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Definition

Post-traumatic stress disorder (PTSD) is a mental health issue that often starts after a shocking event. PTSD has also been called "shell shock" or "battle fatigue."

Causes

The exact cause of PTSD is unknown. It is often triggered by an event that causes intense fear, helplessness, or horror. PTSD is known to happen after:

  • War
  • Rape
  • Physical assault
  • Natural disaster such as earthquakes, hurricanes, or fires
  • Sexual abuse
  • Motor vehicle accidents
  • Animal attack

Changes in the brain after injury may be linked to PTSD.

Risk Factors

PTSD may be more likely in those with:

  • Previous traumatic experiences
  • Past physically abused
  • Poor coping skills
  • Lack of social support
  • Existing ongoing stress
  • A social environment that produces shame, guilt, stigmatization, or self-hatred
  • Alcohol use disorder
  • Family history of mental health problems

Symptoms

Symptoms may last for a short time after an event or last for months after. Some may not begin until 6 months or more after the event. PTSD can cause anxiety, which leads to:

  • Dreams or nightmares about the event
  • Intrusive memories
  • Flashbacks
  • Anxious reactions to reminders of the event
  • Avoiding reminders of the event, such as places, people, or situations
  • Avoiding feelings, thoughts, or memories related to the event
  • Feeling detached or numb
  • Difficulty remembering relevant details of the trauma
  • Difficulty falling asleep or staying asleep
  • Anger and irritability
  • Difficulty concentrating or paying attention
  • Being easily startled
  • Hypervigilance

PTSD may also lead to:

  • Substance abuse problems
  • Physical symptoms, such as pain, rapid breathing or heart rate, and sweating
  • Depression or anxiety
  • Relationship problems

Diagnosis

The doctor will ask about symptoms and past health. They will also ask about your moods, and overall wellness. The doctor will make a diagnosis based on your symptoms and details that you share.

Treatment

PTSD can be managed with therapy. The goal is to reduce the effect of PTSD on everyday life and relationships. The exact steps will depend on your specific needs. Treatment may be short or long term. Some treatment options include:

Cognitive-Behavior Therapy

Cognitive-behavior therapy (CBT) is a very effective type of counseling for PTSD. Therapy focuses on:

  • Learning about your current PTSD symptoms
  • Better awareness of thoughts, feelings, and negative patterns
  • Learning coping skills to manage thoughts about the trauma and current day challenges
  • Understand and find the balance between your beliefs before the trauma and beliefs after the trauma

There are a few different types of CBT including:

  • Cognitive processing therapy (CPT)—understand and change thought pattern.
  • Prolonged exposure therapy—repeated discussion of the trauma to decrease negative feelings. Should be done with a therapist.

Eye Movement Desensitization and Reprocessing (EMDR)

A therapist will ask you to do simple tasks while talking about the traumatic event. Tasks may include hand-tapping, following therapist's hand with your eyes, or listening to tones through headphones. This allows your brain to process the trauma in a different way.

Other Therapy

Other therapeutic options that may help include:

  • Stress inoculation therapy (SIT)—use relaxation techniques, positive reframing of negative thoughts, and assertive communication.
  • Group meetings—with other survivors of trauma.
  • Family therapy—to help with relationships between family members, give family members support, and help family understand PTSD.
  • Mindfulness meditation—focus on breathing and present experiences to manage stress.

Medication

Medicine can help to manage some symptoms. They may help with anxiety, depression, and insomnia while you work through treatment.

Prevention

PTSD cannot be prevented.

RESOURCES:

Anxiety and Depression Association of America
https://adaa.org

National Center for PTSD—US Department of Veterans Affairs
https://www.ptsd.va.gov

CANADIAN RESOURCES:

Canadian Psychiatric Association
https://www.cpa-apc.org

Canadian Psychological Association
https://cpa.ca

REFERENCES:

Jeffereys M. Clinician's guide to medications for PTSD. National Center for PTSD—US Department of Veterans Affairs website. Available at: https://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp. Accessed January 31, 2021.

Post-traumatic stress disorder. American Psychiatric Association website. Available at: http://www.apa.org/topics/ptsd/index.aspx. Accessed January 31, 2021.

Posttraumatic stress disorder (PTSD). EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-stress-disorder-PTSD. Accessed January 31, 2021.

Treatment. National Center for PTSD—US Department of Veterans Affairs website. Available at: http://www.ptsd.va.gov/public/treatment/therapy-med/index.asp. Accessed January 31, 2021.

10/12/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-stress-disorder-PTSD: 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 January 2021 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 01/20/2021