People have instinctive responses that are designed to keep them alive when faced with extreme stress. This collection of instincts, often called the “fight-or-flight” response, is designed to help someone escape an immediate, short-term stressor. However, in certain situations, a person can experience the fight-or-flight response for prolonged periods of time.
When exposed to intense, chronic stress, such as battle, or a severe or life-threatening situation, such as rape, a person’s fight-or-flight response may remain active well after the dangerous situation has passed. In these instances, if an individual’s ability to function has become hindered as a result, he or she may be diagnosed with posttraumatic stress disorder.
As described above, posttraumatic stress disorder (PTSD) occurs when a person’s normal stress response persists long after danger has passed, impairing his or her ability to function appropriately on a daily basis. People do not always need to be personally at risk in a situation for PTSD to develop. For example, sometimes learning of a natural disaster or watching something happen to someone else can trigger PTSD. People with PTSD show many symptoms of anxiety, such as increased awareness of the environment and a strong startle response. Along with other symptoms, they may also experience flashbacks, during which they vividly re-experience a traumatic situation. Sometimes in an attempt to numb themselves from the pain of their traumatic past, people who suffer from PTSD turn to the use of drugs or alcohol. While PTSD can be disruptive to a person’s life, there is help available to treat this disorder.
Not all people develop PTSD after a traumatic experience. Of the seventy percent of U.S. adults who have experienced or witnessed a trauma of some kind, approximately twenty percent develop PTSD. Nationwide, between four and eight percent of people suffer from the disorder. Women are twice as likely as men to be diagnosed with PTSD, though there is some discussion that men may be underdiagnosed due to their not wishing to seek treatment.
Causes and Risk Factors for PTSD
Like most mental health disorders PTSD results from a combination of environmental and genetic factors. These include the following:
Genetic: People with a certain genetic makeup are more likely to develop PTSD after experiencing a trauma. Because of this, people with family members who either have anxiety disorders or have developed PTSD are more likely to develop PTSD themselves.
Environmental: While individual genetic factors can affect a person’s chances of developing PTSD, environmental factors can also play a role. Past experiences of trauma and a chaotic home life increase a person’s vulnerability to PTSD. Other factors, such as a positive appraisal of how one reacted to the stressful situation, having coping strategies, and being able to take action in response to the stressor, all reduce the chance of a posttraumatic stress response to an incident. Conversely, the lack of these protective factors, such as having a poor social network, little to no control, limited coping strategies, additional stressors after the event, can increase the chances of a person developing PTSD.
- Living through trauma
- Being hurt or seeing others hurt or killed
- History of mental illness
- Poor social network
- Additional stressors after the event (for example, loss of job or home)
- Elevated levels of proteins and neurotransmitters involved in forming fear memories
- History of head injury
Signs and Symptoms of PTSD
Posttraumatic stress disorder can manifest differently depending on the nature of the traumatic event and the person’s individual genetic and personality structure. These symptoms tend to fall in three categories: re-experiencing, avoidance, and hyperarousal. Below are some common signs and symptoms of PTSD:
- Flashbacks, which are vivid moments of re-experiencing the traumatic event
- Nightmares related to the event
- Intrusive thoughts
- Physiological reactions when reminded of the trauma, such as racing heart, sweating, and difficulty breathing
- Avoidance of certain everyday situations that remind the person of the trauma
- Inability to remember details about the event
- Loss of interest or pleasure in things that were previously enjoyable
- Feeling disconnected or numb
- Dissociation or feeling that the environment or one’s body is not real
- Excessive attunement to the environment
- Trouble sleeping
- Self-protective behaviors, such as insisting on sitting near an exit with one’s back to the wall at a restaurant
- Exaggerated startle response
- Outbursts of anger
Effects of PTSD
When left untreated, PTSD can have dramatically negative effects on a person’s life. Sometimes a person may even develop a substance abuse problem as an attempt to deal with the intense stress of PTSD. Effects of untreated PTSD can include the following:
Strain in relationships, which can result in separation, divorce, or loss of child custody
Poor work performance or loss of job
Inability to participate in everyday activities
Development of other mental health conditions or substance abuse problems
Shame or feelings that one is weak (especially among military members)
PTSD & Co-Occurring Disorders
Because of the severe, traumatic nature of PTSD, it is not uncommon for people to experience other mental health disorders in conjunction with PTSD. These may include:
- Substance use disorders
- Anxiety disorders
- Depressive disorders
- Bipolar disorder
- Personality disorders, such as borderline personality disorder