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What is PTSD? Why does it affect some people and not others?

Posttraumatic stress disorder or PTSD occurs in people who experience a traumatic event. What constitutes a traumatic event can vary significantly. 

Following World War I, the psychiatric disorder was known as shell shock. After World War II, it was named combat fatigue.

We now know that PTSD isn’t something that just affects combat veterans. Many other dangerous events or upsetting events can lead to PTSD. 

Untreated, complications can occur, including other co-occurring mental health disorders and an increased risk of developing a substance use disorder.

Understanding PTSD

You’ll see the condition written as post-traumatic stress disorder, posttraumatic stress disorder, or PTSD. If you experience something dangerous, scary, shocking, or life-threatening, you could be at risk for this psychiatric condition.

It’s normal in a scary situation to feel fear. Fear leads to physiological changes in your body. Your fight-or-flight response is activated, and that’s something that helps protect you from harm. Most people who go through a traumatic event will naturally recover from the symptom of that frightening event. 

If you don’t, you may receive a PTSD diagnosis. Someone with this mental health disorder often feels an ongoing, heightened sense of fear and anxiety even when there’s no danger. You could have an extreme reaction to a life-threatening or upsetting event that doesn’t get better with time. 

What Causes PTSD?

Stressful events or anything frightening can potentially cause PTSD.

Examples include car accidents, natural disasters, domestic violence, or sexual violence. There are also cases where something that’s not necessarily dangerous can contribute to PTSD, like the unexpected death of a loved one. 

You will start to feel normal after the traumatic situation in a normal situation. If you don’t feel better, symptoms of PTSD could be occurring. 

You can develop a mental health condition at any age. Risk factors that make it more likely you’ll develop PTSD can include:

  • Your sex—women are more likely to develop PTSD
  • A history of childhood trauma
  • Feeling helpless or having extreme fear
  • Going through a traumatic event lasting a long time
  • Not having a lot of social support after the event
  • Having additional stress after the event, like the loss of a loved one
  • A history of substance use or mental illness

The Symptoms of PTSD

Symptoms of PTSD usually begin within three months of the traumatic event but can emerge later than that. The symptoms have to last longer than a month and interfere with daily life for a diagnosis. The signs of PTSD have to be unrelated to another illness, substance use, or medication.

Some people will recover within a six-month window. For other people, symptoms of the condition can last a year or more.

A health care provider, including a psychologist or psychiatrist, can diagnose PTSD and begin working on a treatment plan.

The common symptoms of posttraumatic stress disorder are broken down into four main categories.

  • Re-experiencing symptoms can include flashbacks like reliving the traumatic event, reoccurring distressing memories, or frightening dreams related to the event. Intrusive memories are common reactions that are part of re-experiencing symptoms. Distressing thoughts or physical signs of stress can be included in symptoms such as high blood pressure or a racing heart. 
  • Avoidance symptoms: Someone experiencing avoidance symptoms related to PTSD might stay away from things that remind them of the traumatic experience, such as events, places, or objects. They also avoid thoughts or feelings related to the traumatic event, and avoidance symptoms can lead someone to change their routines.
  • Arousal and reactivity symptoms: Symptoms in this category might include being startled easily, feeling tense or on edge, or having trouble concentrating. Having problems falling or staying asleep, feeling irritable, or engaging in destructive or risky behavior might be categorized as arousal or reactivity symptoms. Angry outbursts can fall into this category of arousal symptoms. Physical symptoms can sometimes be categorized as arousal and reactivity. For example, someone might have stomach aches or physical sensations. 
  • Cognition and mood symptoms: For someone with PTSD, these could include thinking negatively about oneself or the world, problems remembering key features of a traumatic event, distorted thoughts about the event, ongoing negative emotions like guilt, shame or fear, feelings of social isolation and loss of interest in previous activities. You might also have a hard time experiencing positive emotions like happiness or have feelings of detachment from other people in your life. 

Why Doesn’t Everyone Develop PTSD?

When exploring the answer to “what is PTSD,” a common question is why some people experience the condition after exposure to a traumatic event, and others don’t. Nearly everyone will be exposed to something traumatic in their life, but most people don’t develop symptoms of PTSD.

Some factors increase the risk, which we talked about above.

There are also resilience or protective factors that can reduce the likelihood of developing PTSD.

These resilience factors can include seeking support from friends and family and having a coping strategy after the traumatic incident. 

Treatment Options for PTSD

Anyone who thinks they could have symptoms of PTSD needs to work with a mental health professional. Effective treatments are available and are similar to the approaches for treating an anxiety disorder. 

There are two primary types of treatment—psychotherapy or medication. An experienced medical professional can work with you to figure out the treatment plan that will address your symptoms and meet your needs.

Along with treating PTSD, it’s important to receive treatment for any co-occurring conditions such as panic disorder, alcohol or drug abuse, depression, or suicidal thoughts. Treating these co-existing conditions can improve treatment outcomes.

Talk Therapy

Talk therapy or psychotherapy includes different treatment techniques that a mental health professional can use to help people identify problematic emotions, behaviors, and thoughts. During talk therapy, someone with PTSD can gain support and education.

Therapy for PTSD can occur individually on a one-on-one basis, or it can take place in a group setting. Most therapy treatments for PTSD will last 6 to 12 weeks but can last longer.

  • In some forms of psychotherapy for PTSD, the focus is on the symptoms themselves. Other forms of therapy will focus on problems in a specific area of your life, such as relationships or at your job.
  • When you go through therapy for PTSD, you should learn how to identify triggers and manage your symptoms.
  • Cognitive-behavioral therapy is one of the most frequently utilized specific forms of talk therapy for PTSD.
  • Cognitive-behavioral therapy or CBT can include exposure therapy and cognitive restructuring.
  • Exposure therapy helps people learn how to effectively manage their fears through gradual exposure in a safe environment.
  • Cognitive restructuring is a way to help people sort through the traumatic event.

Medications

Some medications can help with symptoms of PTSD also.

Serotonin reuptake inhibitors or SSRIs are the antidepressant types that are most often used. These medications can help with specific PTSD symptoms like worry, sadness, and anger.

PTSD Treatment in Southern California

PTSD can be debilitating when it’s not treated. Too often, we see people who have the symptoms of PTSD, and they believe that it’s normal because of their traumatic exposures. 

The reality is that treatment is available, and when you don’t seek help, PTSD can lead to problems in relationships, at school or work, and in social functioning.

We encourage you to get in touch with Story Wellness confidentially to learn more about PTSD treatment by calling (866) 476-2823.