Post-Traumatic Stress Disorder

9/27/13
Post-Traumatic Stress Disorder
To print: Use your web browser's print feature. Close this window after printing. Click here to change your print selections.
Table of Contents
Topic Overview In Their Own Words Symptoms Recovery Emotional Health and Well-Being Family and Community Other Places To Get Help Credits Appendix Depression: Supporting Someone Who Is Depressed
Topic Overview
What is PTSD? Post-traumatic stress disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening. Anyone who has gone through a life-threatening event can develop PTSD. These events can include: Combat Military sexual trauma. Terrorist attacks. Physical violence.
https://print.healthwise.net/kaiser/kpisg/Print/PrintTableOfContents.aspx?token=kpisg&localization=en-us&version=&docid=hw184188 1/18
9/27/13
Sexual violence, such as rape. Serious accidents, such as a car wreck. Natural disasters, such as a fire, tornado, flood, or earthquake. After the event, you may feel scared, confused, and angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities. What are the symptoms? After going through a traumatic event, you may: Feel upset by things that remind you of what happened. Have nightmares, vivid memories, or flashbacks of the event. You may feel like it's happening all over again. Avoid places or things that remind you of what happened. Feel numb or lose interest in things you used to care about. Feel that you are always in danger. Feel anxious, jittery, or irritated. Have trouble sleeping or keeping your mind on one thing. PTSD symptoms can change your behavior and how you live your life. You may pull away from other people, work all the time, or use drugs or alcohol. You may find it hard to be in relationships, and you may have problems with your spouse and family. You may become depressed. Some people with PTSD also have panic attacks, which are sudden feelings of fear or worry that something bad is about to happen. Children can have PTSD too. They may have the symptoms above and symptoms that depend on how old they are. As children get older their symptoms are more like those of adults. Young children may become upset if their parents are not close by. Or children may have trouble sleeping or suddenly have trouble with toilet training or going to the bathroom. Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event. What can you do if you think you have PTSD? If you think you have PTSD, it's important to get treatment. Treatment can work, and early treatment may help reduce long-term symptoms.1, 2 If you think you have PTSD: Talk to your family doctor. Talk to a mental health professional, such as a therapist. If you're a veteran, contact your local VA hospital or Vet Center. Talk to a close friend or family member. He or she may be able to support you
9/27/13
and find you help. Talk to a religious leader. Fill out this form and take it with you to the doctor. If you have thoughts about hurting yourself or someone else, call 911, 1-800273-TALK (suicide hotline), or go to a hospital emergency room. How does PTSD develop? All people with PTSD have personally experiencedor have experienced through othersa traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.3 Many people who go through a traumatic event don't get PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include: How intense the trauma was. If you lost a loved one or were hurt. How close you were to the event. How strong your reaction was. How much you felt in control of events. How much help and support you got after the event. PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. About half of people who develop PTSD get better at some time. But other people who develop PTSD always will have some symptoms.4 If you have symptoms of PTSD, counseling can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships. It is never too late to get professional help or other forms of support that can help you manage the symptoms of PTSD. Reminders and anniversaries of the event can make symptoms worse. How is PTSD treated? The most effective treatments for PTSD are:5, 6 Counseling, which can help you understand your thoughts and learn ways to cope with your feelings. This can help you feel more in control and get you back to the activities in your life. A type of counseling called cognitivebehavioral therapy has been shown to be the most effective form of counseling for PTSD.1, 2 Antidepressant medicines, especially selective serotonin reuptake inhibitors (SSRIs). These can help you feel less sad and worried. SSRIs include fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).
9/27/13
You may need to try different types of treatment before finding the one that helps you. Your doctor will help you with this. These treatments may include other types of medicines and other forms of counseling, such as group counseling. If you have other problems along with PTSD, such as overuse of alcohol or drugs, you may need treatment for those also. Treatment can help you feel more in control of your emotions, have fewer symptoms, and enjoy life again.
One Man's Story: "I can't turn my brain off. Sometimes I stay up all night. The bad part is not staying up, but what's going through my head. I can't stop it."Marvin Read more about Marvin.
In Their Own Words

Telling others about having post-traumatic stress disorder (PTSD) is hard. But for the following people, it's part of recovering. Read what they say about how PTSD felt, how it affected their families, and how treatment is helping them get better.
One Man's Story: Marvin and his family survived Hurricane Katrina on a neighbor's rooftop. "I have visions of being up on the roof and going through it all over again. I just keep seeing the water coming up and up."Marvin Read more about Marvin.
One Man's Story: Tim is an Iraq war veteran and former medic. "When I came home, so much had changed for me on a day-to-day basis. I just couldn't communicate the same." Tim Read Tim's story.
9/27/13
One Man's Story: Ron is a Vietnam veteran who has had PTSD symptoms for decades. "Whenever I was under extreme stress, it would come back and slam me."Ron Read Ron's story.
Symptoms
Symptoms of post-traumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day. PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you may have PTSD. Even if you always have some symptoms, counseling can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships. Most people who go through a traumatic event have some symptoms at the beginning but don't develop PTSD. There are four types of symptoms: Reliving the event Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include: Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran. Seeing a car accident, which can remind a crash survivor of his or her own accident. Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped. Avoiding situations that remind you of the event
9/27/13
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes. A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants. Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event. Feeling numb You may find it hard to express your feelings. This is another way to avoid memories. You may not have positive or loving feelings toward other people and may stay away from relationships. You may not be interested in activities that you enjoyed in the past. You may forget about parts of the traumatic event or not be able to talk about them. Feeling keyed up You may be alert and on the lookout for danger. This is known as increased emotional arousal. It can cause you to: Suddenly become angry or irritable. Have a hard time sleeping. Have trouble concentrating. Fear for your safety and always feel on guard. Be very startled when someone surprises you. Other symptoms Other symptoms also may include: Physical symptoms for no reason you can think of (called somatic complaints). Feelings of shame, despair, or hopelessness. Difficulty controlling your emotions. Problems with family or friends. Impulsive or self-destructive behavior. Changed beliefs or changed personality traits.
One Man's Story: "People don't understand the emotion tied to flashbacks. It's like it's happening all over again, and you're having the same physiological reactions." Marvin
https://print.healthwise.net/kaiser/kpisg/Print/PrintTableOfContents.aspx?token=kpisg&localization=en-us&version=&docid=hw184188
6/18
9/27/13
Read more about Marvin.
PTSD in children and teens Children can have PTSD too. They may have the symptoms listed above and/or symptoms that depend on how old they are. As children get older, their symptoms are more like those of adults. Young children may become upset if their parents are not close by. Or children may have trouble sleeping or suddenly have trouble with toilet training or going to the bathroom. Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may have fears and anxiety that don't seem to be caused by the traumatic event. If you think you or a loved one has symptoms of PTSD, see your doctor right away. Fill out this form and take it to your doctor. Treatment can work, and early treatment may help reduce long-term symptoms.2
Recovery
Recovery from PTSD does not mean forgetting the past trauma. It does mean that you learn how to not have the bad physical and emotional reactions in response to memories so that you can fully live your life. Recovery is not a cure. It helps you believe that you can reach your goals and learn new things to help yourself. It helps you gain self-confidence and respect for yourself. The 10 principles of recovery make you the most important part of your recovery. Your counselor, doctor, family, and medicines can help you, but you're the one who makes the decisions. In the recovery process, you learn to cope with your symptoms and challenges and to develop social support.
One Man's Story: "I'm a much more peaceful person now. I sleep so much better."Ron Read Ron's story.
7/18
9/27/13
Positive coping skills Coping is about dealing with your symptoms. When you cope with your symptoms in a positive way, you often feel more in control. You accept what the traumatic event did and take steps to improve your life. Learn about PTSD to better understand how and why it affects you. Relieve stress to relax and feel less anxious. Exercise and be active to reduce how tense you feel. People who are fit usually have less anxiety, depression, and stress than people who aren't active.9 Get enough sleep to help your mood and make you feel less stressed. Many people with PTSD have trouble sleeping because they feel nervous and anxious or can't stop thinking about the traumatic event. Eat a balanced diet to help your body deal with tension and stress. Whole grains, dairy products, fruits, vegetables, and protein are part of a balanced diet. Find things to do to ease your memories and reactions. Consider channeling your emotions into activities or sports, painting or writing, or a rewarding job. Identify your beliefs to keep you balanced. PTSD can cause a spiritual crisis. You may begin to question your own beliefs and values and ask yourself why war or disasters happen. If this happens to you, talk to a family member, friend, or spiritual advisor. Consider spiritual study, prayer, or meditation. Negative coping skills Negative coping skills are certain ways you may try to deal with your symptoms and problems that cause more harm than good. These are quick fixes that don't improve your situation in the long run. They include drinking too much, avoiding others, and lashing out. Support groups and social support There are times when you may need a shoulder to cry on or a ride to the doctor. You may want to learn more about PTSD or talk with others who have PTSD. You need people who understand what you are going through and will help you and care about you. This is your support network. Support takes many forms. You can find it in seminars and groups led by professionals, in groups made up of others with PTSD, and in your relationships with family and friends.
Emotional Health and Well-Being

Post-traumatic stress disorder (PTSD) doesn't always occur alone. Other medical conditions often occur with it, such as: Alcohol and drug abuse. Depression. Suicide.
9/27/13
Anger and fear. Grief. Panic attacks. Physical health problems.
One Man's Story: "I didn't know why I needed to drink or wanted to drink. But Vietnam was never very far away when I did."Ron Read Ron's story.
Family and Community

Post-traumatic stress disorder (PTSD) can harm your relationships with your family and community. Feelings of anger and depression and not wanting to deal with people can make it hard to connect with them. Pay attention to how you act with your family and try not to pull away. Your relationships can make a big difference in your recovery from PTSD. Here are things you can do to help yourself, your family, and your community better understand and deal with PTSD. Know when to get crisis help. Sometimes you need help right away. This may be the case when you have had thoughts about suicide or if anger turns to rage. Help your family. Your family plays an important part in your recovery from PTSD. But you also have to help them. This means: Talking to your family about PTSD and what it does to you. Talking to your kids. Be sure they know they aren't to blame. Talking about your triggers. Triggers are places, sounds, and sights that can cause symptoms. They can be locations, social events, or holidays. Know that life transitions, even positive ones such as getting married, having a baby, or starting a new job, can cause stress and result in more PTSD symptoms. Know that your relationship to your community can be changed by PTSD. Your family and community are part of your recovery. Do as much as you can to work with them. With knowledge, your family and community can better help you.
One Man's Story: "Talking about it with my wife is getting easier. The more I talk about it with people, the better."Tim Read more about Tim.
9/27/13
What can others do to help? If you care about someone with PTSD, here's what you can do to help. Learn what you can about PTSD. The more you know, the better you can understand what your loved one is going through. Help your loved one make friends and form a social network. Learn how to deal with anger. Both you and your loved one may be angry at times. Learn the best way to talk with your loved one. Be positive when you can. Don't give advice unless you are asked. Take care of yourself by taking time for yourself and having your own support system. Some people with PTSD are also depressed. For information on how to help with this, see: Depression: Helping Someone Get Treatment. Depression: Supporting Someone Who Is Depressed (See Depression: Supporting Someone Who Is Depressed in appendix). Your family and community are part of your recovery. Do as much as you can to work with them. With this knowledge, your family and community can better help you.
Other Places To Get Help Organizations

Anxiety Disorders Association of America (ADAA) 8730 Georgia Avenue Suite 600 Silver Spring, MD 20910 Phone: (240) 485-1001 Fax: (240) 485-1035 Web Address: www.adaa.org
The Anxiety Disorders Association of America (ADAA) works to improve the lives of
9/27/13
people who have anxiety disorders. Members of the association are not only people who have or are interested in anxiety disorders but also health professionals who do research and treat people who have anxiety disorders.
International Society for Traumatic Stress Studies (ISTSS) 111 Deer Lake Road Suite 100 Deerfield, IL 60015 Phone: (847) 480-9028 Fax: (847) 480-9282 Email: istss@istss.org Web Address: www.istss.org
The International Society for Traumatic Stress Studies (ISTSS) is an international forum for sharing research, clinical strategies, and public policy concerns on traumatic stress. The Society offers newsletters and other publications, conferences, and links from its Web site to other organizations that have the same interests.
National Alliance on Mental Illness (NAMI) 3803 North Fairfax Drive Suite 100 Arlington, VA 22203 1-800-950-NAMI (1-800-950-6264) hotline for help with depression Phone: (703) 524-7600 Fax: (703) 524-9094 Email: info@nami.org Web Address: www.nami.org
The National Alliance on Mental Illness is a national self-help and family advocacy organization dedicated solely to improving the lives of people who have severe mental illnesses such as schizophrenia, bipolar disorder (manic depression), major depression, obsessive-compulsive disorder, and panic disorder. NAMI focuses on support, education, advocacy, and research. The mission of the organization is to "eradicate mental illness and improve the quality of life of those affected by these diseases."
National Center for Posttraumatic Stress Disorder Veterans Administration Medical Center (116D) 215 North Main Street
9/27/13
White River Junction, VT 05009 Phone: (802) 296-6300 Email: ncptsd@va.gov Web Address: www.ptsd.va.gov
The National Center for PTSD carries out a wide range of activities, including research, education, and training to help understand, diagnose, and treat PTSD in veterans. The website has fact sheets and videos to answer questions on trauma, PTSD, and related issues.
National Institute of Mental Health (NIMH) 6001 Executive Boulevard Bethesda, MD 20892-9663 Phone: 1-866-615-6464 toll-free Phone: (301) 443-4513 Fax: (301) 443-4279 Web Address: www.nimh.nih.gov
The National Institute of Mental Health (NIMH) provides information to help people better understand mental health, mental disorders, and behavioral problems. NIMH does not provide referrals to mental health professionals or treatment for mental health problems.
National Suicide Prevention Lifeline Phone: 1-800-273-TALK (1-800-273-8255) TDD: 1-800-799-4TTY (1-800-799-4889) Web Address: www.suicidepreventionlifeline.org
The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service. Crisis centers are located in 130 locations across the United States. Each caller is routed to the closest provider of mental health and suicide prevention services.
Credits for Post-Traumatic Stress Disorder

By Healthwise Staff
12/18
9/27/13
Primary Medical Reviewer Adam Husney, MD - Family Medicine Specialist Medical Reviewer Last Revised Jessica Hamblen, PhD - Post Traumatic Stress Disorder January 9, 2013
Appendix
Depression: Supporting Someone Who Is Depressed
If someone you care about has been diagnosed with depression, you may feel helpless. Maybe you're watching a once-vibrant person slide into inactivity or seeing a good friend lose interest in activities that he or she used to enjoy. The change in your loved one's or friend's behavior may be so great that you feel you no longer know him or her. You probably want to help in some way. This topic will give you the tools to do so. Depression is a disease. It's not being lazy, and you can't "just get over it." The best thing you can do for someone who is depressed is to help him or her start or continue treatment. Offer support. You can do this by understanding what depression is, being patient, and offering help. Don't ignore talk about suicide. Talk to a doctor, or call 911 or emergency help if needed. Reassure the person that he or she will get better with the right kind of treatment. Treatment depends on how severe the depression is and includes medicine, counseling, self-care, or a combination of these. What is depression? Why is it important to support someone who is depressed? How can you help someone who is depressed? Where to go from here
What is depression?
Depression is a disease. It's caused by changes in the chemicals in the brain. Depression isn't a character flaw, and it doesn't mean that the person is bad or weak. It doesn't mean that he or she is going crazy. Depression causes a person to feel sad and hopeless much of the time. It's different from normal feelings of sadness, grief, or low energy. The person may lose interest in daily activities and may feel sad and grouchy for a long time.
13/18
9/27/13
Many people don't get help because they are embarrassed or think that they'll get over depression on their own. But most people need treatment to get better. Treatment depends on how severe the depression is and includes medicine, counseling, selfcare, or a combination of these. Sometimes a person has to try several types of treatment before finding one that works. Most people feel better in 1 to 3 weeks, but it can take as many as 6 to 8 weeks for treatment to work as well as it can. Depression is common. Men and women of all ages, ethnic groups, and economic groups can have it. It often runs in families. But it also can happen to someone who doesn't have a family history of depression. A person can have depression one time or many times. Test Your Knowledge 1. Depression is a disease, just like asthma is a disease. a. True This answer is correct. Depression is a disease. It's caused by changes in the chemicals in the brain. It's not a character flaw, and it doesn't mean that the person is bad or weak or going crazy. b. False This answer is incorrect. Depression is a disease. It's caused by changes in the chemicals in the brain. It's not a character flaw, and it doesn't mean that the person is bad or weak or going crazy.
Why is it important to support someone who is depressed?

If you've never been depressed, it's hard to understand just how hopeless and discouraged depression can make you feel. Depression can upset your life as much as other major illnesses, and it can make it hard to take care of family, work, and social duties. Supporting someone who has depression is important because it can: Help the person continue treatment. This is the best thing that can happen. Boost the person's self-esteem and self-confidence. This helps the person deal better with family, work, school, and daily life. Show the person that he or she has a friend. Friendship can show the person that he or she is not alone. Test Your Knowledge 1. Helping someone with depression is important because: a. It may help the person stay in treatment.
9/27/13
This answer is correct. Most people need treatment to recover from depression. If your help gives the person a reason to continue treatment, you've done the best possible thing. b. It makes you feel good about yourself. This answer is incorrect. The most important reason to help is to help the person stay in treatment. If your help gives the person a reason to continue treatment, you've done the best possible thing.
How can you help someone who is depressed?

Here are some things you can do to help: Educate yourself The more you know about depression, the better you can understand what the person is going through. Know what is true about depression, and know the myths about depression. Myths include thinking that depression isn't real or that you're weak if you're depressed. Know the warning signs of suicide, such as talking a lot about death or giving things away and writing a will. If you notice them, call the doctor. Call 911 or emergency help if you think: The person is going to harm himself or herself or others. For example, the person has a written plan or a weapon or is saving (stockpiling) medicines. The person is hearing or seeing things that are not real. The person seems to be thinking or speaking in a bizarre way that is unlike his or her usual behavior. Help with professional treatment If you have permission, you can: Help the person set up and get to visits with a doctor or other health professional. Help the person manage medicines. Know the side effects of medicines and contact the doctor if needed. Remind the person who has depression that medicine is important and that the dose or medicine can be changed to reduce or get rid of side effects. Home support A person who has depression may feel alone in the world. Your support can help. Listen when the person wants to talk. If you're there to help the person talk things through,
9/27/13
it may help the person feel better or continue treatment. Avoid giving advice. But gently point out that not everything is bad, and offer hope. Urge the person to continue treatment. Don't tell the person that he or she is lazy or should be able to get over it. Keep your relationship as normal as you can, but don't pretend that depression doesn't exist or that there isn't a problem. Ask the person to do things with you, such as go for walks or to a movie, and encourage the person to continue with favorite activities. If the person says no, then that's okay. But be sure to ask again in the future. Don't push too much, which may make the person feel worse. Ask what you can do to help in daily life. You might help with housework or lawn care, getting the kids to school, or running errands. Don't be offended. If you are a spouse or are very close to someone, you may feel hurt because the person isn't paying attention to you and may seem angry or uncaring. Remember that your loved one still cares for you but just isn't able to show it. Take care of yourself Spending a lot of time with someone who has depression may be hard on you too. These caregiver tips can help: Take care of yourself first. Do things you enjoy, such as seeing family or going to movies. Don't help too much. A common mistake caregivers make is providing too much care. Even if they don't admit it, people like to help themselves. Take some time off. Don't do it alone. Ask others to help you, or join a support group. The more support you have, the more help you can give to the person. For more information, see the topic Caregiver Tips. Test Your Knowledge 1. A way to help someone who has depression is: a. Tell the person to face up to things and get back to normal. This answer is incorrect. Most people cannot get better on their own. Listening and helping the person with the tasks of daily life can help. b. Listen and give support, but also point out that not everything is bad. This answer is correct. Listening and giving support to someone who is depressed can help. So can helping around the house. c. Help out around the house. Someone who is depressed may not have energy, so running errands or doing some housework can help the person. This answer is correct.
9/27/13
Lending a hand to someone who is depressed can help. So can listening and giving support.
2. You need to do everything possible and put your life on hold to help a person with depression. a. True This answer is incorrect. Help as much as you can, but you also need time for yourself. Take some time off to see other people and do things you enjoy. Join a support group if that helps you. b. False This answer is correct. Help as much as you can, but you also need time for yourself. Take some time off to see other people and do things you enjoy. Join a support group if that helps you.
Where to go from here

Now that you have read this information, you are better prepared to help someone who has depression. Some medicines for depression have side effects that cause people to stop taking them. Depression: Dealing With Medicine Side Effects Depression: Taking Antidepressants Safely If you would like more information on depression, the following resource is available:
Organization
National Alliance on Mental Illness (NAMI) 3803 North Fairfax Drive Suite 100 Arlington, VA 22203 1-800-950-NAMI (1-800-950-6264) hotline for help with depression Phone: (703) 524-7600 Fax: (703) 524-9094 Email: info@nami.org Web Address: www.nami.org
9/27/13
The National Alliance on Mental Illness is a national self-help and family advocacy organization dedicated solely to improving the lives of people who have severe mental illnesses such as schizophrenia, bipolar disorder (manic depression), major depression, obsessive-compulsive disorder, and panic disorder. NAMI focuses on support, education, advocacy, and research. The mission of the organization is to "eradicate mental illness and improve the quality of life of those affected by these diseases."
Credits for Post-Traumatic Stress Disorder

By Primary Medical Reviewer Healthwise Staff Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry Last Revised January 11, 2013
Note: The "printer friendly" document will not contain all the information available in the online document. Some information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.
18/18

Post-Traumatic Stress Disorder

Caricato da

Informazioni sul documento

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Post-Traumatic Stress Disorder

Caricato da

Copyright:

Formati disponibili

9/27/13