What Is A Trauma
A trauma is a stressful event that makes a person fear for their or other people’s life or safety.
Trauma events that can lead to PTSD include:
- physical or sexual abuse, or assault
- school or neighborhood violence
- sudden or forceful loss of a parent
- arrests, evictions
- being the target of hate, or threats of harm
An event can be a trauma for someone even if they dont go through the danger themselves. For example, seeing someone else be hurt or die from violence can be a trauma.
Hearing that someone close died by violence or suicide can be a trauma too. The grief can be intense with this type of loss. It is called traumatic grief.
Disinhibited Social Engagement Disorder
Disinhibited social engagement disorder occurs in children who have experienced severe social neglect or deprivation before the age of 2. Similar to reactive attachment disorder, it can occur when children lack the basic emotional needs for comfort, stimulation and affection, or when repeated changes in caregivers prevent them from forming stable attachments.
Disinhibited social engagement disorder involves a child engaging in overly familiar or culturally inappropriate behavior with unfamiliar adults. For example, the child may be willing to go off with an unfamiliar adult with minimal or no hesitation. These behaviors cause problems in the childs ability to relate to adults and peers. Moving the child to a normal caregiving environment improves the symptoms. However, even after placement in a positive environment, some children continue to have symptoms through adolescence. Developmental delays, especially cognitive and language delays, may co-occur along with the disorder.
The prevalence of disinhibited social engagement disorder is unknown, but it is thought to be rare. Most severely neglected children do not develop the disorder. Treatment involves the child and family working with a therapist to strengthen their relationship.
What Are The Symptoms Of Ptsd
There are four type of PTSD symptoms: reliving the event , avoiding situations that remind you of the event, negative changes in beliefs and feelings, and feeling keyed up . Symptoms may not be exactly the same for everyone. PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.
Learn more: Symptoms of PTSD
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What Is Complex Ptsd
The main symptoms of PTSD and complex PTSD are the same. Complex PTSD is sometimes known as c-PTSD, or CPTSD. If you have complex PTSD, you may have extra symptoms such as:
- issues with keeping a relationship,
- finding it difficult to feel connected to other people,
- a belief that you are worthless with deep feelings of shame, guilt or failure that can be related to the trauma, and
- difficulty controlling your emotions.
Youre more likely to develop complex PTSD if your trauma has been an ongoing event. Or series of different traumatic events. The trauma might be very threatening or frightening. Most commonly from a trauma which you werent able to escape from such as:
- a long period of domestic abuse, or
- a long period of sexual or physical abuse as a child or adult.
Next Steps For Ptsd Research
In the last decade, progress in research on the mental and biological foundations of PTSD has lead scientists to focus on better understanding the underlying causes of why people experience a range of reactions to trauma.
- NIMH-funded researchers are exploring trauma patients in acute care settings to better understand the changes that occur in individuals whose symptoms improve naturally.
- Other research is looking at how fear memories are affected by learning, changes in the body, or even sleep.
- Research on preventing the development of PTSD soon after trauma exposure is also under way.
- Other research is attempting to identify what factors determine whether someone with PTSD will respond well to one type of intervention or another, aiming to develop more personalized, effective, and efficient treatments.
- As gene research and brain imaging technologies continue to improve, scientists are more likely to be able to pinpoint when and where in the brain PTSD begins. This understanding may then lead to better targeted treatments to suit each persons own needs or even prevent the disorder before it causes harm.
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Factors Influencing The Duration Of Ptsd
How long PTSD lasts depends on multiple factors. Some relate to the trauma itself, while others relate to the person and his/her life.
Trauma-related factors that impact the duration of PTSD include:
- Multiple or chronic trauma experiences vs. a single traumatic event
- Intentional trauma vs. accidental trauma
- Human-induced trauma vs. natural disasters/traumas
- Sexual assault vs. traumatic event not sexual in nature
Experiencing multiple traumas tends to make PTSD last longer, as do repetitive traumas, intentional traumas, human-induced traumas, and sexual assaults.
Person- and life-related factors that impact the duration of PTSD include:
- History of other traumatic experiences
- Living with other mental health challenges
In general, PTSD lasts longer in people who have experienced other traumatic events in the past, have current or past mental health difficulties, use fewer coping skills, and have little social support.
Do You Avoid Things That Remind You Of The Trauma
Trauma is scary and disruptive. Its natural to want to avoid situations that might remind us of unpleasant or threatening events.
People with PTSD want to avoid places, activities, objects that bring up unpleasant reminders or feelings about the trauma.
People with PTSD tend to avoid thoughts or feelings that related to the trauma.
For example, I try to avoid feeling startled, because the adrenaline rush and sudden jolt reminds me of times I wasnt safe. So, while balloons popping have nothing to do with my abuse, the feeling the loud sound brings about does.
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How Can I Help Myself
If you have been through trauma, or think you might have PTSD, here are things you can do:
- Confide in an adult you trust. Reach out to someone who will listen and care. Its OK if you need extra time and support for a while. Pay it forward by being kind or helpful to someone else. Helping makes the helper feel good too.
- Get treatment for PTSD or trauma. This can help you cope with what you have been through. It can help you discover strengths you never knew you had. Your parent, doctor, or school counselor can help you find the right person to work with.
- Practice ways to relax. Make time every day to take a few slow breaths. If you can, make the exhale just a bit longer than the inhale. Try this: Breathe in while you count to 3. Breathe out while you count to 5. Take 34 breaths like this. It seems so simple. But it has a powerful benefit. It helps to reset the brains threat sensor. The benefit adds up, so practice it often.
- Do things that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help you recharge. Play, laugh, enjoy nature, make music or art, cook. These activities can reduce stress, build your resilience. They even help you be a better learner when its time to focus.
- Know that you can do this. Believe in yourself. Everyone has the ability to adapt and grow, even with difficult challenges. It takes patience and effort. And there are people who will help you.
You Answered Yes To Question
If you answered No to Question 1, you most likely do not have PTSD. If you have concerns about anxiety, stress, depression, or other mental health issues, speak with a licensed professional.
Based on the answers you provided, it is unlikely you meet the criteria for PTSD. However, if you are struggling with the symptoms you are experiencing, you are encouraged to seek help from a qualified mental health professional.
Based on the answers you provided, it is possible you meet the criteria for PTSD. If you are struggling to cope with the symptoms you identified, you are encouraged to seek additional assessment from a qualified mental health professional.
Based on your answers, it is likely you meet the criteria for PTSD. If these are symptoms you have been experiencing for longer than 6 months you are strongly encouraged to seek assistance from a qualified mental health professional.
Some resources to find a licensed professional include:
Company
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Feeling Like You’re Observing Yourself
The DSM-5 notes that an indicator of PTSD can be when people experience depersonalization and/or derealization .
Depersonalization is when you feel detached from yourself and your emotions, possibly like you’re watching yourself out of your body. The DSM-5 explains this could mean feeling like you’re in a dream or that time is moving slowly.
Derealization is when you feel like your surroundings aren’t exactly real. The world around you may feel dreamlike or distorted.
Being Constantly On The Lookout For Threats
This PTSD symptom is called hypervigilance. “You’re scanning the environment all the time,” said Dr. Ritchie, or on high alert constantly. This can be exhausting, stressful, and frightening.
That might mean always sitting with your back to the wall in restaurants or lecture halls so you can see everyone and everything taking place in front of you.
“They don’t want anyone sneaking behind them,” said Sonya Norman, Ph.D., director of the PTSD consultation program at the National Center for PTSD and psychiatry professor at the University of California San Diego. “They want to be ready to respond.”
Like nightmares, this heightened awareness can contribute to sleep problems in people with PTSD. Falling asleep and staying asleep can be more difficult if any small noise or change wakes you up.
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What Are Residual Symptoms
Researchers still dont know a lot about residual symptoms of PTSD, because most of the literature focuses on active PTSD and treatment methods.
However, one thing is clear: residual symptoms are somewhat different from PTSD symptoms, which include distress, flashbacks, nightmares, and unpleasant memories about the traumatic experience.
Residual symptoms can be more gradual, though just as pervasive in day-to-day life. They may also appear well after PTSD treatment is over even months or years later blurring the lines between active and recovery states.
In one study, 59% of those who had been treated for PTSD reported subthreshold levels of symptoms. As in, not enough to warrant full-on treatment, yet not completely back to a normal baseline either.
In that same study, 1 in 3 participants reported clinical-level symptoms after treatment, meaning that further treatment would be a good idea.
Does Any Of This Sound Familiar
When I figured out I had PTSD, I was surprised. I thought I was doing really well for years and years.
In hindsight, I was just numb and had a constricted range of feelings, also related to the trauma. Later, my PTSD presented with some of the more dramatic characteristics like flashbacks, nightmares, and extreme emotional reactivity.
Its easy to explain away symptoms as more socially acceptable and common conditions. Must be depression! or Oh, I guess Ive always been hypersensitive. Those statements are easier to say than I think I have PTSD.
If youve been the victim of a traumatic event or episode and have assumed youre struggling with depression or anxiety, or if you feel youre over it, but dont feel much of anything when you really think about it, it might be worth familiarizing yourself with the symptoms of PTSD and get in touch with your doctor or a mental health professional who can help.
The good news is, there are many effective treatments for PTSD that can improve the way you feel and function.
If you or someone you know has been affected by sexual violence, its not your fault. You are not alone. For people based in the US, help is available 24/7 through the National Sexual Assault Hotline: 1-800-656-HOPE and online at rainn.org, y en español: rainn.org/es. For people outside of the US, theres this list of resources divided by country.
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Find The Best Treatment For You
Today, there are several treatment options for PTSD. For some people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense.
You can learn about effective PTSD treatment options using the National Center for PTSD’s Treatment Decision Aid. It includes videos to explain how the treatments work.
You can also build a chart to compare the treatments you like most. Both psychotherapies and medications are included in the decision aid.
From the National Center for Posttraumatic Stress Disorder, US Department of Veterans Affairs. www.ptsd.va.gov.
What Are The Signs & Symptoms Of Ptsd
Most kids and teens with PTSD will:
- have upsetting thoughts of the trauma
- have bad dream or sleep problems
- have bad memories, called flashbacks, that make it seem like the trauma is still happening
- avoid things that remind them of the trauma
- be more easily startled, scared, or anxious
- feel more moody, sad, angry, or not enjoy things as before
- not remember some parts of what happened
Younger children may show more fearful and regressive behaviors They may re-enact the trauma through play.
When symptoms like these happen in the first days and weeks after the trauma, it may be called an acute stress reaction. Doctors diagnose PTSD when symptoms last longer than a month.
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Cognition And Mood Symptoms
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted thoughts about the event that cause feelings of blame
- Ongoing negative emotions, such as fear, anger, guilt, or shame
- Loss of interest in previous activities
- Feelings of social isolation
- Difficulty feeling positive emotions, such as happiness or satisfaction
Cognition and mood symptoms can begin or worsen after the traumatic event and can lead a person to feel detached from friends or family members.
Why Ptsd Can Go Untreated
Paula Schnurr, executive director of the National Center for PTSD, said about 70 percent of adults in the U.S. experience at least one traumatic event, which the Centers for Disease Control and Prevention defines as an experience marked by a sense of horror, helplessness, serious injury or the threat of serious injury or death. But only 6 percent of the population will develop PTSD at some point in their lives, according to the Department of Veterans Affairs, the bulk of whom are women. Scientists are still trying to identify the biological and societal factors behind these discrepancies like how generational trauma, the notion that some elements of PTSD may be passed down genetically, works, and what complex trauma, which is caused by repeated traumatic events, does to ones psyche.
When we first created this diagnosis of PTSD, we said it came from an extraordinary event outside of the range of human experience, Dr. van der Kolk said, referring to the scientists and researchers who treat the disorder. Thats how completely out to lunch we were to think that trauma is exceptional.
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Ptsd In Children And Teenagers
Older children and teenagers experience similar problems to adults when they develop PTSD. Younger children can express distress in a different way. For example, they may re-live the traumatic event through repetitive play rather than having unwanted memories of the event during the day. Many children have frightening dreams without recognisable content rather than nightmares that replay the traumatic event. Children may also lose interest in play, become socially withdrawn, or have extreme temper tantrums.
About one third of children who experience a traumatic event will develop PTSD.
Other problems that can develop alongside PTSD include anxiety or depression, defiant behaviour, attention deficit hyperactivity disorder, and in teenagers and young adults, suicidal thoughts and alcohol or drug use.
How Is Ptsd Treated
It is important for anyone with PTSD symptoms to work with a mental health professional who has experience treating PTSD. The main treatments are psychotherapy, medications, or both. An experienced mental health professional can help people find the treatment plan that meets their symptoms and needs.
Some people with PTSD may be living through an ongoing trauma, such as being in an abusive relationship. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms. People who have PTSD or who are exposed to trauma also may experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an important part of recovery.
For tips to help prepare and guide you on how to talk to your health care provider about your mental health and get the most out of your visit, read NIMHs fact sheet, Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider.
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Signs And Symptoms Of Ptsd
PTSD develops differently from person to person because everyones nervous system and tolerance for stress is a little different. While youre most likely to develop symptoms of PTSD in the hours or days following a traumatic event, it can sometimes take weeks, months, or even years before they appear. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell.
While everyone experiences PTSD differently, there are four main types of symptoms.
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