PTSD: What are the symptoms, causes and treatments? - explainer

Post-traumatic stress disorder, abbreviated as PTSD, is a mental and behavioral disorder that follows a traumatic experience.

Exactly what kind of trauma can trigger it varies from person to person, but cases and symptoms are widespread throughout the world.

PTSD itself is nothing new, as people have experienced similar symptoms following trauma for thousands of years. This condition has therefore gone under many different names in the past, such as shell shock and combat neurosis.

There are a number of possible symptoms of PTSD, some of which appear earlier than others as early signs. 

But what exactly is PTSD? What are the symptoms? How common is it and what can be used to treat it?

Here is everything you need to know.

What is PTSD? What does PTSD mean?

PTSD refers to post-traumatic stress disorder. In other words, it literally means a stress disorder that follows a traumatic event. 

Though the exact wording may vary, almost all commonly-used PTSD definitions cite it as a mental health, emotional and/or anxiety condition that is triggered by either experiencing or witnessing a traumatic and terrifying event.

How do you know if you have PTSD? What causes PTSD?

Essentially, anything that could be considered traumatic, stressful and anxiety-inducing can in theory cause PTSD. 

This can include witnessing a traumatic event or outright being part of it.

Stressful events that can induce PTSDS include the following:

• Sexual assault or rape
• Armed conflict/war
• Physical assault or mugging
• Personal betrayal
• Serious health issues
• Car accident or similar vehicular disaster
• Experiencing a natural disaster
• Living in a conflict zone, such as near Gaza where rockets are fired

While traumatic experiences can always cause the disorted, not everyone who experiences trauma develops PTSD.

As explained by the National Institute of Mental Health (NIMH) at the US National Institutes of Health (NIH), most people who experience trauma are to some extent traumatized and will experience short term symptoms.

However, that is not the same as ongoing or chronic PTSD. 

To be considered PTSD, symptoms need to last more than a month and be severe enough to actually interfere with one's daily life. Some people, like those who only have short-term symptoms, end up recovering within half a year. Most people who experience trauma will only have short term symptoms. But some will develop a chronic case of PTSD.

There are some other things we know about who gets PTSD and why.

For instance, women are more likely to develop PTSD than men, and physical assault-based trauma is more likely to trigger PTSD than non-physical trauma.

Certain professions also make one more likely to develop PTSD, most notably soldiers, healthcare workers, police officers, journalists and more. 

There are also comorbidities like substance use, such as with alcohol, as well as other mental health and emotional regulation issues.

Children and teenagers are also able to develop PTSD, though their symptoms may differ from adults.

Some have even theorized that there may be a genetic predisposition to developing PTSD, though this is still the subject of debate.

What are the symptoms of PTSD? What will PTSD do to a person?

PTSD comes with a whole host of symptoms, most of which typically manifest very quickly after the traumatic event, within three months or so. However, they will sometimes manifest later, sometimes even years later.

As noted by the NIMH, there are a few different categories of PTSD symptoms: Re-experiencing symptoms, avoidance symptoms, arousal and reactivity symptoms and cognition and mood symptoms.

To be diagnosed with PTSD, one must have at least one re-experiencing symptom, one avoidance symptom, two arousal and reactivity symptoms and two cognition and mood symptoms, which must last for at least a month.

Re-experiencing symptoms of PTSD include nightmares and flashbacks to the traumatic event which can even cause physical symptoms like a panic attack. These can be debilitating as they can be triggered by things such as words, objects or a situation that act as reminders of the trauma, or they can just be sparked by one's own feelings and thoughts.

Avoidance symptoms of PTSD include avoiding anything that can trigger a reminder of the trauma, whether it be something physical like a place, object or event or something abstract like a feeling or a thought. These avoidance symptoms can also be debilitating, as it may cause someone to completely change their daily routine, like avoiding where they experienced trauma or avoid driving if the trauma was triggered by a car crash. 

Arousal and reactivity symptoms of PTSD are different in that they aren't necessarily triggered as much as they are constant and ongoing. These can range from being easily frightened, being very tense, insomnia and sleeping difficulties and having angry emotional outbursts. 

Cognition and mood symptoms of PTSD are more abstract and relate to one's personal thoughts and feelings, and can have serious ramifications for one's personal life. These include overall negative feelings about the world or yourself, feelings of guilt and blame, no longer being interested in things you once enjoyed and not being able to easily remember key details about what caused the trauma.

There are different PTSD symptoms for children and teenagers. Very young children, for instance, might become unusually attached to a parent or adult, they may stop talking or forgetting how to talk, they may start wetting the bed or acting out the trauma.

Among older children and teenagers, however, symptoms are usually closer to that of adults, though there are some additional signs of PTSD, such as becoming disruptive, destructive or disrespectful, and developing thoughts of revenge.

What is C-PTSD?

It should also be noted that there is another variation of PTSD that exists known as C-PTSD, or complex PTSD or complex post-traumatic stress disorder.

While very similar to PTSD, there seem to be some distinctions in C-PTSD, specifically in causes and additional symptoms.

Regarding causes, C-PTSD differs from PTSD in that while PTSD may be triggered by a single traumatic event, C-PTSD is typically triggered by an ongoing traumatic event or a series of traumas. 

Potential causes for C-PTSD include, but are not limited to:

• Ongoing physical or sexual abuse and assault
• Ongoing bullying
• Long kidnapping or hostage situations
• Being held in captivity or as a prisoner of war or concentration camp
• Slavery and human trafficking
• Child labor
• Being in an abusive relationship
• Having lived under an authoritarian regime or religion

C-PTSD is typically caused by prolonged traumatic experiences that causes the sufferer to feel trapped, not in control and with no chance of ever escaping. It is when your fate is entirely out of your control, and often in someone else's control. 

This, in turn, leads to other symptoms as well, specifically a greater focus on emotional dysregulation and severe distortions of one's personal identity, self-perception and sense of self, such as developing severe low self-esteem and feeling worthless, helplessness and self-loathing.

In particular, C-PTSD can be more severe if the trauma in question took place earlier in life, as noted by the UK National Health Services (NHS), because it can alter the course of childhood development.

However, in both cases, a declining and spiraling mental health without intervention is possible, which can even escalate to self-harm and suicide.

How can you treat PTSD?

A number of PTSD treatment methods exist and are used around the world.

Sometimes, seeing early signs of PTSD and responding to them can do wonders. In particular though, having support from people, such as a support network of friends and family as well as a support group, can make significant progress in dealing with PTSD. 

It is also important to try and find a positive coping strategy and be able to act despite fear, and being able to feel good about yourself and your actions.

While many treatment methods do exist, such as Israel treating IDF soldiers' PTSD with hyperbaric oxygen chambers, on a professional level, there are roughly two categories for treating PTSD: medication and psychotherapy. Because every case is different, there is no universal treatment, but employing variations of one or both of these methods is usually the best bet.

Having a therapist is essential, but they must have experience in treating PTSD before. This can be one-on-one sessions or in a group, and there are many different types of psychotherapy (talk therapy) that can help, though one of the most commonly touted methods used to treat PTSD is cognitive behavioral therapy (CBT). 

This includes exposure therapy, which focuses on helping patients face and control their fears by exposing them to trauma in a safe environment, and cognitive restructuring, which helps cope with guilt or shame by revisiting and making sense of traumatic memories and looking at it in a new light.

There are a few types of PTSD medications available. The most commonly used medication to treat PTSD are antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs). These medications are used to treat the emotional symptoms, like sadness, anger, feeling numb and so on.

Medications can also treat other symptoms, like sleep issues.

Other medical treatments available for PTSD include medical cannabis, which is used in some countries.

Regarding C-PTSD, all of the above applies as well, but because symptoms can manifest while the trauma is ongoing, there is another step that is often needed: Getting out of that traumatic situation.

A number of hotlines are available for those seeking help, including ERAN which can be reached by dialing 1201 (in Hebrew, English, Russian and Arabic) or through an online chat here.

Get Help Israel and Kol Zchut are among some of the sites containing English-language information on how to access psychological and emotional help.

In the US, dial 1-800-273-8255 or 988.

In the UK, dial 116-123.