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How do I know if I have PTSD?
In the immediate aftermath of traumatic events such as natural disasters, wars, and violence, it is normal to have adjustment and coping difficulties; impacted individuals may experience insomnia, extreme anxiety, paranoia, flashbacks, and nightmares, among other symptoms. Over time, however, with a good support system, some counseling, and good daily habits, these symptoms should gradually decrease in intensity and, ultimately, disappear altogether.
Post-traumatic stress disorder (PTSD) is one of two mental health conditions under the DSM-5 category known as Trauma and Stress-Related Disorders. In PTSD, impacted individuals never fully recover from a traumatic incident. The symptoms they experience typically linger on for months and, in some instances, years after the traumatic event; in some individuals, the onset of symptoms may manifest months after the traumatic incident. These symptoms can be so debilitating that they negatively affect the quality of life; significant deterioration in social as well as work activities, and personal relationships usually occur as a result of PTSD. Given its devastating effects, early diagnosis of PTSD is important so that remedial measures can be instituted quickly and its negative impact on the quality of life can be minimized.
Symptoms of PTSD
Being able to recognize symptoms of PTSD is crucial to its early diagnosis and treatment; this is especially the case in toddlers and younger who may not be able to adequately express their thoughts and feelings. Generally, PTSD symptoms can be grouped into four primary categories; each of these categories has a variety of related symptoms:
1) Intrusive thoughts/memories
- Memory disorders: PTSD sufferers constantly remember the traumatic event; even when they make conscious and deliberate efforts to forget, these memories do not leave and push their way back to the forefront of their minds.
- Flashbacks/nightmares: Victims of PTSD may experience flashbacks and nightmares whereby they repeatedly relive the traumatic incident. Each flashback episode feels real and generates negative feelings of fear and anxiety each time. As a result of the flashbacks and nightmares, PTSD sufferers may develop insomnia, the inability to fall asleep.
- Triggers: Circumstances that remind the individual of the traumatic event can trigger extreme negative physical or emotional reactions such as physical aggression, fear, or anxiety, among others.
2) Avoidance behaviors
- Subject avoidance: Sufferers tend to avoid talking about the traumatic incident; they change the conversation whenever the subject is brought up.
- Location avoidance: With PTSD, individuals go to extreme lengths to avoid the site, people, or activities associated with the traumatic incident.
3) Altered thoughts and moods
- Anhedonia: This is the inability to feel pleasure in activities that were previously enjoyable; victims feel emotionally numb.
- Relational challenges: Victims find it difficult to cultivate new relationships and maintain existing ones. Within a marriage or any other form of intimate relationships, this can lead to discord and strain.
- Negative thoughts: PTSD sufferers tend to have negative views of themselves and the world around them.
- Selective amnesia: With PTSD, the victims may be unable to fully recollect all the details surrounding the traumatic incident.
4) Altered emotional and physical reactions
- Aggression: Victims of PTSD may exhibit uncharacteristic angry outbursts or physical aggression.
- Self-destructive behaviors: Substance abuse, reckless endangerment, and alcoholism are some of the self-destructive behaviors that PTSD victims may adopt.
Jumpiness: PTSD sufferers are prone to be easily startled and frightened. Symptoms of PTSD in children are markedly different from that of adults. Due to their inability to fully comprehend the traumatic event as well as adequately communicate their
thoughts, children manifest PTSD in other ways:
- Increased acting out and physical aggression
- Regression to earlier childhood behaviors such as bed-wetting, thumb sucking, reduced speech
- Separation anxiety; fear of parental separation
- Using drawings, playing, or stories to reenact the traumatic event
- Insomnia and night terrors
Causes of PTSD
PTSD is caused by the impacted individual either being involved or witnessing a traumatic event. Events that can lead to PTSD in susceptible individuals include, but are not limited to, the following:
- Sexual assault
- Car accidents
- Natural disasters such as tornadoes, earthquakes, flooding
- Difficult childbirth
- Death of a loved one
- War and other forms of extreme violence
- Physical or emotional abuse
Risk Factors of PTSD
There are several risk factors that increase the likelihood of developing PTSD. Individuals with any of the issues mentioned below are at an increased risk of developing PTSD after a traumatic event:
- A previous history of mental illness such as anxiety or depression
- A previous history of childhood trauma or abuse
- Persistent continuous trauma such as living in a war zone or conflict-filled household
- Poor life coping skills; poor mental resiliency
- Poor physical and emotional support following a traumatic event
- Subsequent stressors following a traumatic event such as loss of a job, home, or a divorce
Common Coexisting Conditions with PTSD
One of the reasons that PTSD can be difficult to diagnose is because sufferers tend to have other coexisting mental conditions. These coexisting conditions may mask the symptoms of PTSD and thereby present a diagnostic challenge to the clinician or mental health professional. Some conditions that can coexist with PTSD are:
- Obsessive-compulsive disorders (OCD): Individuals have persistent, recurring, and unwanted thoughts that drive them to perform repetitive compulsive actions.
- Panic disorders: This manifests as bouts of recurring panic attacks. Individuals have sudden bouts of intense fear manifesting as heart palpitations, shortness of breaths, and a feeling of impending doom. Each bout of a panic attack can last anywhere from a few minutes to a few hours.
- Borderline personality disorder: Individuals have difficulty regulating their emotions and can have wide mood swings. This condition is also associated with a high degree of impulsivity, poor self-image, and strained relationships.
- Major depression: Individuals manifest with decreased energy levels, anhedonia, poor appetite, poor sleeping habits and, in extreme circumstances, suicidal thoughts and behaviors.
- Anxiety disorders: Restlessness, easy irritability, heart palpitations, increased sweating, and tremors are some of the symptoms manifested by individuals with anxiety disorders.
Prevention and Treatment of PTSD
There are several options available to prevent the onset of PTSD or, once diagnosed, manage and potentially resolve this condition. Given its detrimental effects on impacted individuals as well as surrounding loved ones, preventative as well as corrective measures should be implemented as soon as possible after the traumatic event; this allows for earlier restoration of the quality of life. Some of the measures that are used to manage PTSD include:
- Cognitive processing therapy: This involves thought modification practices so that unhelpful or negative thought patterns regarding the traumatic incident are broken and replaced with healthier thought processes.
- Exposure therapy: Individuals are gradually exposed to the trauma in a controlled environment so that fears and anxieties can be faced and then managed.
- Group therapy: Group sessions are conducted so that individuals who have experienced the same kind of trauma can talk and share their experiences in a safe non-judgmental setting.
- Medications: In extreme cases of PTSD, some medications may be required to help manage the PTSD symptoms so that the impacted individuals can better participate in other treatment modalities.
At Sollars and Associates, we have trained counselors and psychotherapists at several locations around Michigan who are well equipped in the diagnosis, treatment, and management of PTSD. If you are suffering from PTSD, or you know someone that is, reach out to us at any of our locations so that necessary measures can be initiated to begin the path to recovery.