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Alternative Names Return to topPTSD
Definition Return to top
Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.
Causes Return to top
Post-traumatic stress disorder (PTSD) may occur soon after a major trauma, or it can be delayed for more than 6 months after the event. When it occurs soon after the trauma, it usually gets better after 3 months. However, some people have a longer-term form of PTSD, which can last for many years.
PTSD can occur at any age and can follow a natural disaster such as a flood or fire, or events such as war, a prison stay, assault, domestic abuse, or rape. The terrorist attacks of Sept. 11, 2001, in the U.S. may have caused PTSD in some people who were involved, in people who saw the disaster, and in people who lost relatives and friends. These kinds of events can produce stress in anyone, but not everyone develops PTSD.
The cause of PTSD is unknown, but psychological, genetic, physical, and social factors are involved. PTSD changes the body’s response to stress. It affects the stress hormones and chemicals that carry information between the nerves (neurotransmitters). Having been exposed to trauma in the past may increase the risk of PTSD.
Having good social support helps to protect against PTSD. In studies of Vietnam veterans, those with strong support systems were less likely to get PTSD than those without social support.
People with PTSD re-experience the event again and again in at least one of several ways. They may have frightening dreams and memories of the event, feel as though they are going through the experience again (flashbacks), or become very upset during anniversaries of the event.
Symptoms Return to top
Symptoms of PTSD fall into three main categories:
1. Repeated "reliving" of the event, which disturbs day-to-day activity
You also might feel a sense of guilt about the event (including "survivor guilt"), and the following symptoms, which are typical of anxiety, stress, and tension:
Exams and Tests Return to top
There are no tests that can be done to diagnose PTSD. The diagnosis is made based on a certain set of symptoms that continue after you've had extreme trauma. Your doctor will do psychiatric and physical exams to rule out other illnesses.
Treatment Return to top
Treatment aims to reduce symptoms by encouraging you to recall the event, express your feelings, and gain some sense of control over the experience. In some cases, expressing grief helps to complete the necessary mourning process. Support groups, where people who have had similar experiences can share their feelings, are very helpful.
People with PTSD may need to treat depression, alcohol or substance abuse, or related medical conditions before addressing symptoms of PTSD. Behavioral therapy is used to treat avoidance symptoms. This can include being exposed to the object that triggers your symptoms until you become used to it and no longer avoid it (called graded exposure and flooding).
Medicines that act on the nervous system can help reduce anxiety and other symptoms of PTSD. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), can be effective in treating PTSD. A doctor should monitor you if you take these drugs, because they can have side effects. Sedatives can help with sleep disturbance. Anti-anxiety medicines may be useful, but some types, such as benzodiazepines, can be addictive.
Support Groups Return to top
You can find more information about post-traumatic stress disorder and coping with a national tragedy from the American Psychiatric Association -- www.psych.org.
Outlook (Prognosis) Return to top
The best outcome, or prognosis, depends on how soon the symptoms develop after the trauma, and on how quickly you get diagnosed and treated.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Although traumatic events like the September 11 tragedy can cause distress, not all feelings of distress are symptoms of PTSD. Talk about your feelings with friends and relatives. If your symptoms last longer, or are worse, than those of your friends, contact your doctor.
Seek help immediately by going to the emergency room or calling the local emergency number (such as 911) if:
You can also contact your doctor for help with ongoing problems such as recurrent thoughts, irritability, and problems with sleep.
Prevention Return to top
Research into ways to prevent PTSD is ongoing.
References Return to top
Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007;3:CD003388.
Ipser JC, Carey P, Dhansay Y, Fakier N, Seedat S, Stein DJ. Pharmacotherapy augmentation strategies in treatment-resistant anxiety disorders. Cochrane Syst Rev. 2006;4:CD005473.Update Date: 1/20/2009 Updated by: Paul Ballas, DO, Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.