When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.
PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.
Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or is harmed. The sudden, unexpected death of a loved one can also cause PTSD.
People with PTSD may startle easily, become emotionally numb (especially in relation to people with whom they used to be close), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are often very difficult. PTSD symptoms seem to be worse if the event that triggered them was deliberately initiated by another person, as in a mugging or a kidnapping.
Most people with PTSD repeatedly relive the trauma in their thoughts during the day and in nightmares when they sleep. These are called flashbacks. Flashbacks may consist of images, sounds, smells, or feelings, and are often triggered by ordinary occurrences, such as a door slamming or a car backfiring on the street. A person having a flashback may lose touch with reality and believe that the traumatic incident is happening all over again.
Not every traumatized person develops full-blown or even minor PTSD. Symptoms usually begin within 3 months of the incident but occasionally emerge years afterward. They must last more than a month to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.
PTSD affects thousands of Australian adults but it can occur at any age, including childhood.7 Women are more likely to develop PTSD than men,8 and there is some evidence that susceptibility to the disorder may run in families.9 PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.4
Certain kinds of medication and certain kinds of psychotherapy usually treat the symptoms of PTSD very effectively.
Why do some people get PTSD and other people do not?
It is important to remember that not everyone who lives through a dangerous event gets PTSD. In fact, most will not get the disorder.
Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event.
Risk factors for PTSD include:2 • Living through dangerous events and traumas
• Having a history of mental illness
• Getting hurt
• Seeing people hurt or killed
• Feeling horror, helplessness, or extreme fear
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.
Resilience factors that may reduce the risk of PTSD include:3 • Seeking out support from other people, such as friends and family
• Finding a support group after a traumatic event
• Feeling good about one’s own actions in the face of danger
• Having a coping strategy, or a way of getting through the bad event and learning from it
• Being able to act and respond effectively despite feeling fear.
Researchers are studying the importance of various risk and resilience factors. With more study, it may be possible someday to predict who is likely to get PTSD and prevent it.
PTSD Assessment and Diagnosis A practitioner who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD. The diagnosis is made after the practitioner conducts a comprehensive behavioral health assessment of the person who has symptoms of PTSD. Ideally, the practitioner will use a multi-disorder behavioral health assessment tool to ensure they get a differential diagnosis. To be diagnosed with PTSD, a person must have all of the following for at least 1 month:
• At least one re-experiencing symptom
• At least three avoidance symptoms
• At least two hyperarousal symptoms
• Symptoms that make it hard to go about daily life, go to school or work, be with friends, and take care of important tasks.
How can I help a friend or relative who has PTSD? If you know someone who has PTSD, it affects you too. The first and most important thing you can do to help a friend or relative is to help him or her get assessed. You may need to make an appointment for your friend or relative and go with him or her to see the practitioner. Encourage him or her to stay in treatment, or to seek different treatment if his or her symptoms don’t get better after 6 to 8 weeks.
To help a friend or relative, you can:
• Offer emotional support, understanding, patience, and encouragement.
• Learn about PTSD so you can understand what your friend or relative is experiencing.
• Talk to your friend or relative, and listen carefully.
• Listen to feelings your friend or relative expresses and be understanding of situations that may trigger PTSD symptoms.
• Invite your friend or relative out for positive distractions such as walks, outings, and other activities.
• Remind your friend or relative that, with time and treatment, he or she can get better.
Never ignore comments about your friend or relative harming him or herself, and report such comments to your friend’s or relative’s therapist or practitioner.
How can I help myself? It may be very hard to take that first step to help yourself. It is important to realize that although it may take some time, with treatment, you can get better.
To help yourself:
• Talk to your practitioner about treatment options.
• Engage in mild activity or exercise to help reduce stress.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities, and do what you can as you can.
• Try to spend time with other people and confide in a trusted friend or relative. Tell others about things that may trigger symptoms.
• Expect your symptoms to improve gradually, not immediately.
• Identify and seek out comforting situations, places, and people.