Post-traumatic Stress Disorder (PTSD) & Depression

Post-traumatic Stress Disorder (PTSD) & Depression

Frightening situations happen to everyone at some point. People can react in many different ways: they might feel nervous, have a hard time sleeping well, or go over the details of the situation in their mind. These thoughts or experiences are a normal reaction. They usually decrease over time and the people involved can go back to their daily lives. Post-traumatic stress disorder, on the other hand, lasts much longer and can seriously disrupt a person’s life.

What is PTSD

Post-traumatic stress disorder (PTSD) is a mental illness. It often involves exposure to trauma from single events that involve death or the threat of death or serious injury. PTSD may also be linked to ongoing emotional trauma, such as abuse in a relationship.

Something is traumatic when it is very frightening, overwhelming and causes a lot of distress. Trauma is often unexpected, and many people say that they felt powerless to stop or change the event. Traumatic events may include crimes, natural disasters, accidents, war or conflict, sexual violence or other threats to life or safety. It could be an depressionevent or situation that you experience yourself or something that happens to others, including loved ones.

PTSD causes intrusive symptoms such as re-experiencing the traumatic event. Many people have vivid nightmares, flashbacks, or thoughts of the event that seem to come from nowhere. They often avoid things that remind them of the event—for example, someone who was hurt in a car crash might avoid driving.

PTSD can make people feel very nervous or ‘on edge’ all the time. Many feel startled very easily, have a hard time concentrating, feel irritable, or have problems sleeping well. They may often feel like something terrible is about to happen, even when they are safe. Some people feel very numb and detached. They may feel like things around them aren’t real, feel disconnected from their body or thoughts, or have a hard time feeling emotions.

People also experience a change in their thoughts and mood related to the traumatic event. For some people, alcohol or other drugs can be a way to cope with PTSD.


Who does it affect?

Many people feel a lot of guilt or shame around PTSD because we’re often told that we should just get over difficult experiences. Others may feel embarrassed talking with others. Some people even feel like it’s somehow their own depressionfault. Trauma is hurtful. If you experience problems in your life related to trauma, it’s important to take your feelings seriously and talk to a health care professional.



Symptoms

PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years later. The disorder is characterized by three main types of symptoms:

  • Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
  • Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
  • Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.

Diagnosis criteria that apply to adults, adolescents, and children older than six include those below. Read more details here.

Exposure to actual or threatened death, serious injury, or sexual violation:

  • directly experiencing the traumatic events
  • witnessing, in person, the traumatic events
  • learning that the traumatic events occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental
  • experiencing repeated or extreme exposure to aversive details of the traumatic events (Examples are first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless exposure is work-related.

The presence of one or more of the following:

  • spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events (Note: In children repetitive play may occur in which themes or aspects of the traumatic events are expressed.)
  • recurrent distressing dreams in which the content or affect (i.e. feeling) of the dream is related to the events (Note: In children there may be frightening dreams without recognizable content.)
  • flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring (Note: In children trauma-specific reenactment may occur in play.)
  • intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
  • physiological reactions to reminders of the traumatic events

Persistent avoidance of distressing memories, thoughts, or feelings about or closely associated with the traumatic events or of external reminders (i.e., people, places, conversations, activities, objects, situations)

Two or more of the following:

  • inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
  • persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”).
  • persistent, distorted blame of self or others about the cause or consequences of the traumatic events
  • persistent fear, horror, anger, guilt, or shame
  • markedly diminished interest or participation in significant activities
  • feelings of detachment or estrangement from others
  • persistent inability to experience positive emotions

Two or more of the following marked changes in arousal and reactivity:

Also, clinically significant distress or impairment in social, occupational, or other important areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition, such as traumatic brain injury.

Learn about PTSD symptoms in children age six and younger.

Screen yourself or a family member for PTSD.

Check out the mobile app PTSD Coach, from the U.S. Department of Veterans Affairs.

If you suspect that you might suffer from PTSD, answer the questions below, print out the results and share them with your health care professional. To locate a specialist who treats PTSD, visit the ADAA Find a Therapist.


Are you troubled by the following?

Yes  No You have experienced or witnessed a life-threatening event that caused intense fear, helplessness, or horror.

Do you re-experience the event in at least one of the following ways?

Yes  No Repeated, distressing memories, or dreams

Yes  No Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)

Yes  No Intense physical and/or emotional distress when you are exposed to things that remind you of the event

Do reminders of the event affect you in at least three of the following ways?

Yes    No Avoiding thoughts, feelings, or conversations about it

Yes    No Avoiding activities and places or people who remind you of it

Yes    No Blanking on important parts of

Yes    No Losing interest in significant activities of your life

Yes    No Feeling detached from other people

Yes    No Feeling your range of emotions is restricted

Yes    No Sensing that your future has shrunk (for example, you don’t expect to have a career, marriage, children, or normal life span)

Are you troubled by at least two of the following?

Yes    No Problems sleeping

Yes    No Irritability or outbursts of anger

Yes    No Problems concentrating

Yes    No Feeling “on guard”

Yes    No An exaggerated startle response

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate PTSD and other anxiety disorders.

Yes    No Have you experienced changes in sleeping or eating habits?

More days than not, do you feel…

Yes    No sad or depressed?

Yes    No disinterested in life?

Yes    No worthless or guilty?

During the last year, has the use of alcohol or drugs…

Yes    No resulted in your failure to fulfill responsibilities with work, school, or family?

Yes    No placed you in a dangerous situation, such as driving a car under the influence?

Yes    No gotten you arrested?

Yes    No continued despite causing problems for you or your loved ones?

Reference:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994.


 Treatments

There are many types of treatment for post-traumatic stress disorder (PTSD). You and your doctor will discuss the best treatment for you. You may have to try a number of treatments before you find one that works for you.

A type of counseling called cognitive-behavioral therapy and medicines known as SSRIs appear to be the most effective treatments for PTSD.2 Treatment can help you feel more in control of your emotions and result in fewer symptoms, but you may still have some bad memories.

Counseling means talking with a therapist on your own or in a group about the traumatic event and PTSD. You will talk with your therapist about your memories and feelings. This will help you change how you think about your trauma. You will learn how to deal with painful feelings and memories, so you can feel better.

Counseling

There are different types of counseling for PTSD. Several types of therapy have been shown to be effective in treating PTSD. These therapies are:

  • Cognitive therapy, in which you learn to change thoughts about the trauma that are not true or that cause you stress.
  • Exposure therapy, inThere are many types of treatment for post-traumatic stress disorder (PTSD). You and your doctor will discuss the best treatment for you. You may have to try a number of treatments before you find one that works for you.
  • A type of counseling called cognitive-behavioral therapy and medicines known as SSRIs appear to be the most effective treatments for PTSD.2 Treatment can help you feel more in control of your emotions and result in fewer symptoms, but you may still have some bad memories.
  • Counseling means talking with a therapist on your own or in a group about the traumatic event and PTSD. You will talk with your therapist about your memories and feelings. This will help you change how you think about your trauma. You will learn how to deal with painful feelings and memories, so you can feel better.
  • which you talk about the traumatic event over and over, in a safe place, until you have less fear.
  • Eye movement desensitization and reprocessing (EMDR), in which you focus on hand movements and sounds while talking about the traumatic event. (This is the treatment Iam taking)

Finding a therapist you trust is important. A good therapist will listen to your concerns and help you make changes in your life. Your doctor can help you find one. If you are a veteran, the VA is a good place to start. Churches sometimes offer services that help people get counseling. Or you can call your state Health and Welfare office. I personally have a councillor with Nova Vita Domestic Violence Prevention Services. 


SSRI medicine

SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective. SSRIs include fluoxetine(such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).


What is avoidance?

Avoidance is a common reaction to trauma. It is natural to want to avoid thinking about or feeling emotions about a stressful event. But when avoidance is extreme, or when it’s the main way you cope, it can interfere with your emotional recovery and healing.


What are the different types of avoidance?

Emotional avoidance is when a person avoids thoughts or feelings about a traumatic event. For example, a rape survivor may try to force herself to think about other things whenever thoughts about the rape arise. Or, she may stop herself every time she begins to feel sadness about the rape, or focus on something else that makes her feel less sad. She may say things to herself like, “Don’t go there,” or “Don’t think about it.”

Avoiding reminders of a trauma is called behavioral avoidance. For example, a combat Veteran may stop watching the news or reading the newspaper because of coverage of the war. Someone who lived in Manhattan might move out of the city after the 9/11 terrorist attacks. Assault survivors might go out of their way to stay away from the scene of their attack.

What are the consequences of avoidance?

Growing up, you may have heard advice like, “just try not to think about it” or “don’t dwell on it.” But if you avoid thoughts and feelings of the trauma all of the time, your symptoms may get worse. Using avoidance as your main way to cope can make it harder to move on with your life.

Is all avoidance bad?

Not all avoidance is bad. It can be helpful to learn ways to focus your thoughts and feelings on things that are not related to the trauma. Distraction is a useful skill that can help you to get on with your daily life after a trauma. It can allow you to go to school or work, or buy groceries, even in the face of difficult life events. Although distraction and avoidance can be helpful in the short-term, they should not be your primary way of coping.


How can you learn to cope with difficult thoughts and feelings?

You may be afraid that if you let yourself feel difficult emotions, they might overwhelm you. You may be afraid that if you start crying, you’ll cry forever. Or you may worry that if you experience the anger inside you, you might lose control. Therapy can help you learn to deal with your thoughts and feelings about the trauma instead of being afraid of them.


How can I help a loved one?

When someone is diagnosed with PTSD, loved ones can also experience a lot of difficulties. You may feel guilty or angry about the trauma itself—then, on top of those feelings, experience difficulties around PTSD. You may feel like your loved one is a different person, worry that things will never be normal, or wonder what will happen in the future. Here are some tips to help you cope:

  • Start by learning more about PTSD. This can give you a better idea of your loved one’s experiences.
  • People who experience PTSD may withdraw from family and friends. Even if your loved one doesn’t want to talk, you can still remind them that you are there to listen when they’re ready.
  • Understand that behaviours related to PTSD—like avoiding certain situations or reacting angrily to a minor depressionproblem—are not about you. They are about the illness.
  • While it’s usually not a good idea to support behaviours that create problems, it’s still important to support your loved one’s overall movement toward wellness. This balance is not always easy, but you need to respect your own boundaries, too.
  • Ask what you can do to help, but don’t push unwanted advice.
  • Try to put your own feelings into words and encourage your loved one to do the same. It’s easier to solve problems or look at conflicts when you know what’s really going on.
  • Take care of your own wellness, and seek support for yourself if you experience difficulties.
  • If a loved one’s PTSD is affecting other family members, it may be helpful to seek family counselling.

 

With support, people can recover from PTSD and the effects of trauma. Recovery is good for the entire family, especially for young people who are still learning how to interact with the world. A loved one’s recovery is a chance for everyone to learn the skills that support wellness.


Post-traumatic Stress Disorder is a very emotional and personal subject with me as I suffer from it myself. I started to research treatments and the effects it has on someone because I actually will be starting my treatments with my councillor next Friday. I started to realize that there are probably ALOT more people out there that suffer from PTSD and don’t even know it. I know until I was diagnosed with it I always thought PTSD was something that only war vetrans could have. If you think you or someone you know may have PTSD please keep reading. Understanding the symptoms and knowing there is help actually may save someone’s life, maybe your own or maybe a loved one.


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