Post-traumatic stress disorder (PTSD) is a trauma and stressor-related disorder anxiety disorder that develops after a traumatic event. PTSD has also been called "shell shock" or "battle fatigue."
The exact cause of PTSD is unknown. PTSD is triggered by exposure to a traumatic event. Situations in which a person feels intense fear, helplessness, or horror are considered traumatic. PTSD has been reported in people who experienced:
Researchers are studying how problems with synapses in the brain may be linked to PTSD.
Not everyone who experiences a traumatic event will develop PTSD. Symptoms of PTSD are more likely to occur if the person has:
People with PTSD experience symptoms of anxiety following a traumatic event. These symptoms fall into 3 categories:
People with PTSD may also have:
You will be asked about your symptoms and medical history. This may be done by using a structured interview and/or a questionnaire. You will also likely be given a psychological assessment. PTSD will be diagnosed if you have:
PTSD is categorized according to when symptoms occur and how long they last. There are 3 types of PTSD:
There are many treatments available to help manage PTSD. General goals include learning how to cope with symptoms, reducing symptoms, and strategies to improve relationships with family or friends. Treatment will also focus on any other conditions you may have, such as depression or substance abuse. The length of treatment will depend on the individual but can range from a few months to a few years. Treatment can often include a combination of approaches.
Cognitive-behavior therapy (CBT) is a very effective type of counseling for PTSD. Therapy focuses on:
There are a few different types of CBT including:
During this type of therapy, you are asked to talk about the traumatic event, including your memories, feelings, and sensations. While talking, you will be asked to do simple tasks like tapping hand, following therapist's hand with your eyes or listening to tones through headphones. The reason why is not clear, but repeating the story with the physical distraction allows your brain to process the trauma in a different way. In effect the process overwrites some of the negative thought processes related to the trauma.
Other therapeutic options that may help include:
Medication can help manage some symptoms while you go through counseling or during a crisis period. They may help manage anxiety, depression, and insomnia. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are often prescribed.
Anxiety and Depression Association of America
National Center for PTSD—US Department of Veterans Affairs
Canadian Psychiatric Association
Canadian Psychological Association
Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated December 23, 2014. Accessed January 26, 2016.
Benedek DM, Friedman MJ, Zatzick D. Guideline watch: practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Focus. 2009;7:204-213.
Jeffereys M. Clinician's guide to medications for PTSD. United States Department of Veterans Affairs website. Available at: http://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp. Updated August 17, 2015. Accessed January 26, 2016.
Post-traumatic stress disorder. American Psychiatric Association website. Available at: http://www.apa.org/topics/ptsd/index.aspx. Accessed January 26, 2016.
Post-traumatic stress disorder (PTSD). EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-stress-disorder-PTSD. Updated August 19, 2016. Accessed September 15, 2016.
Treatment of PTSD. US Department of Veterans Affairs website. Available at: http://www.ptsd.va.gov/public/treatment/therapy-med/index.asp. Accessed January 26, 2016.
3/16/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Schnurr PP, Friedman MJ, Engel CC, et al. Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial. JAMA. 2007;297(8):820-830.
11/19/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ji L, Xiaowei Z, Chuanlin W, Wei L. Investigation of posttraumatic stress disorder in children after animal-induced injury in China. Pediatrics. 2010;126(2):e320-324.
10/12/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Polusny MA, Erbes CR, Thuras P, et al. Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial. JAMA. 2015;314(5):456-465.
Last reviewed December 2015 by Adrian Preda, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.