Could you be experiencing PTSD?

You may have heard post-traumatic stress disorder (PTSD) talked about in relation to combat veterans. While people who have served in active combat in the military are vulnerable to PTSD, they’re not the only ones at risk. So are people who have experienced any number of other traumas, from physical or emotional abuse to being a victim of a crime. Here’s what you need to know if you suspect your trauma has triggered PTSD.

What is PTSD?

PTSD is a mental health condition that can happen to anybody who witnesses or experiences an event or a series of events seen as traumatic. People with PTSD may experience intrusive and vivid memories of the event and intense and disturbing feelings connected with the experience. These memories and feelings can persist for months or even years, and they can get in the way of daily life.

For some, it may feel as if the event is happening again in real time. Similar situations or even objects that remind them of the incident can trigger intense stress and emotions such as fear. Others may experience more low-level symptoms, such as hopelessness and detachment.

Who is at risk for PTSD?

Estimates from the National Center for PTSD suggest that 6 in 100 people will have PTSD at some point in their life. Certain populations are more vulnerable than others. Women, for instance, have PTSD at a higher rate than men: PTSD affects about 8% of women versus 4% of men. This may be because women are more likely than men to be a victim of sexual assault. They may also be more likely to blame themselves for a traumatic event.

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Resilience also matters in making you more — or less — vulnerable to PTSD. “Research shows that resilience plays a role in your ability to thrive after a traumatic experience and to mitigate the impact,” says Ashley Mead, MHC-LP. She is vice president of culture and community engagement at Cobb Psychotherapy in New York City.

She notes that resilience depends on several factors, including:

• Your support system (think friends, family and colleagues)
• Your ability to cope, including your sense of optimism and ability to adapt your thinking and behaviors according to the situation
• Your ability to meet basic needs like housing, food and having regular employment
• Feeling a sense of belonging and self-respect

What kinds of events outside of military combat can lead to PTSD?

Single events. “Natural disasters, car accidents and/or a one-time sexual assault are just some examples,” says Colleen Cira, PsyD. She is a licensed clinical psychologist and founder and executive director of Cira Center for Behavioral Health in Chicago.

Repeated experiences. PTSD can also result from experiences that are more chronic in nature, Cira says. Some traumas that happen over months or years, often during childhood, can result in what’s called complex PTSD, or complex trauma. These experiences include physical, sexual, verbal and emotional abuse. Physical and emotional neglect may also lead to complex trauma. So can witnessing domestic violence.

PTSD can also be triggered by devastating experiences as an adult. Domestic violence or other toxic relationships can lead to PTSD. And for many individuals, systemic issues such as racism, homophobia, transphobia and xenophobia can be a trigger for PTSD.

What makes trauma unique, though, is that everybody processes and responds to events differently. “What might be processed in the brain as traumatic for one person is not for another,” Mead says.

In fact, she notes that studies have shown that the same childhood trauma, such as a car accident or the death of a parent, can leave one sibling with a PTSD diagnosis while another sibling has limited long-term psychological impacts. “Resilience, temperament and other personal characteristics play a role in whether someone processes an event as traumatic,” Mead says.

Spotting the signs of PTSD

When you experience a threat, whether it’s real or perceived, your body initiates a stress response. This response includes the unconscious feeling to fight, flee, freeze and/or eventually submit to the threat. “This sequence of unconscious impulses is biologically correct, normal and predictable,” Cira says. “It means that your nervous system is doing exactly what it’s designed to do.”

Yet when that stress response is unable to turn off, as in the case of PTSD, the effect on the mind, body and emotions is disastrous. “You vacillate between experiencing hyperarousal, commonly experienced as intense anxiety, and hypo-arousal, commonly experienced as depression or sadness,” Cira says.

In the hyperarousal state, you may feel moody, grouchy and hostile, and experience things such as sleep or appetite disturbances, agitation, mistrust and fear. Meanwhile, during the hypo-arousal state, you might feel numb, empty, hopeless, helpless and worthless. You may struggle to experience joy, love or playfulness, and you can have difficulty envisioning your future. If the trauma has been especially horrific, you may even have intrusive thoughts, memories or feelings about that event, Cira says.

Diagnosing PTSD and mental trauma

If you’re worried that you’re suffering from PTSD, seek help from a mental health professional or trauma therapist. He or she can do an evaluation and give you a proper diagnosis. “Working with a professional will help you get the right level of support you need to validate your experience and make sure that you’re able to cope and function at your best,” Mead says.

How do you know when to reach out? Take a look at your quality of life, and if it’s going downhill, that’s a red flag. “If you’re no longer able to function or show up in your life in a way that you feel good about, it’s time to seek professional help,” Cira says. “Experiencing trauma is painful but also common. Connecting with a trauma-informed therapist and being in a space where you can be honest about what you experienced is the first step toward a more fulfilling, less painful life.”

Your therapist will work with you to figure out if you are suffering from PTSD. He or she will evaluate your symptoms and any other issues you might be having, such as depression or anxiety. “It’s important for therapists to understand if your symptoms are related to a traumatic experience by tracing the history of the presenting issues and then ruling out other reasons for these symptoms. Other reasons can include an underlying medical issue, substance use or other psychiatric problems,” Mead says.

Treatments for PTSD

If you are suffering from PTSD, your therapist will work with you to determine the right treatment. Fortunately, there are several evidence-based therapies that can help, says Cira. These include:

• Trauma-focused cognitive behavioral therapy. This is often used with children and adolescents. It involves discussing the trauma, learning to reframe thoughts about it, relaxation and family therapy.
   
• Prolonged exposure. This is a technique where the person learns to approach the traumatic memory and feelings so they can successfully manage the trauma instead of avoiding it.
   
• Eye movement desensitization and reprocessing (EMDR). EMDR is a therapy in which the person moves their eyes right to left while holding the memory in their mind. EDMR may work by stimulating each side of the brain to alter how the memory is stored, reintegrating it in a way that it loses its emotional charge.
   
• Somatic experiencing. This is a body-focused therapy that helps people become aware of how their physical sensations may be related to how they respond to trauma. They learn how to change their thoughts, feelings and physical responses.

Recovering from PTSD

With professional help, you have a great chance of getting better. For some people, the condition will go away with treatment and time. Others will learn to manage it even though the symptoms won’t completely disappear. PTSD can be a difficult condition to treat for some, and it may become more difficult as the number of traumatic events you’ve experienced increases, Cira says. But even so, there’s a good chance you can feel better and live a healthy, fulfilling life.

“People with PTSD are not crazy, broken, sensitive or dramatic,” says Cira. “Having PTSD means you’re simply a human whose nervous system is fired up more than most and that it’s interfering with healing.” Once you get the right help, you can begin that healing.

If you think you might be experiencing PTSD, you can get support right away by scheduling a virtual visit with one of our mental health professionals. Start here.

Additional sources:
Facts about PTSD: American Psychiatric Association What Is Posttraumatic Stress Disorder? And Mayo Clinic Post-Traumatic Stress Disorder
Prevalence of PTSD: U.S. Department of Veterans Affairs, National Center for PTSD. How Common is PTSD in Adults? and How Common is PTSD in Women?
Resilience and PTSD: Harvard Review of Psychiatry 2018. Understanding Resilience and Preventing and Treating PTSD
Complex PTSD: U.S. Department of Veterans Affairs, National Center for PTSD Complex PTSD
Stress response: Harvard Medical School, Harvard Health Publishing Understanding the stress response
Diagnosis and treatment: Mayo Clinic. Post-traumatic Stress Disorder (PTSD), Diagnosis & Treatment
Trauma-focused cognitive behavioral therapy: Good Therapy Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
EMDR: American Psychological Association. Eye Movement Desensitization and Reprocessing (EMDR) Therapy and The Permanente Journal, 2014. “The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences.”
Somatic experiencing: Good Therapy. Somatic Experiencing (SE).