If you have ever had a traumatic experience (or witnessed one) where your life or livelihood was threatened, you may develop symptoms of post-traumatic stress disorder (PTSD). These symptoms develop and last at least 1 month prior to the incident.
Not everyone will develop PTSD. For some people it will resolve itself. For others, these symptoms can last a long time and be debilitating.
At first the diagnosis was for those who had been in combat. However, there are many other types of trauma that can lead to PTSD such as sexual assault, abuse, car accidents, natural disasters, or sudden death of someone you love.
To receive a diagnosis according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th edition), a number of symptoms must be seen. These symptoms fall into 4 categories.
Categories of PTSD symptoms
Intrusive symptoms that occur after the trauma
Unwanted, recurrent distressing memories of the trauma
Nightmares about the event
Flashbacks where the person feels as if they are reliving the trauma
Intense psychological reaction to places, smells or sounds that remind the person of the event
Persistent avoidance of things that remind you of the event
Trying to avoid any memories, feelings or thoughts of the event
Avoiding, people, places or things that bring up any reminders of the trauma
Negative changes in thoughts and mood
Amnesia-unable to remember all or parts of what happened during the traumatic event. This isn’t related to any type of injury or substance abuse.
Intense negative beliefs or feelings
Thoughts such as I’m a bad person, or I can’t trust anyone
Guilt and shame may be present
Persistent negative thinking leading one to feel that they are to blame for the situation
Intense negative thoughts of horror or anger that last a long time
Feelings of numbness, detachment or estrangement from others
A decrease in desire to engage in activities
Inability to feel positive emotions such as love, happiness or contentment
Changes in arousal and reactivity levels
Irritability
This can be seen as anger or outbursts with little reason. It may be physical or verbal.
Trouble falling or staying asleep
Engaging in risky or self destructive behaviors
Trouble concentrating
Chronic PTSD symptoms
For some people, especially those who have experienced extensive or prolonged abuse (being held captive, childhood abuse, domestic violence) can develop what they refer to as chronic PTSD or C-PTSD. This isn’t a formal diagnosis in our DSM-5, but is commonly used.
Differences in PTSD vs. C-PTSD
PTSD can result from one trauma, whereas C-PTSD is due to prolonged abuse. There may be physical, emotional, sexual abuse or neglect. The person may feel as if they have very little autonomy.
Emotional symptoms
Those with C-PTSD may have trouble with emotion regulation, interpersonal relationships, and low self-esteem.
Identity issues
These individuals may have a fragmented sense of self. They may not understand their own needs, desires and emotions.
Trouble with relationships
These people may have a hard time forming relationships with others. They often times have trust issues, fears of abandonment and intimacy issues.
Emotional dysregulation
Those with C-PTSD may have a hard time managing their emotions. They may have mood swings, intense reactions and challenges dealing with stress.
Self-blame
They may blame themselves for their abuse, or think they deserve it.
Longer term
This type of PTSD tends to be more chronic and pervasive. It is more difficult to treat.
Treatment for PTSD symptoms
Psychotherapy
It helps to talk with someone who is nonjudgmental and will listen to your trauma. Sometimes just the act of talking about it, and recognizing that it wasn’t your fault can help decrease symptoms.
Cognitive Behavioral Therapy
This type of therapy helps you understand the way you think and how it impacts your mood. These cognitive distortions (negative thinking patterns) can keep you stuck in the trauma.
Prolonged exposure
This type of therapy helps you to confront your traumatic situation in a safe way so you can learn ways to cope with your symptoms. This is especially helpful for the nightmares and flashbacks.
Eye-movement desensitization (EMDR)
EMDR uses exposure therapy along with eye movements. This helps you reprocess your traumatic memories, thus changing the way you react to them.
Medication
There are various anti-depressants and anti-anxiety medications that can help with symptom reduction. In addition other medications for sleep may be helpful.
Everyone is different, so your symptoms may look different from someone else with PTSD. In addition what works for you may not work for someone else. If you or someone you love struggles with trauma, please give me a call at 713-304-6554 and we can come up with a treatment plan that is best for you.
Take care,
Debbie
