With Veteran’s Day coming up, it is a good time to talk about post-traumatic stress disorder (PTSD).

As someone with PTSD, I understand how painful and complicated this illness can be. If you are struggling, you are not alone.

Anna Deibel, a licensed clinical professional counselor at Grow Therapy shared with me some of her insights on PTSD to share with you. I hope that you find the following information helpful.

Post-Traumatic Stress Disorder

If someone experiences or witnesses a traumatic event, series of stressful events, or set of circumstances, they may develop post-traumatic stress disorder (PTSD).

Someone may experience these events or circumstances in emotionally, physically harmful, or life-threatening ways. As a result, the person can be left with an impacted mental, physical, social, and/or spiritual well-being long after the trauma has taken place.

The time frame of when PTSD signs appear differs from person to person. For some people, signs may start soon after a traumatic event and then continue, while others might develop new or more severe symptoms months, or even years, later.

PTSD can happen to anyone, even children. However, according to the U.S. Department of Veterans Affairs, about five percent of adults in the U.S. have PTSD in any given year. Women are more likely to develop PTSD than men, with around eight percent of women and four percent of men having PTSD at some point in their lives. This is partly because of the types of traumatic events that women are more likely to experience — such as sexual assault — compared to men.

Symptoms of PTSD: 

Some of the most common post-traumatic stress reactions are flashbacks, hypervigilance, sleep disorder, and anxiety/depression. A person may also have the inability to accept positive emotions.

Symptoms of PTSD fall into the following four categories, and specific symptoms can vary in severity.

• Intrusion – This involves an individual experiencing intrusive thoughts, reliving traumatic memories, or having flashbacks. Flashbacks might be so vivid that someone might feel like they’re re-experiencing the traumatic event. 
• Avoidance – These symptoms manifest as avoiding reminders of the traumatic event, such as people, places, activities, objects, and situations.
• Alterations in Cognition and Mood – Not being able to remember important aspects of the traumatic event, negative thoughts, and feelings that lead to ongoing and distorted beliefs about oneself or others are all symptoms that come from changes in thinking and mood. 
• Alterations in Arousal and Reactivity – Symptoms of this type might include someone being irritable and experiencing angry outbursts, behaving in a self-destructive way, being overly alert or suspicious of their surroundings, being easily alarmed, or having concentration and sleep problems.

To be considered for a PTSD diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria specifies that signs and symptoms must last more than a month and be severe enough to interfere with school, work, or relationships.

Types of Trauma:

Trauma is an emotional response to a distressing event for an individual, this includes:

• Acute Trauma – A single overwhelming incident, like a sexual assault, a car accident, a natural disaster, or a mass shooting.
• Chronic Trauma (or Complex Trauma) – When something highly stressful happens repeatedly or continues for a long time. This can include circumstances such as war, child neglect or abuse, domestic violence, or stress within a community. Those who have experienced a lot of complex trauma can develop a condition called complex PTSD. 
• Insidious Trauma – Gradual and subtle but with harmful effects, insidious trauma may include racism, sexism, or homophobia. Being part of a marginalized community can significantly impact a person’s mental health. 
• Vicarious Trauma (or Secondary/Second-Hand Trauma) – Healthcare professionals, social workers, caregivers, and therapists may experience this kind of trauma because they frequently see or hear about other people’s trauma. Vicarious trauma can also occur if you hear about something bad that happened to a friend or loved one. 
• Mass Trauma – Large-scale natural disasters like earthquakes and human-caused disasters such as terrorist attacks and war can cause mass trauma — trauma experienced by a large group of people. 
• Intergenerational Trauma – When a traumatic experience is passed down from one generation to the next, this is called intergenerational or generational trauma. For example, a mother who was poorly treated by her mother may treat her children the same way. This is because trauma can actually change a person’s DNA, which is then passed on to biological children. 
• Historical Trauma – When a specific cultural, racial, or ethnic group experiences like genocide, slavery, colonialism, and war, the trauma can last for many years and usually spans multiple generations. 

If any kind of trauma continues for an extended period, it can affect your mental health, and conditions such as depression, anxiety disorders, and PTSD can occur.

Risk Factors for PTSD:

Many factors can play a part in whether someone develops PTSD after a traumatic event. The National Institute of Mental Health (NIMH) states that several risk factors may increase the chances of someone developing PTSD, such as:

• Exposure to previous traumatic experiences, particularly during childhood.
• Getting hurt or seeing people hurt or killed.
• Feeling horror, helplessness, or extreme fear.
• Having little or no social support after the event.
• Dealing with stressful situations after the event, such as pain and injury, or losing a job or home.
• Having a personal or family history of mental illness or substance use.

Conversely, there are resilience factors that can reduce the probability of someone getting PTSD after a traumatic event. According to NIMH, those factors include:

• Learning to feel OK with your actions in response to a traumatic event.
• Having a coping strategy for getting through and learning from a traumatic event.
• Being ready to respond to distressing events as they happen, even if you feel scared.
• The willingness to receive support — whether from friends, family, a support group, or through therapeutic intervention.

Treatment for PTSD:

Not all people who experience PTSD need treatment, especially if they have a strong support system in place. PTSD symptoms for some people can dissipate over time, but for others, symptoms can cause severe psychological distress and mental health problems.

The sooner a person with PTSD can access treatment, the better the chances for recovery. Here are some treatment options:  

• Therapy – Talk therapy (psychotherapy) is a way of treating PTSD. Other therapies that are used for PTSD treatment are cognitive behavioral therapy (CBT), prolonged exposure therapy (PE), trauma-focused cognitive behavioral therapy and eye movement desensitization, reprocessing (EMDR) and group therapy,
• Medication – Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are typically used to treat the main symptoms of PTSD, and they can be used alone or in concurrence with therapy, depending on the diagnosis of PTSD and advice of a healthcare provider. SSRIs may help people manage the sadness, worry, anger, and emotional numbness that can come with PTSD. Some medications may help treat specific PTSD symptoms, such as if someone has trouble sleeping or nightmares.
• Support Groups – While support groups haven’t been shown to reduce PTSD symptoms, they can help in other ways, such as giving you a feeling of connection to other people who have been through similar circumstances. Sharing the challenges that occur in daily life might diminish any feelings of isolation and help you learn new perspectives on how others deal with it. Support groups are also a great way of learning how to trust people and how to talk about things that bother you in a safe space. 

To learn more, or to get help, visit the National Center for PTSD.