What is Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder occurs when terrible experiences such as sexual abuse, catastrophes, experiences of violence, or serious accidents put a heavy strain on life afterward, and literally throw people off track. Such an experience is called trauma, which in psychology means “emotional injury”.

Traumatic experiences are sometimes difficult to process and some people develop post-traumatic stress disorder (PTSD) as a result. Both victims and witnesses of a dramatic event can develop PTSD.

Typical of this disorder is that what you have experienced does not go and the stressful memories keep coming back. Support from other people is particularly important in such a life situation. Psychotherapy can help cope with the experience over time.

What are the Symptoms of post-traumatic stress disorder?

Post-traumatic stress disorder is characterized by the following:

• Stressful thoughts: The trauma is relived over and over again. Often very clear memories suddenly come up that cannot be suppressed. These are the so-called flashbacks. The imposing images and feelings are felt as if the event were happening again at that moment. Many people have recurring nightmares. Flashbacks and dreams can revive fear, helplessness, feelings of threat, guilt and shame but they can also cause physical complaints such as pain.

• Overexcitability: People with PTSD are particularly vigilant and often on a kind of constant alert: they sleep poorly, cannot concentrate well, are irritable and impulsive. They also react very strongly to stimuli that remind them of what has happened such as certain smells, sounds or images. This can lead to palpitations, chest tightness, difficulty breathing and tremors.

• Avoidance behavior: Those affected avoid situations, places or people that are related to the experience and could evoke memories and flashbacks. This also applies to certain activities, thoughts or conversations. Some people with PTSD withdraw or lose interest in things that were important to them in the past. Some feel strange in their own life. Some suppress their experiences so much that, they no longer remember important parts of the traumatic event. PTSD can also make you feel numb inside. Often, it is not possible to classify and process what has been experienced.

• Negative thoughts and moods: Many people have shaken confidence in themselves and others. Their self-esteem often drops sharply and they feel weak and powerless. Often they struggle with questions like: Why did it happen to me? How could I have prevented it? Am I (partly) guilty? You can also feel very irritable or constantly upset. They may be angry with the person who caused the trauma but also with people who did not feel supportive afterwards, such as police officers or hospital staff.

• A trauma can lead to other mental illnesses such as depression, anxiety disorders or an addiction. A “dissociative disorder” is also possible in which for example, unbearable memories are deleted from the memory or parts of the personality change (“split off”). In addition, some people develop chronic pain, an eating disorder or psychosis.

• Mild PTSD has milder symptoms or occurs only temporarily in certain situations that are reminiscent of the trauma. Then everyday life can be designed almost normally. On the other hand, severe forms can lead to severe psychological complaints and impair them in such a way that life without help is hardly possible. Some people develop what is known as “complex PTSD”. With this form, a number of the symptoms mentioned last for several years and are very pronounced. Complex PTSD often develops after severe or repeated trauma.

Post-traumatic stress disorder in children

In children, post-traumatic stress syndrome often manifests itself differently than in adults. Often they play through what they have experienced over and over again in symbolic form. For example, with other scenic images and participants. They also become behavioral, very anxious, or aggressive.

What is the difference between mild PTSD and complex PTSD?

Mild PTSD has milder symptoms or occurs only temporarily in certain situations that are reminiscent of the trauma. With this type, everyday life can be lived almost normally. On the other hand, severe forms can lead to severe psychological complaints and impair them in such a way that life without help is hardly possible. Some people develop what is known as “complex PTSD”. With this form, a number of the already symptoms mentioned last for several years and are very pronounced. Complex PTSD often develops after severe or repeated trauma.

The severity of the symptoms does not only depend on the severity of the event but also on how someone can deal with stress.

What are the causes of PTSD?

A post-traumatic stress disorder is always preceded by an experience that was perceived as life-threatening for oneself or on others that led to serious physical or emotional injury. Examples of causes include;

• War

• Violent crime,

• Sexual abuse,

• Traffic accidents,

• Natural disasters and medical emergencies such as a heart attack or life threatening bleeding.

• The news that a close friend or relative has died or is seriously ill can also be perceived as traumatic.

Stress factors such as is felt due to divorce or breakup, job loss, or bullying do not necessarily lead to post-traumatic stress disorder. However, they can trigger individual typical PTSD symptoms and sometimes depression or anxiety disorders.

What are the Risk factors of post-traumatic stress disorder?

Whether and to what extent post-traumatic stress disorder develops depends on:

• What exactly happened? whether the trauma was caused by an experience of violence or a fateful event such as an accident or a natural disaster.

• How intense and lasting the experience was.

• Whether there have been repeated traumatic experiences

• How susceptible someone is to psychological complaints

• What protective factors exist.

How intense the feelings of fear, helplessness, and loss of control were in the traumatic situation, whether they were experienced as life-threatening and whether someone experienced violence from others, plays an important role. How a situation is perceived and assessed has a major impact on whether a post-traumatic stress disorder develops.

People with mental health problems such as depression, anxiety disorders, or addictions are more prone to post-traumatic stress disorder. But there are also people who generally cope better with terrible events than others. In addition, emotional affection and social support can make it easier to deal with what has been experienced – conversely, the risk of post-traumatic stress disorder increases if such assistance is lacking.

How often PTSD occurs depends very much on the trigger.

PTSD prevalence statistics

• 10% of people who have had a serious traffic accident or a life-threatening illness,

• 20% of soldiers after combat missions,

• 25% of victims of violent crime, and

• 50% of the victims of war, rape and torture

What is the Prevalence Rate?

How often this happens depends very much on the living conditions. Certain professional groups are more likely to be confronted with dramatic events. These include police officers, firefighters, train drivers, and rescue workers. In addition, people in war zones are affected much more often.

However, post-traumatic stress disorder after stressful events is not the rule. Many people may feel very sad or depressed again and again after trauma when they think about the experience. However, their everyday life and feelings are not permanently impaired. In addition, these feelings often fade over time.

How does PTSD develop?

Post-traumatic stress disorder can develop very differently. The first symptoms can appear during or shortly after the trauma but it can also take some time for them to show up. Symptoms can subside after a few weeks but they can last for many years and become chronic. There are phases with weaker, and phases with more severe complaints.

It is also possible that the memories of the trauma only become stressful a long time after the event and that it takes years for someone to develop a post-traumatic stress disorder. It is more common for soldiers to observe that complaints are delayed. Other examples are war memories from childhood and adolescence, which for some people only become stressful in old age.

Many people manage to overcome what they have experienced and come to terms with the memories. Within a year, some of those affected feel significantly better and often without treatment. In around 30%, the symptoms persist for three years or more and they often develop further problems such as an addiction.

Severe complaints can mean that you can no longer cope with everyday life. Some people lose their jobs because they are no longer able to meet the demands of their jobs due to sleep and concentration problems or they are reminded of the event again and again at work and which can make it difficult to continue doing the job. Sexual problems can also develop, especially after experiences of abuse.

How is PTSD Diagnosed?

The diagnosis of PTSD is only made if the symptoms persist for more than four weeks. This is because most people are initially very stressed after a severe event and it always takes a while to process such experiences. Complaints that occur immediately after a traumatic event are initially referred to as “acute stress reactions“.

A post-traumatic stress disorder can be diagnosed by talking to a doctor or a psychotherapist. The main aim of these discussions is to find out how severe the symptoms are and how much they affect the current life situation. The living conditions such as family, work, and living situation are recorded. Sometimes, a self-assessment questionnaire is also filled out. For children, painting or playing can be a way of accessing their experiences.

A post-traumatic stress disorder can easily be overlooked in situations such as physical injury after serious accidents. In addition, some people do not associate their psychological complaints with stressful events from the past. Another reason is that it can be very difficult to talk about certain events and problems at first. In such instances, developing mutual trust is therefore very important for the diagnosis.

The diagnostic discussions are conducted very carefully. The experience itself is only touched on – it is not necessary to report in more detail.

Traumatic experiences can also trigger other mental illnesses such as depression or anxiety disorders. They too must therefore be taken into account in the diagnosis.

How can post-traumatic stress disorder be Prevented?

Immediately after a stressful event, emotional affection and practical support are important in order to cope with the experience. Those affected need a safe environment in which they are protected from further stress and can find support. The best form of help depends on the event and on whether for example, consolation, security, or organizational help is needed. Medicines are usually not suitable for prevention.

What are the treatment options for PTSD?

First of all, it is important to clarify a person’s needs and treatment goals. The following questions could be asked in the process.

• Which complaints are in the foreground?

• What are the realistic treatment goals that can be achieved with the existing therapies?

• What additional support is needed?

• Is treatment even necessary?

Some people need psychotherapy to get back to life. For others, support from family, friends, or psychological counseling is sufficient. Medicines are only useful in certain situations. In addition, there are other offers such as body art or music therapy, especially in clinics which are often offered in addition to the other treatments.

The central part of psychotherapy for PTSD is what is known as trauma therapy. The aim is to specifically deal with what has been experienced. Various psychotherapeutic methods are available:

• Cognitive Behavioral Therapy (CBT): With CBT, the focus is on reevaluating thoughts or feelings associated with the trauma. It is most commonly used in post-traumatic stress disorder.

• Psychodynamic Therapy: Developed from psychoanalysis, it focuses more on current and previous relationships and experiences than other treatments.

• The So-called EMDR (Eye Movement Desensitization and Reprocessing) treatment can also be used as part of psychotherapy. With this, certain stimuli are used during the therapeutic discussions in order to facilitate the processing of the trauma. For example, the therapist moves a finger evenly back and forth which the patient follows with his or her eyes.

• If there are other mental illnesses in addition to PTSD, it must be decided depending on the situation which the disorder will be treated with priority.

How does PTSD affect everyday life?

A traumatic event can seriously affect life. On the other hand, some of those affected manage to come to terms with what they have experienced over time. Until then, a lot of support and care may be necessary.

The complaints can also affect social relationships as trust in other people is often lost after a traumatic experience. This makes it difficult to make new friends or maintain relationships. Sex life can also be severely affected. Some people with PTSD become extremely withdrawn. It is all the more important that friends and family remain loyal to you even if the relationship can be more difficult than before.

For example, some people experience years of litigation following an accident or violent crime. This can also be very stressful. Good legal support is then important to ease the situation.

In order to regain a foothold in work and social life and to cope with everyday life, seek help for those affected wherever you live.

Conclusion

In children and adolescents, PTSD can also affect everyday school life. In order to be able to cope with their traumatic experiences, they need a reliable environment and stable relationships – also in daycare and schools. Educators and teachers can contribute a great deal to this.

Let’s also be on the watch out for family and friends and help them get the needed medical attention from experts. Leaving every occurrence to fate and spirituality, most times is not the best solution.

Take care!