Post Traumatic Stress Disorder
(PTSD)

Post Traumatic Stress Disorder (PTSD): Overview

There is a growing awareness among healthcare providers that traumatic experiences are widespread and that it is common for people who have been traumatized to develop medical and psychological symptoms associated with the experience.

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Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing Post Traumatic Stress Disorder (PTSD).  Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape.  PTSD is associated with an extremely high rate of medical and mental health service use, and possibly the highest per-capita cost of any psychological condition.

But there is help and there is hope.

PTSD is a long-term problem for many people.  Studies show that 33-47% of people being treated for PTSD were still experiencing symptoms more than a year after the traumatic event.  Without treatment many people continue to have PTSD symptoms up to ten years after the traumatic event.

Incidence; Contributing Risk Factors

Conservative estimates show that 9-10% of the general population has PTSD.  Among people who were victims of specific traumatic experiences (rape, child abuse, violent assaults, etc.), the rate of PTSD is 60-80%.

PTSD can affect anyone at any age who has been exposed to a traumatic event where he/she experienced terror, threat (or perceived threat) to life, limb or sanity and his/her ability to cope was overwhelmed.

Signs and Symptoms

PTSD symptoms are divided into three categories.  People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination.  However, the diagnosis of PTSD means that someone has met very specific criteria.  The symptoms for PTSD are listed below.

  • Intrusive Re-experiencing People with PTSD frequently feel as if the trauma is happening again.  This is sometimes called a flashback, reliving experience or abreaction.  The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma.  Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in ways that they did when the trauma originally occurred.  For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.
  • Avoidance People with PTSD work hard to avoid anything that might remind them of the traumatic experience.  They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings.  Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD.  Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.
  • Arousal Symptoms of psychological and physiological arousal are very distinctive in people with PTSD.  They may be very jumpy, easily startled, irritable and may have sleep disturbances like insomnia or nightmares.  They may seem constantly on guard and may find it difficult to concentrate.  Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

Below you will find some reactions and symptoms that are often experienced by individuals who have been through a trauma.  These symptoms reflect your body's way of trying to cope and adjust to what has happened.

Physical

  • Pounding heart
  • Sweating
  • Flushed
  • Shortness of Breath/Hyperventilation
  • Chest Pains
  • Nausea/Vomiting
  • Upset stomach, Diarrhea
  • Loss of appetite or craving junk food
  • Muscle tremors
  • Loss of coordination
  • Frequent headaches or migraines
  • Muscle soreness
  • Rapid uncontrolled speech
  • Difficulty sitting or relaxing
  • Dizzy or fainting
  • Dryness of mouth and throat
  • Frequent need to urinate
  • Grinding of teeth
  • Inability to shake a cold
  • Weight change (gain or loss)
  • Insomnia/difficulty sleeping, nightmares
  • Feeling of exhaustion and fatigue
  • Change in sexual functioning or desire
  • Missed menstrual cycle

Thoughts and Attitudes

  • Disbelief
  • Horror
  • Confusion
  • Poor concentration
  • Spaciness
  • Poor decision making abilities
  • Disorientation
  • Poor memory
  • Poor attention (not retaining information)
  • Preoccupied with trauma memories
  • Preoccupation with health
  • Time distortion (time slows down or speeds up)
  • Increased rigidity and closed thinking (inflexibility)
  • Feeling omnipotent (unrealistic appraisal of situation)
  • Cynicism or negativism
  • Absolute thinking (I will never; This always)
  • Negative/Critical judgments against self (I am such a failure)
  • Hindsight thinking (If only; Why didn't)

Emotions

  • Numb/Emotionally shut down
  • Shocked
  • Anxious
  • Agitated
  • Panicked or fearful (specific or general)
  • Overwhelmed
  • Anger (at self, others, God)
  • Mood swings
  • Troubling dreams
  • Sad
  • Depression
  • Helpless or inadequate feelings
  • Sense of guilt
  • Loss of sense of humor
  • Less able to cope with new or continued emotional stress

Relationships

  • Irritability
  • Easily frustrated
  • Insensitivity
  • Loss of interest in others
  • Isolating/Distancing (Avoiding fellowship)
  • Insecurity
  • Avoidance of intimacy
  • Suspicious
  • Clingy
  • Discord/Arguments
  • Critical of others
  • Scapegoating (a focal point for suppressed anger and depression)
  • Hypersensitivity (feelings easily hurt)

Avoidance behaviors

  • Use of alcohol to numb
  • Use of drugs (prescription or not) to numb
  • Abandonment of fun activities
  • Overly involved in work
  • Desire to leave field
  • Less productive

Risky/Self-destructive behaviors

  • Increased smoking
  • Excessive spending
  • Accident prone
  • Sexual immorality
  • Losing or misplacing things
  • Easily startled/Hyperalert to environment
  • Tearful

Meaning/Ministry

  • Increasingly busy with task orientation
  • Loss of sense of purpose/role
  • Less meaning in ministry
  • Disappointment with God
  • Loss of motivation
  • Questioning former beliefs

Conclusion
Each person is unique in how they respond to a trauma, so your response may not be the same as another person who has gone through the same or a similar experience.

Remember that it takes time to heal.

After you work through these reactions, you will come to a new place in your life that is characterized by deeper understanding, healthy conclusions, resilience, deeper trust, and an expanded world view.  You will be one who has suffered and yet thrived.

Even after many of the memories are gone and you are feeling much better, there may still be things which "trigger" these symptoms and painful memories.

If these symptoms become very intense and persist over a long period of time, or if you are noticing impairment in your ministry or relationships, you may want to consider talking with a counselor who specializes in trauma.  This does not mean that you are crazy, only that you need some help.

Diagnosis and Tests

Unfortunately, it is common for those with PTSD to avoid treatment.  Also, it is common for those who do seek treatment to be misdiagnosed.  Because PTSD often occurs at the same time as other physiological and mental health disorders, PTSD symptoms may be masked or difficult to identify.  Examples of common co-occurring conditions are depression, substance use/dependence and bipolar disorder.  Trauma survivors may also experience headaches, chest pain, digestive or gynecological problems as well.  However, there is a growing number of clinicians who are skilled at recognizing PTSD and still others who are specializing in treatment of traumatic stress disorders.  If you think you might have PTSD you should seek professional help for a thorough physical and mental health assessment.

Treatment and Prevention

A person who has survived a traumatic event will probably never feel as if the event didn't happen, but the disruptive, distressing effects of PTSD are completely treatable.  Depending on the source of the trauma (man-made versus natural), the nature of the trauma (accidental versus purposeful), and the age of the victim at the time of the trauma, treatment strategies may vary.  Treatment involves both managing symptoms and working through the traumatic event.  Most experts agree that psychotherapy is an important part of recovery.  Medications can help reduce some symptoms allowing psychotherapy to be more effective.

Signs, symptoms & indicators of Post Traumatic Stress Disorder (PTSD):

Symptoms - Mind - Emotional

(Severe) unresolved traumatic memories

People with PTSD work hard to avoid anything that might remind them of the traumatic experience.  They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings.  Numbing of thoughts and feelings in response to trauma is known as "dissociation" and is a hallmark of PTSD.  Many with PTSD often feel as if the trauma is happening all over again.

Symptoms - Mind - General

Jumpiness

Symptoms of psychological and physiological arousal are very distinctive in people with PTSD.  They may seem constantly on guard and may find it difficult to concentrate.

Symptoms - Respiratory

Symptoms - Sleep

Regular/frequent nightmares

Nightmare disorder has been linked to PTSD.  Those with PTSD may have intrusive mental images or hallucinations about a trauma, or recurrent nightmares, much more than the average person.

Conditions that suggest Post Traumatic Stress Disorder (PTSD):

Addictions

Alcohol-related Problems

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Mental

Panic Attacks

Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

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Risk factors for Post Traumatic Stress Disorder (PTSD):

Childhood

(Severe) sexual abuse during childhood

Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

Harsh punishment/physical abuse during childhood

Recent studies have shown that childhood abuse (particularly sexual abuse) is a strong predictor of the lifetime likelihood of developing PTSD.

Supplements, Medications, Drugs

(Past) marijuana use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

(Past) cocaine use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

(Past) heroin/morphine use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

(Past) LSD use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

(Past) methamphetamine use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

(Past) ecstasy use

Frequently, people with PTSD use drugs or alcohol to avoid trauma-related feelings and memories.

Symptoms - Mind - Emotional

Having suffered rape

Although many people still equate PTSD with combat trauma, the experience most likely to produce PTSD is rape.

History of panic attacks

Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.

Post Traumatic Stress Disorder (PTSD) can lead to:

Mental

Recommendations for Post Traumatic Stress Disorder (PTSD):

Psychological

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