Post-Traumatic Stress Disorder: Causes, Symptoms & Treatment

Post-traumatic stress disorder can follow traumatic experiences, such as the death of a family member or a serious accident, and then usually sets in very quickly after the experience. Treatment approaches are varied.

What is post-traumatic stress disorder?

Post-traumatic stress disorder is a mental disorder that can occur in a person as a result of a traumatic situation. In this context, a traumatic situation is one in which the health or life of oneself or a loved one is threatened. Post-traumatic stress disorder can occur during any age and usually begins immediately after a traumatic situation. It is not uncommon for a person to not have an isolated post-traumatic stress disorder, but to have other mental health issues that occur alongside post-traumatic stress disorder (such as depression or anxiety). Post-traumatic stress disorder is manifested, for example, in the fact that the traumatic situation is frequently relived by the affected person in thoughts or dreams (this is also referred to as flashbacks). Sleep disturbances and feelings of threat (e.g., violence threatened or perpetrated by other people) are also among the symptomatology that post-traumatic stress disorder may entail.

Causes

The direct cause of a person developing post-traumatic stress disorder is being part of a traumatic situation. In this case, the traumatic situation that causes posttraumatic stress disorder may either have been experienced directly by the person, or the person in question may have been an observer of the situation. Appropriate traumatic situations would include war experiences or terrorist attacks, serious accidents, rape, hostage taking, or even news of the unexpected death of a loved one. Scientific studies also suggest that post-traumatic stress disorder is more common in people who had mental health problems prior to a traumatic situation, who receive little social support, or who had negative childhood experiences.

Symptoms, complaints, and signs

Posttraumatic stress disorder can occur shortly after a traumatic event, but it can also occur with a significant time delay. In this case, the stressful event constantly recurs in nightmares and abruptly occurring snatches of thoughts (flashbacks); the distressing memories cannot be controlled and largely determine thinking and feeling. Partial amnesia, in which important details of the trauma are suppressed from consciousness, is also possible. Patients suffer great anxiety and helplessness, but are unable to talk about it. Physical pain is felt as strongly as in the traumatic situation. In order to protect themselves, affected persons avoid all situations that could remind them of the experience; they become indifferent to their surroundings and fellow human beings and blunt emotionally. In addition, post-traumatic stress disorder affects the autonomic nervous system: signs of autonomic overexcitation can include difficulty falling asleep or sleeping through the night, increased irritability, difficulty concentrating and excessive jumpiness. Many patients lose confidence in themselves and others; feelings of guilt and shame can increase to the point of self-hatred. In everyday life, PTSD leads to massive limitations that can result in job loss and social isolation. Often, post-traumatic stress disorder is accompanied by addictive disorders, depression or other mental illnesses, and pre-existing physical complaints can worsen massively.

Course and diagnosis

In medicine, there are various manuals that define criteria according to which post-traumatic stress disorder is diagnosed. According to these, the prerequisites for diagnosing post-traumatic stress disorder are, for example, that a person has been confronted with a traumatic experience and reacts to it with strong fear, horror or helplessness.Other criteria that may indicate post-traumatic stress disorder include persistent re-experiencing of the traumatic situation, avoidance of topics related to the traumatic situation, reduced emotional responsiveness, or increased nervousness; for example, increased jumpiness, sleep problems, difficulty concentrating, or increased irritability are observed in individuals who exhibit post-traumatic stress disorder. While post-traumatic stress disorder usually occurs in individuals immediately after a traumatic situation, in some cases it can occur with a time delay.

Complications

The risk for complications related to posttraumatic stress disorder increases with the length of time that treatment is not provided and, in addition, is dependent on the individual’s circumstances and ability to seek help. The high level of comorbidity associated with PTSD also plays a role. For example, in a chronic course of PTSD, there is increased abuse of substances, including primarily alcohol or non-prescription medications. This onset of addictive behavior causes physical symptoms to be added to the psychological symptoms after a period of time, which can further increase the anxiety of those affected. In addition, the physical symptoms resulting from the body’s constant alertness can lead to increased damage to the cardiovascular system, digestion, and other chronic diseases. Overall, susceptibility to illness is higher. Accident victims with PTSD have a longer average hospital stay and a higher risk of injury-related complications. Emerging depression and personality changes not infrequently involve social complications that find expression in isolation or excessive aggression. The tendency to self-injurious behavior is increased, which can extend to suicide. In this context, the psychological disorders that arise, first and foremost anxiety disorders and personality disorders, are often a reason for extended therapy.

When should you see a doctor?

After a traumatic event, it is generally a good idea to talk to a therapist or another trusted person. If increased startle response, feelings of indifference, and other signs of PTSD occur after the event, a visit to the doctor is recommended. The symptoms can be reduced with the support of a professional by working through and coping with the triggering event. After a trauma or a stressful phase of life, expert advice should be sought early, because the earlier post-traumatic stress disorder is treated, the better the chances of recovery. Individuals who notice symptoms of PTSD after a serious accident or violent crime are best to speak with a psychologist immediately. Other contacts are the family doctor, a psychotherapist or the telephone counselling service. If a child shows symptoms of post-traumatic stress disorder, the pediatrician or a child and adolescent psychologist should be consulted first. The expert can help determine the cause, assist the affected person in processing the trauma and, if necessary, prescribe an appropriate medication for the symptoms.

Treatment and therapy

There are various treatment approaches according to which post-traumatic stress disorder is treated. For example, there is the approach known as cognitive behavioral therapy to combat post-traumatic stress disorder. For example, anxiety management is used as part of this psychotherapeutic intervention. In addition, there are a number of other psychotherapy approaches in psychology that are specifically designed to combat Pposttraumatic Stress Disorder. Another method that is used to combat post-traumatic stress disorder is EMDR (Eye-Movement Desensitization and Reprocessing). This method is based, among other things, on a combination of confronting the affected person with the stimuli that caused post-traumatic stress disorder and very rapid eye movements. In combination, it should be possible to reduce the severity of the mental illness. Pharmacotherapy (i.e., therapy using drugs) also has products available that are used to combat post-traumatic stress disorder.For example, appropriate medications are thought to reduce anxiety that accompanies post-traumatic stress disorder or alleviate depressive symptoms that the disorder can also bring.

Prevention

Because traumatic situations that cause posttraumatic stress disorder are very rarely predictable and are also usually beyond the control of the individual, it is very difficult to take preventive measures against posttraumatic stress disorder. However, it can be very important that therapeutic care is provided immediately after a traumatic situation so that post-traumatic stress disorder can possibly be prevented. Post-traumatic stress disorder can be successfully treated if the individual seeks therapy. Although the symptoms heal in about 50 percent of sufferers without professional help, psychotherapeutic care is still advisable. In the case of untreated PTSD, it is not possible to fully come to terms with what has been experienced, and the prognosis for the future is worse in this case.

Aftercare

The future is primarily what aftercare is about. Aftercare for PTSD is useful in terms of prevention and planning for the patient’s future. The sufferer’s mental state is strengthened so that future stresses do not trigger a second episode of the disease. A chronic course of the disease should be avoided; the risk of manifestation exists in about one third of those affected. In these cases, they have already been suffering from the symptoms for years. Follow-up care is necessary to enable the patient to process what he has experienced and to restore his quality of life. It is useful so that the affected person can control his emotions when he is reminded of the stressful events. At the same time, his social skills should be stabilized and reintegration into his familiar environment should be accomplished under supervision. If, despite a stay in the clinic, the patient encounters difficulties with reintegration or suffers an unexpected relapse, aftercare support is not only advisable but essential.

Here’s what you can do yourself

Patients with post-traumatic stress disorder can learn immediate relief measures that can make their daily lives much easier. In addition, this can support the process of healing. Information about one’s own clinical picture is very important; this should be done by reading appropriate books or guidebooks. Exchanging information with other sufferers, ideally in self-help groups, helps to reduce one’s own level of suffering. It is also advisable to do a lot of sport. Sport of any kind is particularly helpful in the case of sleep disturbances and anxiety, which often occur in post-traumatic stress disorder. It is also very helpful to improve one’s own sleep quality. In special group seminars, procedures can be learned to make it easier to fall asleep and stay asleep. Patients with post-traumatic stress disorder should avoid addictive substances of any kind in everyday life, because this could lead to an aggravation of the clinical picture. Legal drugs, i.e. alcohol or nicotine, can also negatively contribute to delaying the healing process. It makes sense for PTSD sufferers to involve their own family and, if possible, their friends and acquaintances in the illness. This often requires many explanatory discussions. Patients with post-traumatic stress disorder should learn to be attentive and mindful of the world in the long term, because in this way they often discover completely new qualities about themselves. It would also be ideal to give free rein to one’s own creativity, for example with a new artistic hobby.