Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by seeing or experiencing a terrifying event. Though it varies case by case, common PTSD symptoms include flashbacks, intrusive thoughts about the traumatic event, nightmares, emotional distress and severe anxiety.
The National Center for PTSD reports that about 6 in 100 people in the U.S. will develop PTSD at some point in their lives, and that an estimated 15 million adults suffer from the disorder each year.
A common misconception is that PTSD exclusively affects soldiers returning from war. While many soldiers and veterans do struggle with PTSD, the disorder also affects millions of civilians as the result of a variety of triggering events.
"PTSD may develop after a stressful event or situation of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone," said Hadi Estakhri, a psychiatrist based in Newport Beach, California. "A traumatic stressor usually involves a perceived threat to life—either one's own life or that of another person—or physical integrity, and intense fear, helplessness or horror."
Estakhri said traumatic events can include deliberate acts of interpersonal violence, including physical or sexual assault, severe accidents and illnesses, living through man-made or natural disasters or experiencing certain military actions.
Toni Aswegan, a licensed mental health counselor and the founder and clinical director of Riverbank Therapy, noted that it's also important to remember that PTSD can be borne out of a set of enduring circumstances that overwhelm someone's ability to cope rather than an event or series of events that have already taken place.
"Ultimately, everyone's trauma looks different," she said. "This might be a distinct event, like a car accident or an assault. It might also be an ongoing event, like childhood physical, emotional or sexual abuse with multiple instances of trauma. It can also be an enduring circumstance, such as living in the United States as a person of color experiencing daily acts of racism and microaggressions."
Aswegan added that everyone experiences and copes with trauma differently.
"Almost everyone has experienced a traumatic event, but only 20 percent of the population goes on to develop PTSD," she explained. "Our nervous systems are typically able to go through a traumatic event and process it without ongoing distress lasting 30 days past the event. However, some people develop PTSD after a traumatic event. It is hard to tell exactly who is likely to develop PTSD after trauma and who isn't. However, some factors include a history of safe and secure relationships, continued social supports, emotional awareness and coping skills, and general resources, such as housing and access to healthcare."
An important part of knowing when to seek help for PTSD is being able to recognize the symptoms of the disorder in yourself. Though they manifest differently for everyone, Estakhri noted there are generally four types of PTSD symptoms: reliving the trauma, avoiding things that remind you of the trauma, having more negative thoughts and feelings than you did before the trauma, and feeling on edge.
"Symptoms usually start soon after the event, but for some people they may come and go, or start much later," Estakhri said. "You may notice that your loved one has nightmares, gets upset by things that remind them of the event, or often seems distracted or absent. This can happen because people with PTSD often have memories of the trauma even when they don't want to. They may have flashbacks—memories that are so real and scary that it feels like the trauma is happening all over again."
A symptom of avoidance would be if someone suffering from PTSD related to a car accident decided to avoid driving at all costs.
"They may also try to stay busy all the time so they don't have to think about the event," Estakhri added.
It's also not uncommon for people with PTSD to feel disconnected from those around them.
"You may notice that your loved one seems sad, scared or angry, and has trouble relating to family and friends," Estakhri explained. "They may also feel numb, or lose interest in things they used to enjoy. You may notice that your loved one startles easily, has trouble sleeping, or seems angry or irritable. They may be overprotective of their family or always 'on guard' — like they're worried that something bad will happen."
If you think you may have PTSD and are struggling with the symptoms described above, reaching out to a mental health professional is the first step in learning how to manage your symptoms and find healing.
Living with PTSD can be extremely challenging as it can affect your ability to carry out daily activities and connect with the people around you. Fortunately, there is effective treatment.
According to the Mayo Clinic, PTSD is primarily treated with psychotherapy, though medication is also used in some cases to help address symptoms such as depression, anxiety, sleeplessness and more. Psychotherapy is targeted to help individuals develop ways to cope with their symptoms and to help shift their outlook on life, themselves and those around them.
"Therapy for PTSD can look like exploring the impacts of the traumatic event, exploring how your body holds onto the traumatic memory and restoring a sense of agency, safety and meaning," Aswegan said. "Sensorimotor psychotherapy, somatic experiencing, and eye movement desensitization and reprocessing (EMDR) are some of the most helpful treatments for PTSD, as they address the body and nervous system's reactions to trauma, and don't always require the client to tell the story of the event."
Other helpful treatments include trauma-focused cognitive behavioral therapy (TF-CBT) and dialectical behavior therapy (DBT).
"Trauma-focused means that the treatment focuses on the memory of the traumatic event or its meaning," Aswegan added. "These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8 to 16 sessions."
If you're personally struggling with PTSD, you might wonder if it will ever go away or if it's something you'll have to deal with forever. Experts say that while the journey may not be easy or even short, healing is possible.
"PTSD shows substantial natural recovery in the initial months and years after a traumatic event," Estakhri explained. "Whereas a high proportion of trauma survivors will initially develop symptoms of PTSD, a substantial proportion of these individuals recover without treatment in the following years, with a steep decline in PTSD rates occurring in the first year.
"On the other hand, at least a third of the individuals who initially develop PTSD remain symptomatic for three years or longer."
"The length of necessary treatment varies from person to person, so an exact timeline of healing is difficult to predict," Aswegan said. "PTSD symptoms can remit over time with treatment. However, therapy cannot change what happened. The result of therapy is typically integrating the traumatic experience into how you make meaning of your life."
No one should have to go through PTSD alone, and treatment can help.
"For some people, treatment can get rid of PTSD altogether," Estakhri said. "Others may have fewer symptoms or find that their symptoms are less intense. After treatment, most people say they have a better quality of life."
PTSD has been shown to negatively affect not only emotional, mental and physical health, but sexual health as well. Given the pervasive effects of the disorder, it's no surprise that it is often difficult to know how best to help a loved one or partner who is struggling with PTSD.
It turns out the first step toward learning how to best support them might be easier than you thought. According to Estakhri, education is the best place to start.
"If you're concerned about a loved one who has experienced trauma, it's important to learn about PTSD," he said. "Knowing how PTSD can affect people will help you understand what your loved one is going through—and how you can support them."
Simply being there as a supportive presence for a person with PTSD can make a huge difference. But it's also important to understand your own limits. Your role as a support system is an important one, but you should also encourage your loved one to seek treatment so that a mental health professional can help in the ways that you're simply unable to.
"Validation is one of the best supports you can provide a loved one with PTSD," Aswegan said. "Let them know that you believe them. Talk with them about how you can support them in feeling safe. Encourage them to seek treatment."
If you or a loved one is experiencing negative or suicidal thoughts, call 1-800-273-8255 immediately for the National Suicide Prevention Lifeline and seek help from a medical professional for proper treatment.
