Psyche Boston
DBT and CBT in Nashville for Adults and Adolescents. Treating Depression, Anxiety, and Personality Disorders.

Posttraumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD)

“Oh, that’s the thing that happens when you go to war.” 

While that’s definitely a possibility, war isn’t the only form of trauma, nor does every person who goes to war develop PTSD. PTSD is a possible complication of having experienced trauma, just like pneumonia can be a complication of an upper respiratory infection. It doesn’t always happen, but when it does, it can seriously impair your life.

 Want more info? Click the photo for an article on PTSD versus experiencing trauma.

Want more info? Click the photo for an article on PTSD versus experiencing trauma.

Post-traumatic Stress Disorder (PTSD) can develop from being exposed to a wide variety of traumatic events such as motor vehicle crashes, home accidents, sexual assault, domestic violence, or being involved in a natural disaster.  As the diagnostic “Bible,” (DSM-V)  describes it, PTSD happens after “being witness to or being exposed to situations involving threatened or actual serious physical harm or death.” But it’s important to keep in mind that experiencing a trauma doesn’t mean a person will absolutely develop PTSD. In fact, the vast majority of those exposed to a trauma will NOT develop the disorder. Only 7 or 8 people out of 100 who are exposed to a trauma event will develop PTSD according to the National Center for PTSD.

Immediately after a significantly traumatic event, it is completely normal (and expected!) to experience symptoms such as difficulty sleeping, mood changes, feeling “on edge,” and having nightmares. This is the body’s natural response when bad things happening. It is when a full month goes by and symptoms have not improved that therapists begin to consider a diagnosis of PTSD.  Prior to one month, a person may instead meet criteria for what is referred to as Acute Stress Disorder

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PTSD symptoms can include feeling as though the traumatic event is recurring, unwanted thoughts and memories of the event popping into their mind, recurrent bad dreams about what happened, and feeling “on edge” and generally mistrustful of others. They may find themselves feeling fearful “for no reason” and in new or odd situations (e.g. the grocery store, a wide-open space, etc.). This can lead to an increased startle response and feeling “on alert.” 

Ironically, one of the main reasons why people develop PTSD is because they work so hard to “get over it” by putting the event out of their mind in an attempt to “just move on.” But avoidance of thoughts, memories, and places and things that remind a person of the event are actually PTSD symptoms AND the cause of the disorder. Avoidance unfortunately lead to problems in how the memory is stored in the brain. The brain will not let a traumatic memory go if it’s not first processed before it’s stored.  Avoidance leads to more and more avoidance, and over time, an increase in overall PTSD symptoms.   

One of the main treatment options for PTSD is referred to as Prolonged Exposure (PE). This therapy involves “revisiting” the traumatic and describing it in specific detail with the therapist. It is sort of the “anti-avoidance.” While this is likely the LAST thing a person with PTSD wants to do, it has been demonstrated to be highly effective in resolving symptoms. The good news is, the worst of the discomfort in telling the story improves very quickly, and overall symptom alleviation can be swift. Over time with repeated recalls of the event, the memory and symptoms lose their intensity and the emotional pain subsides. While the person will never forget the painful memory, they may regain the ability to live life without the past event getting in the way of their peace of mind, relationships, and overall happiness.