Post-Traumatic Stress Disorder

What is post-traumatic stress disorder (PTSD)?

From: MedlinePlus, National Library of Medicine

Post-traumatic stress disorder (PTSD) is a mental health disorder that some people develop after they experience or see a traumatic event. The traumatic event may be life-threatening, such as combat, a natural disaster, a car accident, or sexual assault. But sometimes the event is not necessarily a dangerous one. For example, the sudden, unexpected death of a loved one can also cause PTSD.

It's normal to feel afraid during and after a traumatic situation. The fear triggers a "fight-or-flight" response. This is your body's way of helping to protect itself from possible harm. It causes changes in your body such as the release of certain hormones and increases in alertness, blood pressure, heart rate, and breathing.

In time, most people recover from this naturally. But people with PTSD don't feel better. They feel stressed and frightened long after the trauma is over. In some cases, the PTSD symptoms may start later on. They might also come and go over time.

What causes post-traumatic stress disorder (PTSD)?

From: MedlinePlus, National Library of Medicine

Researchers don't know why some people get PTSD and others don't. Genetics, neurobiology, risk factors, and personal factors may affect whether you get PTSD after a traumatic event.

Who is more likely to develop post-traumatic stress disorder (PTSD)?

From: MedlinePlus, National Library of Medicine

You can develop PTSD at any age. Many risk factors play a part in whether you will develop PTSD. They include:

• Your sex; women are more likely to develop PTSD
• Having had trauma in childhood
• Feeling horror, helplessness, or extreme fear
• Going through a traumatic event that lasts a long time
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
• Having a history of mental illness or substance use

What are the symptoms of post-traumatic stress disorder (PTSD)?

From: MedlinePlus, National Library of Medicine

There are four types of PTSD symptoms, but they may not be the same for everyone. Each person experiences symptoms in their own way. The types are:

• Re-experiencing symptoms, when something reminds you of the trauma and you feel that fear again. Examples include Flashbacks, which cause you to feel like you are going through the event again Nightmares Frightening thoughts
• Avoidance symptoms, when you try to avoid situations or people that trigger memories of the traumatic event. This may cause you to Stay away from places, events, or objects that are reminders of the traumatic experience. For example, if you were in a car accident, you might stop driving. Avoiding thoughts or feelings related to the traumatic event. For example, you might try to stay very busy to try to avoid thinking about what happened.
• Arousal and reactivity symptoms, which may cause you to be jittery or be on the lookout for danger. They include Being easily startled Feeling tense or "on edge" Having difficulty sleeping Having angry outbursts
• Cognition and mood symptoms, which are negative changes in beliefs and feelings. They include Trouble remembering important things about the traumatic event Negative thoughts about yourself or the world Feeling blame and guilt No longer being interested in things you enjoyed Trouble concentrating

The symptoms usually start soon after the traumatic event. But sometimes they may not appear until months or years later. They also may come and go over many years.

If your symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

How is post-traumatic stress disorder (PTSD) diagnosed?

From: MedlinePlus, National Library of Medicine

A health care provider who has experience helping people with mental illnesses can diagnose PTSD. The provider will do a mental health screening and may also do a physical exam. To get a diagnosis of PTSD, you must have all of these symptoms for at least one month:

• At least one re-experiencing symptom
• At least one avoidance symptom
• At least two arousal and reactivity symptoms
• At least two cognition and mood symptoms

What are the treatments for post-traumatic stress disorder (PTSD)?

From: MedlinePlus, National Library of Medicine

The main treatments for PTSD are talk therapy, medicines, or both. PTSD affects people differently, so a treatment that works for one person may not work for another. If you have PTSD, you need to work with a mental health professional to find the best treatment for your symptoms.:

• Talk therapy, or psychotherapy, can teach you about your symptoms. You will learn how to identify what triggers them and how to manage them. There are different types of talk therapy for PTSD.
• Medicines can help with the symptoms of PTSD. Antidepressants may help control symptoms such as sadness, worry, anger, and feeling numb inside. Other medicines can help with sleep problems and nightmares.

Can post-traumatic stress disorder (PTSD) be prevented?

From: MedlinePlus, National Library of Medicine

There are certain factors that can help reduce the risk of developing PTSD. These are known as resilience factors, and they include:

• Seeking out support from other people, such as friends, family, or a support group
• Learning to feel good about your actions in the face of danger
• Having a coping strategy or a way of getting through the bad event and learning from it
• Being able to act and respond effectively despite feeling fear

Which doctor should you see?

The suggested department for discussing Post-Traumatic Stress Disorder is Psychiatry, with a psychiatrist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How are symptoms affecting safety, sleep, relationships and everyday function?
• What roles could psychological treatment, medicines or support services have?
• Who should be contacted if safety or functioning deteriorates?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.