, you learn to change negative emotions and thoughts related to the trauma.
• Antidepressant medicines, especially selective serotonin reuptake inhibitors (SSRIs). They can help with many PTSD symptoms. SSRIs include fluoxetine, paroxetine, and sertraline.

You may need to try different types of treatment before you find the one that helps you. Your doctor will help you with this. These treatments may include other types of medicines and other forms of counseling, such as group counseling. If you have other problems along with PTSD, such as overuse of alcohol or drugs, you may need treatment for those too.

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Self-Care

It's important to take care of yourself when you have PTSD. Here are some things that you can do.

• Learn about PTSD.

  This can help you better understand how and why it affects you.

• Accept and cope with your symptoms in a positive way.

  It may be tempting to avoid or ignore your symptoms. But when you accept what the traumatic event did, you can take steps to help you get better. And you may find that you feel more in control.

• Develop and maintain healthy habits.

  Get regular exercise and enough sleep, reduce stress, and be sure to eat a balanced diet.

• Identify and talk about your triggers.

  Certain places, people, or experiences may remind you of the trauma. You may withdraw or avoid those things to prevent new or worse symptoms. Share these triggers with your doctor. Your doctor may be able to help.

• Recognize and accept your anxiety.

  When you are in a situation that makes you anxious, say to yourself, "This is not an emergency. I feel uncomfortable, but I am not in danger. I can keep going even if I feel anxious."

• Find things that help ease your memories and reactions.

  Consider channeling your emotions into activities or sports, painting or writing, or a rewarding job.

• Identify your beliefs to keep you balanced.

  PTSD can cause a spiritual crisis. You may start to question your own beliefs and values and ask yourself why war or disasters happen. If this happens to you, talk to a family member, friend, or spiritual adviser. Consider spiritual study, prayer, or meditation.

• Avoid negative coping skills.

  These are certain ways you may try to deal with your symptoms and problems that cause more harm than good. They're quick fixes that don't improve your situation in the long run. They include drinking too much, avoiding others, and lashing out.

• Seek support.

  You may want to learn more about PTSD or talk with others who have PTSD. You need people who understand what you're going through and will help you and care about you. This is your support network. Support takes many forms. You can find it in seminars and groups led by professionals, in groups made up of others with PTSD, and in your relationships with family and friends.

• Get help right away if you or someone you know talks about suicide, self-harm, or feeling hopeless.

  Where to get help 24 hours a day, 7 days a week

  If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

  • Call the Suicide and Crisis Lifeline at 988.
  • Call 1-800-273-TALK (1-800-273-8255).
  • Text HOME to 741741 to access the Crisis Text Line.

  Consider saving these numbers in your phone.

  Go to 988lifeline.org for more information or to chat online.

Learn more

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Getting Support

When you have PTSD, social situations can bring up a lot of emotions. For example, you may feel on edge, anxious, or angry. Because of this, you may withdraw from those who are closest to you to cope with your symptoms. This can make it hard to connect with your community or accept support from those who care about you.

Here are things you can do to help yourself, your family, and your community better understand and deal with PTSD.

• Know when to get crisis help. Sometimes you need help right away. This may be the case when you've had thoughts about suicide or if anger turns to rage.
• Let your friends and family know how they can help. They play an important part in your recovery from PTSD. But you also have to help them. This means:
  • Talking to your family and friends about PTSD and what it does to you.
  • Talking to your kids. Be sure they know that they aren't to blame.
  • Talking about your triggers. Triggers are places, sounds, and sights that can cause symptoms. They can be locations, social events, or holidays.
• Remember that life transitions—even positive ones such as getting married, having a baby, or starting a new job—can cause stress and result in more PTSD symptoms.

Your family and community are part of your recovery. Do as much as you can to work with them. With knowledge, your family and community can better help you.

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Helping Someone Who Has PTSD

If you care about someone with PTSD, here's what you can do to help.

• Learn what you can about PTSD.

  The more you know, the better you can understand what your loved one is going through.

• Encourage contact with family and close friends.

  A support system will help your family member get through hard changes and stressful times.

• Learn how to deal with anger.

  Both you and your loved one may be angry at times.

• Learn the best way to talk with your loved one.

  When a loved one has PTSD, communication can be hard. These tips may help.

  • Be clear and to the point.
  • Be a good listener.
  • Put your feelings into words.
  • Don't give advice unless you are asked.
• Offer to go to doctor visits with your loved one.

  You can help keep track of appointments, and you can be there for support.

• Be open to talking.

  Tell your loved one you want to listen and that you also understand if they don't feel like talking. Give your loved one space, but let them know you're there to help.

  • If the person doesn't want your help, keep in mind that withdrawal can be a symptom of PTSD.
  • A person who withdraws may not feel like talking, taking part in group activities, or being around other people.
• Stay active.

  Take a walk, go for a bike ride, or do some other physical activity together. Exercise is important for health and helps clear your mind.

• Take care of yourself.

  Take time for yourself, and have your own support system.

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