Post-Traumatic Stress Disorder (PTSD): Identification, Analysis, And Healing
- Megan Maysie
- Mar 6, 2024
- 10 min read
Updated: Jul 28, 2024
Debilitating, distressing, devoid of boundaries, Post Traumatic Stress Disorder- or PTSD as it is commonly referred to, is far more prevalent than statics can reveal. Confusion first arises at deciding whether it’s a disease, disorder, syndrome, mental illness, or any other label that could be applied. But what is PTSD?
PTSD traps you in a life that you wouldn’t choose for yourself
It’s generally accepted that while a disorder disrupts normal body functions, it is a group of symptoms that disrupts your normal body functions but does not have a known cause, whereas a disease is a medical condition with an identifiable cause. A doctor, Henry A. Nasrallah, MD, asks a pertinent question: Are mental illnesses diseases, disorders, or syndromes? His short answer is that no objective laboratory test can differentiate one particular psychiatric malady from another.
While the word "malady" adds an extra layer, he does point out that many documented disturbances of normal brain functions are consistent with a disorder paradigm. The concept of interference with normal brain functions resonates with PTSD sufferers- whether diagnosed or not. It's not just an anagram that's flung around, it is a daily reminder of one's own human frailties.
Dr Nasralla’s paper points out that there is a distinct overlap of symptoms when it comes to mental illnesses. Almost all psychiatric maladies have some degree of suicidality, insomnia, and addictive behavior, and there are other parallels:
Bipolar mania and schizophrenia have the same psychotic features, as well as cognitive deficits and other mechanics, including agitation, suicidality, aggressive behavior, and more.
Obsessive-compulsive disorder (OCD) obsessions look like and can morph into the delusions of psychosis. OCD’s compulsions can be at the heart of behaviors encountered in other psychiatric disorders, such as bulimia nervosa or anorexia.
Depression and anxiety share many symptoms and occur concurrently
PTSD symptoms encapsulate those of several diagnostic categories, including personality changes, OCD, anxiety, negative symptoms, psychosis, depression, impulsive behavior, and mania. According to the National Mental Health Institute, fear is a normal part of the body’s so-called fight-or-flight response- it helps us avoid or react to potential danger, and it’s natural to feel afraid during and after a scary, disturbing, or dangerous event. People’s responses differ. Some experience a range of reactions after trauma- even after the danger is long removed, but most recover over time. Those who continue to experience ongoing symptoms may be diagnosed with post-traumatic stress disorder (PTSD).
The Mayo Clinic indicates that symptoms could include flashbacks, nightmares, and severe anxiety, as well as unrestrained thoughts about the event. The clinic says that most people who go through traumatic events could have temporary difficulty adjusting and coping, but with time and by practicing good self-care, people living with PTSD have a good prognosis. If the symptoms get worse, last for months or even for years-and they interfere with day-to-day functioning, it could be PTSD.
What Are The Signs And Symptoms Of PTSD?
With the overlaps in symptoms, identifying PTSD can be challenging, and a mental health practitioner such as a psychiatrist, psychologist, or clinical social worker needs to make the diagnosis. The National Mental Health Institute indicates that symptoms of PTSD usually start within 3 months of the traumatic event, but they may only emerge later.
Depression is an overwhelming symptom of PTSD
For clinical diagnosis, a person must have experienced symptoms for more than a month, and they must be severe enough to interfere with daily life- aspects such as relationships or work. Medication, substance use, or other illnesses should be examined as unrelated causes.
After a traumatic event, it is natural for some symptoms to emerge. Some people feel detached from the experience- feeling like an outsider looking in, but on a clinical level, the following should be present for at least a month and are signs of PTSD:
One or more:
Re-experiencing symptom/s
Avoidance symptom/s
Two or more:
Arousal and reactivity symptoms
Cognition and mood symptoms
With no one-size-fits-all, children are the most charming but unpredictable creatures on earth. As they grow into their teenage years, many biological, internal, and external forces are playing havoc on their sense of self as they start finding their way in the world. Trauma can change the entire path and personality of a child or teenager, but it's sometimes difficult to figure out whether there is an underlying problem or if it can just be written down as part of their evolving selves.
When parents and caregivers are aware of a traumatic event, their spidey senses are heightened and they often seek out giveaway signs to see how a child is coping. But where the event takes place in secret- as is often the case in sexual assault of children, the children often blame themselves and feel too guilty to talk or have been blackmailed into keeping quiet. Yet suddenly, extreme reactions start popping up.
Children’s responses to traumatic events are unique and they may not be the same as how adults react. Depending on their ages, there are some red flags to look out for, but the list isn’t comprehensive:
Children younger than age 6:
Acting out the traumatic event
Bed-wetting even though they know how to use the toilet
Being unusually clingy with a caregiver, parent, or other adult
Unable to talk or forgetting how to talk
As they get older, children and teens usually show symptoms similar to those displayed by adults. Older children and teens sometimes have guilty feelings- projecting thoughts about them not preventing injury or death themselves, or they start experiencing thoughts of revenge. Some children also develop behavior that is disruptive, disrespectful, or destructive.
Children, especially teenagers, have unique ways of expressing their feelings
Helping children and adolescents cope with traumatic events is a critical but difficult journey that starts with gleaning enough information and getting the right support.
Post Traumatic Stress Disorder (PTSD) develops in about 1 in 3 people who experience severe trauma. The UK’s NHS lists the kinds of instances where PTSD could follow:
Death: Someone close to you passes away
Violence: Physical or sexual assault
Abuse: This includes abuse from childhood or domestic abuse
Conflict and war
Torture
Illness: Serious health problems, such as being admitted to intensive care
Confinement and Delivery of babies: Traumatic childbirth experiences, for example losing a baby
Workplace Trauma: Exposure to traumatic events at work, including remote exposure
Serious accidents
Post-traumatic stress disorder (PTSD) can develop after a prolonged traumatic experience or an exceptionally stressful, terrifying, or distressing event. While a formal PTSD diagnosis doesn't usually result from events such as a divorce, the emotional fallout can cause similar symptoms.
Losing a child affects parents, siblings, caregivers, extended families, and the networks the child was a part of. Whether it's through death or alienation, the symptoms of PTSD can appear.
Everybody is different, whether through genetic makeup, nurturing, or their unique history. In the same way, people respond differently to a traumatic event or incident and not everyone who lives through a distressing event develops PTSD. Similarly, the course of the disorder varies. Some take less than 6 months to recover, while other people experience symptoms that last for a year or longer.
Many factors play a role- some exist before the traumatic event, and others occur during and after a traumatic event. However certain risk factors may increase the likelihood of developing PTSD. These include:
Physical Violence: Getting physically hurt or seeing others hurt or killed
History: A personal or family history of mental illness or substance use
Acute fear: Feeling extreme fear, horror, or helplessness
Previous trauma: Exposure to previous traumatic experiences, especially childhood events
Lack of support: Having limited or no social support or networks after the traumatic event
Other stressors that occur after the event, for example, the loss of a loved one, pain and injury, or loss of a home or job
Counteracting the development of PTSD, there are resilience factors that could limit the possibility that PTSD will develop:
Developing a support network: Seek out and get support from family, friends, or support groups
Acceptance: Learning to feel okay with your response actions to a traumatic event
Map out a strategy: Put in place a coping strategy as a mechanism to get through and learn from a traumatic incident
Be prepared: Be ready and able to respond to distressing events as they happen, despite feeling fearful
People with PTSD often have co-occurring conditions that complicate the factors. Depression, substance use, or one or more anxiety disorders sometimes play a role.
What Are The 4 Stages Of PTSD?
The clinician-founded and -led Thriveworks defines four stages of PTSD that can indicate that a person is living with Post Traumatic Stress Syndrome:
Stage 1 of PTSD: The Impact or Emergency
Stage 2 of PTSD: Rescue
Stage 3 of PTSD: Starting Recovery
Stage 4 of PTSD: Long-Term Recovery
Many different events cause trauma- even hearing about it can
Stage 1 of PTSD: The Impact or Emergency
The way trauma is experienced differs from person to person, but the emotions that appear after the event bring on the impact stage.
Varying in length depending on the severity of the trauma and other factors, some people stay locked into this stage for weeks, but for others, it could only be a few hours or days. Emotions that crop up in this stage could include:
Fear
Anxiety
Shock/being overwhelmed
Survivor’s guilt
Helplessness
Hyperalertness
The intensity and duration of the emotions differ and it can take a while to accept the event.
Stage 2 of PTSD: Rescue
Moving away from the symptoms and emotions of the first stage, some kind of acceptance of the traumatic experience takes recognizing that trauma has occurred. Some effort is made to deal with the aftermath of a traumatic event- returning to the scene of the event, and talking with other victims or survivors are steps that people take. The paralyzing emotions of the first stage can be replaced with others, including:
Panic and fear
Hopelessness and sadness
Nightmares and flashbacks to the traumatic event
Denial
Anger towards the person responsible for the trauma
Apathy and numbness
Uncertainty and indecision
These feelings can be overwhelming but healing starts when recovery options start being explored.
Stage 3 of PTSD: Starting Recovery
Once acceptance is found, healing can start. In the Intermediate Recovery Stage of PTSD, many people living with PTSD begin exploring and identifying ways to overcome debilitating PTSD symptoms. Negative emotions and symptoms are still occurring, but there is a willingness to work toward overcoming them.
Recovery and healing start with the first tentative steps of reaching out for help during this stage of PTSD. Engaging productively with support networks, and applying techniques like CBT therapy, psychotherapy, and counseling are important features, and medication helps in some instances, helping the person move past acceptance. This period is about moving forward by learning, practicing, and entrenching coping skills.
Stage 4 of PTSD: Long-Term Recovery
Recovering from PTSD over the long term means taking what's learned through psychological and medical assistance and implementing these newfound techniques and skills into daily life. Working on identifying triggers that set off symptoms helps manage emotions and reactions. Key to this stage is finding healthy and effective ways to thrive without debilitating other areas of life.
Types Of PTSD
Mental Health UK indicates that within the category of PTSD, there are three distinct types of Post Traumatic Stress Disorder aside from PTSD itself:
Delayed Onset Post Traumatic Stress Disorder (PTSD):
Setting in during the first 6 months after a traumatic event, PTSD sometimes takes years to develop. Making up less than 1 in 5 cases- with the same symptoms as PTSD, there is a delay in symptoms presenting themselves.
Secondary Trauma Related To Post Traumatic Stress Disorder (PTSD):
While supporting a person close to you who has experienced trauma, it's entirely possible to develop symptoms of PTSD. Even though the traumatic event happened to someone else, the effect of the trauma of that event is traumatic to the supporter, even where the traumatic events are witnessed or heard about as part of a job.
Complex Post Traumatic Stress Disorder (C-PTSD):
Separate from PTSD, C-PTSD mostly has some of the PTSD symptoms, but personality changes are experienced after the traumatic event such as:
Avoiding relationships and friendships
Feelings of hopelessness, hostility, and worthlessness
Suicidal thoughts
Feeling as though no one understands what happened
Difficulty controlling emotions
Help should be sought in all these instances.
PTSD Treatments
The American Psychological Association (APA) strongly recommends four particular interventions:
Cognitive Behavioral Therapy (CBT):
Focusing on changing patterns of behaviors and thoughts, CBT hones in on the relationships between emotions, thoughts, and behaviors, targeting current symptoms.
Cognitive Processing Therapy (CPT):
A type of CBT, CPT helps patients learn how they could challenge and change unhelpful beliefs associated with the traumatic event.
Cognitive Therapy:
Modifying pessimistic assessments and memories of a traumatic event, cognitive therapy's goal is to interrupt distressing thought and/or behavior patterns that interfere with daily life.
There is light at the end of the PTSD tunnel:
Reach out!
Prolonged Exposure:
Teaching people living with PTSD to gradually approach trauma-related emotions, memories, and situations, prolonged exposure is a type of CBT that helps the person face what has been avoided, and in the process learn that the triggers and memories are not dangerous.
APA also conditionally recommends three interventions that could lead to a good outcome but may have limited application or need more research:
Brief Eclectic Psychotherapy:
Combining elements of CBT with a psycho-dynamic approach, the therapy seeks to change emotions of shame and guilt, with the relationship between the patient and therapist central to the therapy.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy:
Encouraging a brief focus on the memory of the trauma while at the same time experiencing bilateral stimulation such as eye movements, this structured therapy is associated with reducing the vividness and emotions associated with trauma memories.
Narrative Exposure Therapy (NET):
By establishing a coherent life narrative in which traumatic experiences can be contextualized, NET is often used in group treatment for refugees.
Sometimes medication may be necessary, but the guidance of a qualified medical professional will guide the course. APA conditionally recommended sertraline, paroxetine, fluoxetine, and venlafaxine for use in the treatment of PTSD.
PTSD Healing
Many modalities offer healing, and there a practices that will ease the symptoms and help people living with PTSD to recover, and find themselves living their best lives, but sometimes expert help is necessary. According to the University Of Rochester Medical Center, some instances where professional help should be sought are when certain things occur, like obsessing about the traumatic event, nightmares, and flashbacks. Constantly ruminating over the past isn’t healthy and other signs of PTSD include:
Despondency and hopelessness
Inattentive with an inability to focus on work or daily activities
Always on high alert
Highly strung, edgy or over-alert
Cross patch: Experiencing resentful or grouchy feelings
Disconnection and emotional numbness
Sorrow or depression accompanied by low-energy
Insomnia due to nightmares
Mollycoddling because of being fearful for the safety of loved ones
Indecision
Inability to cope with similar events and being paralyzed with anxiety and fear
Learn to love yourself- flaws and all
Steps toward healing:
How someone reacts to trauma depends on many different things- age, personality, and any exposure to trauma in the past are a few. Many conscious actions can help the PTSD recovery process, starting with being kind by being patient with yourself. A few things that can be done aside from engaging in healthy habits like eating a healthy diet, exercising, and getting enough sleep are:
Get involved: Volunteering is a great way to give back and has many benefits for the volunteer
Breathe and relax: Try different relaxation methods- if yoga isn’t your thing, take a walk in nature
Find your voice: Talk about the traumatic event and share your feelings
Avoid the negatives: Stay away from negative coping actions that can lead to addictions and substance abuse
Be sociable: Spend time with others. And join a support group
It's important to also recognize when to seek professional help- as soon as possible is often a good idea.
And mostly: Get educated by finding out as much as possible about PTSD- blogs like Gezinta are thought provoking and can lead to beautiful destinations.
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