Posted September 2019 by Clifton Stamp, B.S. Psychology; M.A. Rehabilitation Counseling, M.A. English; 10 updates since. Reading time: 6 min. Reading level: Grade 8+. Questions on PTSD? Email Toni at: editor@online-psychology-degrees.org.
Post-Traumatic Stress Disorder (PTSD) is a common and devastating psychological condition that affects people who survive a traumatic event. People typically think of combat veterans as the classic group affected by PTSD, but survivors of natural disasters, accidents, assault, rape or other kinds of violent assault are also commonly affected. PTSD can happen to people who themselves are not physically harmed, but are instead witnesses to the sufferings of others. Caregivers can in this way experience PTSD. Unlike acute stress disorder, PTSD can occur via second-hand exposure. For example, police officers who are witnesses to violence can develop PTSD. People who take care of loved ones who suffer from grave illnesses also may suffer from PTSD.
Psychologists have learned that PTSD may be the result of micro-changes made to the body’s alertness and arousal systems. These two systems are made up of a complex array of nerves and tissues that make us aware of danger, prepare our bodies to respond to that danger and then carry out the fight, flee, or freeze responses. Powerful hormones like cortisol and adrenaline not only energize the body, but they also cause small changes to the way neural circuits work. These tiny physiological changes are typically temporary, but for people with PTSD, they linger for reasons that remain unclear. That most people don’t develop PTSD seems to indicate that in those that do, there is a biological, genetic factor at play.
PTSD will affect one in 11 U.S. adults in their lifetime and affects 3.5 percent of U.S. adults at any given time. Women are more likely than men to have PTSD. The typical symptoms of PTSD include immerse reliving of the event, called a flashback. Flashbacks can happen when a person is awake or asleep, through hyper-realistic nightmares.
PTSD Symptoms
It is the re-experiencing of the traumatic event, a flashback, that’s most known to the public as a hallmark of PTSD. Flashbacks don’t happen every day, but when they do, they’re so powerful they are debilitating. Imagine surviving a horrible event, only to relive it over and over. A flashback isn’t a set of memories; it’s reliving the event, with smells, sounds and all other sensory input included. Flashbacks are often set off by triggers which can be anything reminiscent of the original trauma. Intense feelings of fear, anger and sadness do tend to be daily burdens. People suffering from PTSD may also feel detached from their surroundings, even from themselves. They experience hyper-arousal, a tendency to overreact to common stimuli, like a loud noise, and hyper-alertness, a state of being always on guard, always on the lookout for danger.
When exposed to events or things that remind the PTSD sufferer of the triggering event, flashbacks occur. Even if a person doesn’t have flashbacks, there’s usually a flood of deeply unpleasant effects that may linger for hours or several days, including sadness, anger outbursts, high irritability, feelings of detachment from one’s surroundings, even detachment from one’s body.
Symptoms associated with flashbacks of the traumatic event include:
- Feeling re-immersed in the event all over again.
- Disassociating from the present and one’s surroundings (feeling so detached it’s like not being there at all)Overwhelming emotional responses when recalling the event.
- Profound anxiety when reminded of the trauma, including sweating, shakes, pounding heartbeat or irregular heartbeat, sweats, shortness of breath, and even passing out.
- An overwhelming desire to retreat to safe surroundings.
- Avoidance of reminders of the traumatic event is very common, including avoiding people, places, objects and activities that remind the person in any way of the traumatic event. People also avoid talking about the event, which contributes to feelings of loneliness and detachment.
Symptoms related to negative changes in thought or mood:
- Inability to recall parts of the initial trauma
- Emotional numbness and detachment
- No interest in social activities, lack of desire to socialize
- Bleak, pessimistic outlook
- Periods of unremitting sadness
Symptoms from psychological hyper-arousal:
- Trouble falling asleep or staying asleep
- Anger outbursts, high levels of irritability
- Difficulty concentrating
- Hyper-vigilance (a constant state of elevated awareness
- Low threshold for being startled
PTSD and Complex PTSD
Psychologists make a distinction between PTSD and complex PTSD. PTSD follows after a single event, while complex PTSD results from chronic trauma. Domestic abuse, either spousal or child abuse are the two most common causes of complex PTSD in the United States. Chronic child abuse, especially sexual abuse, often leads to complex PTSD coupled with borderline personality disorder (BPD).
Complex PTSD arises from situations like these:
- Prisoner of War camps
- Chronic domestic violence, sexual abuse or physical abuse
- Child prostitution
- Concentration camps
This is far from an exhaustive list but the unifying elements are a constant threat of grave physical harm, uncertainty, chronic harm and the daily presence of extreme violence and the threat of death.
Characteristics of Complex PTSD
- Self-Perception. Feelings of shame, guilt, helplessness and chronic fear are common.
- Emotional Regulation. Not only do people with complex PTSD have depressive symptoms similar to major depression, but they may swing from suicidal thoughts to explosive anger, violent acting out, inhibited emotions or trouble expressing their feelings in a healthy manner.
- Consciousness. Memories of the traumatic events may become suppressed. People may conversely have vivid flashbacks in which they relive the experiences. Extreme disassociation is also common. Disassociation includes feelings of not being attached to one’s body or a part of one’s surroundings as if a spectator.
- Interpersonal Relationships. Relationships suffer in more involved ways that in PTSD alone. For example, with complex PTSD, people may triangulate. Triangulate involves people seeing those in their lives as either perpetrators of harm or rescuers from harm. The only constant is that the individual with complex PTSD sees themself as a helpless victim. This doesn’t happen with everyone who has complex PTSD, but for those with co-occurring borderline personality disorder, this is a common pattern.
PTSD Treatments
Both complex PTSD and PTSD alone respond well to “talk therapy,” which involves a therapist and a client working together. Cognitive-Behavioral Therapy (CBT). CBT is just one of several “talk” therapies that have shown excellent outcomes. It’s a short treatment. lasting from 3 to 10 months, with one 50 minute session per week. CBT involves examining the way one’s established beliefs affect one’s behaviors. Other treatments include Eye Movement Desensitization and Reprocessing (EMDR) and Stress Inoculation Training (SIT).
Summary
Post-Traumatic Stress Disorder is a complex psychological condition that results from exposure to a traumatic event. It can show up anywhere from a month to a year after exposure and has the potential to be devastating. Although PTSD is a serious condition, it responds well to treatment. There are options for treatment that can reduce symptoms to manageable levels and it some cases, bring about complete remission. Although not every option works for every person, there are reliable and well-established options for everyone.
Clifton Stamp
B.S. Psychology | Arkansas State University
M.A. Rehabilitation Counseling | Arkansas State University
M.A. English | Arkansas State University
September 2019
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