Diagnosis spotlight: posttraumatic stress disorder

Life isn’t always kind. No one is immune to twisting an ankle or feeling heartbreak. The difficult aspects of life are just normal a part of the experience. Trauma, on the other hand, is something damaging that is outside the realm of normal human experiences. It’s not something that is expected and it can be very difficult to cope with. War, sexual assault, major natural disasters and life-threatening accidents are all examples of this.

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Traumatic events can leave anyone shaken for a while, but when symptoms won’t go away, it can become an illness. When the aftereffects of the trauma seriously interfere with major areas of your life for an extended time, it might be post traumatic stress disorder (PTSD). According to the guidelines in DSM-5 (a volume used for mental health diagnosis), this is a psychiatric condition that is the result of “exposure to actual or threatened death, serious injury, or sexual violence.” It can be a result of something that you experienced, witnessed or (in a few cases) heard about. Symptoms have to occur in each of four different areas: reexperiencing, avoidance, cognition/mood alteration and hyperarousal.

Reexperiencing is exactly that: experiencing the trauma over and over again. This can happen in lots of different ways. You might have intrusive memories, nightmares, flashbacks or negative reactions to things that remind you of the event. On the extreme end of the spectrum, you may actually think the trauma is happening right then and there.

Another reaction is to avoid anything that is associated with the event. It could be trying to stay away from external reminders or you might avoid your own thoughts and feelings. If someone was in a serious car accident, he might drive different routes – even when longer – in order to not pass the scene of the accident. An assault victim might go to extreme lengths to distract herself from the memory and associated feelings. It can also include avoiding seemingly benign things, such as teddy bears, frying pans or the rain, if they are somehow reminders of the trauma.

  

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There must also be changes in thoughts and/or feelings as a result of the trauma. It could be being plagued by negative feelings (fear, anger, guilt, etc.) while being unable to experience positive emotions (happiness, calm, love, etc.). Others might be unable to remember an important part of the trauma. Distorted thoughts, such as “it’s my fault that I got mugged” or “nowhere is safe,” can also occur. Feeling detached from others and having a decreased interest in significant activities are also signs.

Hyperarousal refers to having very strong negative reactions to your environment. You can’t feel safe, so you respond as if you are always in danger. An increased startle response or hypervigilance (intense and unwarranted efforts to detect threats) are common reactions. Problems sleeping or concentrating are also potential disruptions. You might also become irritable or angry without being seriously provoked. It can even go as far as engaging in self-destructive behavior. 

Psychotherapy is the most common treatment for PTSD. This can take many forms. Sometimes desensitization to the experience through repeated exposure can reduce symptoms. Other times, processing the event and what it means is called for. Medication might help with individual symptoms, but are not meant to treat the condition as a whole. There are also treatment techniques such as hypnotherapy and what is called EMDR (eye movement desensitization and reprocessing). Talk to your clinician about your treatment options because there might be more than you think. 

PTSD is a normal reaction to an abnormal event. It can seriously interfere with all aspects of living, so it’s very important to seek a professional opinion and subsequent treatment if you are experiencing several of the symptoms described. Recovery might seem unthinkable in the midst of the disorder, but it is possible to overcome extremely difficult parts of your life. It might take a long time, but remember that it can be done and working on it is better than allowing it to take over your life.