Posttraumatic Stress Syndrome - Post-Traumatic Stress Disorder
Overview, Causes, & Risk Factors
Posttraumatic stress disorder, or PTSD, is a condition resulting from a traumatic event outside the range of a person's normal experience.
What is going on in the body?
PTSD is a psychological reaction to a catastrophic event outside of the individual. Researchers have identified changes in the central and autonomic nervous systems in people with PTSD. Changes in hormone systems have also been identified.
There are three types of PTSD reactions:
acute, in which symptoms last less than 3 months
chronic, in which symptoms last longer than 3 months
delayed, in which symptoms start at least 6 months after the actual trauma occurs
What are the causes and risks of the condition?
PTSD is caused by exposure to excessive stress or trauma. Events that spark the condition are not normally part of most people's life experience. Events that can trigger PTSD include the following:
child abuse
high school violence, including shooting incidents
imprisonment
man-made disasters, such as bombings
natural disasters, such as earthquakes
plane crashes
severe assault
sexual abuse, including rape
torture
war
Not everyone exposed to such events will develop PTSD. It is not known why some individuals develop PTSD. However, having strong support systems lessens a person's risk of the disorder.
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of PTSD fall into three main categories.
The first is reliving the event in one or more of the following ways:
flashbacks, or reliving events as if they are occurring right now
hallucinations, which means seeing or hearing things that are not real
illusions, or misinterpretation of things that are seen or heard
memories of the event
physical sensations that recall the event
recurrent dreams of the event
severe emotional responses to new events similar to the traumatic event
The second category involves a tendency to avoid reminders of the event. This tendency can cause the following symptoms:
avoidance of activities, places, or people that might bring the event to mind
avoidance of thoughts, feelings, or talking about the event
difficulty maintaining healthy family, social, or job relationships
feelings of detachment or emotional distance from others
loss of interest in daily activities
a sense of a shortened future
survivor guilt, or feeling guilty about surviving when others did not
trouble recalling key parts of the event
The third category involves a higher level of arousal and anxiety than before the trauma. This level can cause the following symptoms:
agitation, or feelings of restlessness
alcoholism and drug abuse
chest pain
difficulty concentrating
dizziness
an exaggerated startle response
excessive sweating
headache
irritability
memory loss
nausea
persistent anxiety
sleep disorders
suicide attempts or acting out
trouble managing anger
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of PTSD begins with a medical history and physical exam. PTSD is diagnosed based on a person's symptoms. In addition, a major, extreme event must have taken place.
Prevention & Expectations
What can be done to prevent the condition?
Critical incident stress debriefing involves immediate counseling after the traumatic event. It may cut down on the chances of developing PTSD. The earlier counseling is started, the better the chances for success.
What are the long-term effects of the condition?
People with PTSD often have problems in their relationships with others. Marriage problems and high divorce rates are common. Job and legal problems also occur frequently in persons with the syndrome. Alcoholism and drug abuse are significant among people with PTSD.
What are the risks to others?
PTSD is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the condition?
Treatment of PTSD can help reduce symptoms in some individuals. anxiety \ \
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People with PTSD often need treatment for depression or substance abuse. This needs to occur before measures directed at decreasing symptoms of PTSD can be effective.
Medicines used to treat PTSD include the following:
anticonvulsants, such as gabapentin
azaspirones, such as buspirone
benzodiazepines, such as alprazolam or lorazepam
beta-blockers, such as propanolol or atenolol
MAO inhibitors, such as phenelazine
SSRIs, such as paroxetine or sertraline
tricyclic antidepressants, such as amitriptyline
What are the side effects of the treatments?
Medicines used to treat PTSD can cause drowsiness, stomach upset, and allergic reactions.
What happens after treatment for the condition?
Chronic PTSD often persists for years. It usually becomes less intense and bothersome as time passes.
How is the condition monitored?
PTSD is monitored with regular visits to the healthcare provider. Blood tests may be done periodically to measure levels of medicines. Any new or worsening symptoms should be reported to the healthcare provider.
Attribution
Author:Ann Reyes, Ph.D.
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:04/30/01
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:08/20/01