Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can develop in individuals who have witnessed or experienced terrifying events. PTSD symptoms can affect everyday life and relationships, and may last for months, years or—for some—a lifetime.
The Facts About PTSD
Understanding this disorder is the first step toward learning how best to cope with it.
What is PTSD?
Post-traumatic stress disorder is a psychiatric disorder triggered by witnessing or experiencing a terrifying or dangerous event. Though PTSD is often exclusively associated with veterans returning from war, it's a disorder that affects the civilian population as well. In fact, statistics indicate up to 8 percent of Americans will develop and get diagnosed with post-traumatic stress disorder at some point in their lives.
A complex mental disorder, PTSD can sometimes be triggered by a single traumatic event such as a near-death experience, a sexual assault or a violent experience. However, it's important to note the disorder can sometimes develop as the result of myriad factors rather than a single event.
Facts and stats
Experts have found that the prevalence of PTSD is substantially higher for women than men, with the disorder affecting about 11 percent of women as compared to 5.5 percent of men.
World Mental Health Surveys carried out by the World Health Organization (WHO) indicate the burden of PTSD was highest among victims of rape, other forms of sexual assault, victims of stalking and those who experienced an unexpected death of a loved one. These studies define the burden of post-traumatic stress disorder by multiplying the prevalence of trauma by trauma-specific PTSD risk and persistence.
Since there is no single study that asks everyone about post-traumatic stress disorder, it is difficult to provide exact numbers for how many people in the U.S. have the disorder. However, the National Center for PTSD has used the available data to estimate that about 6 in 100 people in the U.S. will have PTSD at some point in their lives.
Though civilians do experience post-traumatic stress disorder, veterans have been found to experience it at higher rates. The risk for PTSD is also higher among veterans deployed to a war zone.
The National Center for PTSD reports that an estimated 13 million Americans experienced post-traumatic stress disorder in 2020.
Considering the fact that exposure to trauma has been part of the human experience since the beginning of history, it stands to reason PTSD has always existed as well. In the 1800s, it was called battle exhaustion or soldier's fatigue, and during WWI the terminology was changed to shell shock.
However, PTSD was not added as a formal disorder to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders until 1980. This was an important step toward recognizing those afflicted with the condition were dealing with real, measurable symptoms resulting from trauma rather than viewing them as "weak" or otherwise to blame for what they were going through.
Nowadays, there are many celebrities who have publicized their own post-traumatic stress disorder in the hope that the condition can be recognized, including Barbra Streisand, Lady Gaga, Whoopie Goldberg and Mick Jagger.
Causes and risk factors
There's no known singular cause of PTSD. Individuals develop the disorder after going through, witnessing or even learning about an event involving a near-death experience, violence, sexual violation or serious injury. It's important to note most people who experience or witness these events do not go on to develop post-traumatic stress disorder, which is part of the reason why nailing down the exact cause of the disorder is difficult.
The Mayo Clinic reports that as is the case with most mental health problems, PTSD is probably caused by a complex combination of factors such as:
- A family history of mental health issues, such as depression and anxiety.
- An individual's natural temperament.
- How an individual's brain regulates chemicals and hormones that are naturally released as part of a stress response.
- The severity and volume of the stressful and/or traumatic experiences an individual has had.
The bottom line, though, is that anyone can develop post-traumatic stress disorder at any age.
However, the following risk factors can make someone more likely to get post-traumatic stress disorder following a traumatic or terrifying event:
- A personal or family history of mental health problems.
- Going through intense trauma, particularly if it lasts a long time.
- Having a job with high exposure to trauma such as military service or being a first responder.
- Substance use.
- Surviving childhood trauma such as abuse.
- The lack of a quality support system.
PTSD tests and diagnosis
To diagnose post-traumatic stress disorder, your doctor will likely begin by performing a physical exam to find out whether you have any existing medical issues that could be responsible for your symptoms.
Next, your doctor may order a psychological evaluation to talk about any signs and symptoms of PTSD you have, when they began and the events that may have occurred before the symptoms appeared.
From there, your doctor will compare the results of the physical and psychological exams to the criteria in the DSM-5 to determine whether you meet the criteria for post-traumatic stress disorder.
If you meet the criteria, you can then be diagnosed with PTSD.
The first line of treatment of PTSD is psychotherapy. In some cases, psychotherapy may be combined with medication.
The objective of PTSD treatment is to teach skills needed to recognize and cope with symptoms, improve self-esteem and outlook, and treat other present-related conditions such as depression, anxiety or substance use.
Common types of psychotherapy used to treat PTSD include:
- Cognitive therapy
- Eye movement desensitization and reprocessing therapy
- Exposure therapy
Genetics and pathophysiology
Experts believe there may be a genetic link to PTSD. A study by the Psychiatric Genomics Consortium produced the first study, which was published in Molecular Psychiatry in 2017, that showed molecular genetic evidence that genes can play a role in a person's risk for developing PTSD.
The research built on past findings in the field demonstrated that there is a genetic overlap between disorders such as PTSD and schizophrenia. Furthermore, women seem to be at the highest genetic risk for post-traumatic stress disorder.
Signs and symptoms
Symptoms of PTSD can manifest within weeks of a traumatic event but can take as long as multiple years to appear.
Post-traumatic stress disorder symptoms are often characterized under the following umbrellas: avoidance, arousal symptoms, altered mood or thinking, and intrusive memories.
Avoidance symptoms can include:
- Avoiding anything related to the traumatic event including places, people or activities.
- Taking deliberate measures to avoid thinking or talking about the event.
Arousal symptoms can include:
- Angry or aggressive outbursts
- Becoming frightened or startled easily
- Difficulty sleeping and concentrating
- Exhibiting reckless behavior
- Having an overwhelming sense of shame or guilt
- Remaining in a constant state of fight-or-flight
Altered mood or thinking symptoms can include:
- A sense of hopelessness
- Difficulty with memory, particularly pertaining to the traumatic event
- Emotional numbness
- Feeling detached
- Lack of interest in things that previously brought enjoyment
- Negative outlook about the world and others
- Negative self-talk
Intrusive memory symptoms can include:
- Emotional distress or physical reactions to being reminded of the event
- Nightmares about the event
- Reoccurring, unwanted memories of the event
When to call the doctor
It's normal to have disturbing thoughts or feelings about traumatic events. However, if these thoughts and feelings persist for more than a month, if they are severe or if you feel out of control because of your symptoms, talk to a medical or mental health professional right away. Early treatment is important to prevent the worsening of symptoms or any resulting complications.
If you ever have suicidal thoughts, seek professional help immediately.
Management and aftercare
Living with PTSD can be hard for both you and your loved ones. In addition to the distressing symptoms post-traumatic stress disorder carries with it, the disorder is often accompanied by related conditions such as memory problems, depression, anxiety and the risk of substance use. This can make fulfilling daily responsibilities and maintaining healthy relationships feel overwhelming.
Fortunately, with ongoing treatment and the help of a loving support system, you can learn to better cope with your PTSD symptoms and reclaim your life.
Veterans and PTSD
The nature of serving in the military means that people who serve may have a greater chance of being exposed to different traumatic events than civilians. These events may occur during combat, natural disasters and life-threatening experiences, among others.
According to the National Center for PTSD, the prevalence of PTSD is slightly higher among veterans than civilians. Specifically, an estimated 7 in 100 veterans will have PTSD at some point in their lives.
Clinical trials and research
There are always clinical trials and research underway aimed at investigating the causes of and potential treatments for conditions such as PTSD.
If you're interested in participating in a clinical trial, talk to your doctor and loved ones and take some time to consider what's in your own best interest. A list of active and upcoming clinical trials that are both publicly and privately funded can be found at this government database.
Resources for patients and caregivers
Learning about post-traumatic stress disorder is the first step to overcoming the condition and there are some useful locations online that can help you on your journey:
What are the five signs of PTSD?
The signs and symptoms of post-traumatic stress disorder are wide-ranging and may vary from person to person. However, some common signs of PTSD are:
- A change in physical and emotional reactions to the world
- An intense need to avoid being reminded of the traumatic event
- Changes in mood
- Changes in thinking about yourself, others and the world
- Intrusive memories
- Things that remind you of the traumatic event.
What does PTSD do to a person?
Post-traumatic stress disorder can make it difficult for a person to carry out their responsibilities in their daily lives and maintain healthy relationships due to intense distress, unwanted memories, emotional and physical symptoms and more.
How do you calm down from PTSD?
With the help of psychotherapy, a loving support system, and in some cases, medication, a person can better understand their symptoms, recognize triggers and learn strategies to help them cope when faced with symptoms of post-traumatic stress disorder.