Posttraumatic stress disorder is defined in terms of the trauma itself and the person’s response to the trauma. Trauma occurs when a person has experienced, witnessed, or been confronted with a terrible event that is an actual occurrence. Alternatively, the person may have been threatened with a terrible event, perhaps injury (physical or psychological) or death to themselves or others. Then, the person’s response to the event or to the threat involves intense fear, helplessness, and/or horror.
It is important to note, however, that having strong reactions to trauma is normal. What’s more, there is a range (spectrum) of expected reactions depending on a person’s prior exposure to trauma and even on hereditary (genetic) factors. Most importantly, you should understand that there are efficient and effective treatments for PTSD.
What are the symptoms of PTSD?
In general, posttraumatic stress disorder can be seen as an overwhelming of the body’s normal psychological defenses against stress. Thus, after the trauma, there is abnormal function (dysfunction) of the normal defense systems, which results in certain symptoms. The symptoms are produced in three different ways:
- Re-experiencing the trauma
- Persistent avoidance
- Increased arousal
First, symptoms can be produced by re-experiencing the trauma, whereby the individual can have distressing recollections of the trauma. For example, the person may relive the experience as terrible dreams or nightmares or as daytime flashbacks of the event. Furthermore, external cues in the environment may remind the patient of the event. As a result, the psychological distress of the exposure to trauma is reactivated (brought back) by internal thoughts, memories, and even fantasies. Persons also can experience physical reactions to stress, such as sweating and rapid heart rate. (These reactions are similar to the “fight or flight” responses to emergencies. The patient’s posttraumatic symptoms can be identical to those symptoms experienced when the actual trauma was occurring.
The second way that symptoms are produced is by persistent avoidance. The avoidance refers to the person’s efforts to avoid trauma-related thoughts or feelings and activities or situations that may trigger memories of the trauma. This so-called psychogenic (emotionally caused) amnesia (loss of memory) for the event can lead to a variety of reactions. For example, the patient may develop a diminished interest in activities that used to give pleasure, detachment from other people, restricted range of feelings, and a sad affect that leads to the view that the future will be shortened.
The third way that symptoms are produced is by an increased state of arousal of the affected person. These arousal symptoms include sleep disturbances, irritability, outbursts of anger, difficulty concentrating, increased vigilance, and an exaggerated startle response when shocked.