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“Never give in.  Never, never, never, never give in.”

-Winston Churchill

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What is Posttraumatic Stress Disorder? 

Posttraumatic stress disorder, often referred to as PTSD, has been recognized in one form or another for a long time.  In the U.S. Civil War doctors, nurses and families realized that people coming home from the war had been changed by what they had seen and been through.  With the advent of the railroad came horrific train crashes, and survivors of those accidents showed similar changes that, in turn, were labeled "Railroad Heart."  During World War I, the term used was "shell shock," during World War II, "battle fatigue."

The modern study of the aftereffects of exposure to extreme events started after the Vietnam War, with psychologists and psychiatrists in the Veterans Administration taking the lead in this important work.  Since then, posttraumatic stress has (in our humble opinion) become one of the better researched areas in psychology.

The symptoms that are associated with posttraumatic stress (PTSD) are:

1. The person has been exposed to a traumatic event (experiencing or witnessing actual or threatened death, injury or threat to one's physical integrity) and has a response that includes intense fear, helplessness, or horror.
2. She or he experiences intrusive, distressing memories, thoughts or nightmares about the event.  Also she or he may feel very distressed and may experience physical signs of anxiety when reminded of the event through external or internal situations or occurrences.
3. She or he avoids reminders of the trauma and may experience emotional numbing.  These responses include (a) efforts to avoid thoughts, feelings, or conversations related to the trauma, (b) efforts to avoid people, places, or activities that arouse recollections of the trauma, (c) inability to recall important aspects of the trauma, (d) decreased interest and participation in activities that used to be part of life, (d) feeling detached or estranged from others, (e) noticing that one's range of feelings seems restricted compared to normal, and (f) finding that one's sense of the future has changed, so that hopes or plans about work, relationships, or life span have diminished. 
4. She or he has difficulty falling asleep, feels more irritable than usual, has difficulty concentrating, and/or is more vigilant than usual and startles easily.
5. The symptoms persist for at least a month.

                                                                                                                                    Am. Psychiatric Assn., DSM-IV

A person does not have to experience every one of these symptoms to fit diagnostic criteria for PTSD.  Similarly, there are other types of psychological difficulties that have similar symptoms, but that are different from PTSD.  For example, Panic Disorder with Agoraphobia can include symptoms that include avoidance of situations that cause intense anxiety.  Major Depression can include symptoms such as feeling detached or estranged from others and feeling hopeless about the future.  Be sure to check with a psychologist or physician to get an accurate diagnosis.

Traumatic events can take many different forms.  While everyone experiences events they find disturbing, there are some occurrences that can have especially intense effects.  These events may include a danger of death or serious injury, or a threat to one's safety.  Even witnessing something bad happening to another person can be highly traumatic.  Unfortunately, traumatic events are not unusual.  Although estimates vary, about 1 in 4 adult women have been sexually assaulted at some point during their lives.  Car crashes are common, and injuries or deaths can happen when they are least expected.  Following events like these, most people will feel shaken.  

Depending on the intensity of the event, some people may be strongly affected and may experience stress-related symptoms that last for a long time.  For example, about half of women who are sexually assaulted will still have significant symptoms of stress three months following an assault.  If symptoms don't go away within several weeks of the trauma, getting treatment may be very important.  Without treatment, for some people symptoms may persist for years or even decades.

If you have significant symptoms that last a few days after a traumatic event, please take a look at this link.  It describes preliminary findings on a treatment that, applied in the days following a trauma, may help prevent posttraumatic stress.  For people who have had significant symptoms that have lasted for more than a few weeks (e.g., longer than 1-3 months), the best researched treatment is probably a cognitive-behavioral approach called Prolonged Exposure.   

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The information posted on this site reflects our understanding of peer-reviewed research and generally accepted principles in psychology.  It is not intended to be used for self-treatment or as a substitute for individualized assessment and treatment by a licensed professional, and should not be construed as professional advice.

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