How does post-traumatic stress disorder manifest itself?
Post-traumatic stress disorder (PTSD) occurs as a physical reaction after a traumatic experience such as a violent crime, a serious accident, or an act of war.
Delayed symptoms
Symptoms of post-traumatic stress disorder usually do not appear immediately. Shock symptoms usually develop first during the emergency situation experienced: The affected persons are numb, many report the feeling of being “beside themselves” (depersonalization feeling). The situation then seems unreal to them. This is a protective mechanism of the body that serves its own survival. This reaction to massive stress is called an acute stress reaction.
To diagnose post-traumatic stress disorder, the treating physician adheres to the criteria and symptoms listed in the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
Symptoms in detail
The main symptoms of post-traumatic stress disorder are:
- Involuntary recollection and reliving of the trauma (intrusions and flashbacks).
- Avoidance, repression and forgetting of the event
- Nervousness, anxiety and irritability
- Flattening of feelings and interests
Involuntary reliving of the trauma (flashbacks)
Triggers are often so-called key stimuli, for example when a war victim hears screams or a fire victim smells smoke. The recurrence of traumatic memories in the form of nightmares is also typical of post-traumatic stress disorder. Symptoms on a physical level such as shortness of breath, trembling, dizziness, rapid heartbeat and sweating sometimes occur in addition.
Avoidance, repression and forgetting
For their own protection, many people with PTSD avoid those thoughts, situations, and activities that might awaken memories of the event. For example, those who have witnessed a traumatic traffic accident avoid public transportation and driving. Burn victims may avoid lighting candles or fires.
Other victims are unable to remember all aspects of the traumatic experience. Experts speak of complete or partial amnesia.
Nervousness, anxiety and irritability (hyperarousal).
Many trauma victims are very sensitive to stimuli, and their nerves are literally on edge. They are hyper-vigilant, subconsciously feeling that they are always in danger. They are also very jumpy and anxious. In the long run, this condition is very exhausting for the body. It comes to concentration difficulties, the attention span shortens with the time more and more. Reading a book or watching a movie then sometimes becomes impossible for trauma victims.
This generalized tension leads to mild irritability and disproportionate outbursts of anger. Relatives of trauma victims often report a sudden change in character from previously balanced and relaxed people.
The persistent anxiety and tension can often be relieved a little with sport and exercise. However, the overcoming to physical activity is very big for many affected persons.
Flattening of interests and feelings (numbing).
The joy of life may be permanently impaired by post-traumatic stress disorder. Often, sufferers lose all interests and withdraw from social life. They lose their zest for life and no longer plan for their future. Some are also no longer able to feel anything – be it joy, love or sadness. There is a dulling of emotions (numbing = numbness).
Trauma victims often feel alienated and have the feeling that what they have experienced separates them from their fellow human beings and loved ones. This change in emotional life then often ends in depression.
Pain and trauma
However, a possible connection between (chronic) pain and PTSD has not yet been precisely clarified. Some scientists see a common neurobiological basis between persistent stress, pain and anxiety.
How does complex post-traumatic stress disorder manifest itself?
A complex post-traumatic stress disorder is preceded by very severe or particularly long-lasting traumas. These trauma victims often show personality changes as a result of the complex PTSD. Symptoms here therefore relate more to behavior and personality:
- Changes in emotion regulation (sexuality, anger, self-injurious behavior).
- Changes in attention and awareness
- Changes in self-perception (feelings of guilt, shame, isolation, loss of self-worth)
- Changes in relationships with others (trust issues)
- Somatization (pain without physical cause)
Some symptoms in detail:
Altered emotion regulation and impulse control.
Emotion regulation and impulse control are often out of balance in complex post-traumatic stress disorder. Affected individuals are unable to view emotions such as anger, resentment, and aggression with the necessary distance. Thus, disproportionate emotional outbursts occur or an enormous effort is made to hide this loss of control from fellow human beings.
Often, sufferers “help” themselves with alcohol or drugs to calm down and try to combat complex post-traumatic stress disorder.
Self-injurious behavior is also found in many people with complex post-traumatic stress disorder. Excessive acting out or avoidance of sexual activity also occurs more frequently.
Alteration of attention
Somatization
Some people with complex post-traumatic stress disorder tend to somatize. That is, they suffer from physical symptoms for which no organic cause can be found.
Changes in relationships with others
Relationship perceptions also suffer from complex post-traumatic stress disorder. Affected persons often have difficulty engaging in human closeness. The traumatizing experience makes it difficult for them to trust, and closer contact with fellow human beings is rarely made. Often, complex trauma victims do not have a good sense of their own limits and occasionally overstep them.
Coping with everyday life and quality of life may be severely impaired by (complex) post-traumatic stress disorder. Symptoms are often not initially associated by the affected person with their traumatic experience, which may make it difficult to identify them.
