Any kind of traumatic event—either experiencing it yourself or witnessing it—can lead to post-traumatic stress disorder (PTSD). Symptoms of PTSD, which is a recognized mental health condition on the anxiety spectrum, can include flashbacks and other recurring, intrusive thoughts about the event, extreme anxiety, nightmares and more.
Triggers are anything that can remind a person with PTSD of the trauma. Triggers are important to identify when treating PTSD in order to develop effective coping skills and learn how to diffuse and avoid triggers. PTSD triggers can be very obvious like an anniversary of a trauma, but they can also be more subtle—hearing a voice that sounds like a perpetrator, a name that was associated, a particular action. Working with a mental health provider to identify triggers and responses to triggers is a critical part of the treatment plan for those with a PTSD diagnosis.
Most of us are familiar with PTSD in relation to war veterans. Between 11-20% of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom have PTSD in a given year, according to the U.S. Department of Veterans Affairs. The Department also estimates that about 30% of Vietnam War veterans have had PTSD in their lifetime.
This condition isn’t limited to military veterans, however. It occurs in children and adults and can result from a variety of traumatic incidents. Examples include mugging, rape, torture, being kidnapped or held captive, child abuse, domestic violence, death of a loved one, serious illness, car accidents, train wrecks, plane crashes, bombings or natural disasters such as floods or tornadoes. Even witnessing any of these events without being directly affected can lead to PTSD.
Symptoms of PTSD
Not everyone who goes through a traumatic event develops PTSD. Even if they have difficulty coping for a while, they usually get better. If the symptoms worsen and/or persist, however, it may be PTSD. Talking with a psychiatrist and a mental health counselor can help fully resolve the post-trauma and ease the healing process.
Symptoms of PTSD typically fall into three categories:
- Re-experiencing the event. These include nightmares, flashbacks, dissociative or "out of body" type of experiences and frightening, panicked thoughts.
- Avoidance. Types of avoidance include staying away from situations that remind one or avoidance of people, places and things that may induce a trigger and a flashback.
- Hyperarousal. Being easily startled, feeling tense or on edge, extreme responses to loud noises, unanticipated events, fear of both open and enclosed spaces as well as new environments, feeling emotionally numb; feelings of strong guilt, depression or worry, losing interest in activities that the person used to enjoy and having difficulty remembering the frightening event. It can sometimes include thoughts of self harm and/or suicidal ideation. Excessive sleeping and/or disrupted sleep and angry outbursts are all forms of hyperarousal. These kinds of symptoms are usually constant. Older children and teens generally have symptoms that are similar to adults. Children, however, the symptoms can be more developmentally regressive and may, include bedwetting, being unable to talk, acting out, "babyish" behavior and being unusually clingy. A qualified mental health provider with experience working with PTSD in children and adolescents can be of great help in resolving these symptoms.
How PTSD is diagnosed
PTSD is diagnosed by a psychiatrist or other mental health care provider. To be diagnosed with this disorder, a person must have all of the following for at least one month:
- At least one re-experiencing symptom
- At least three avoidance symptoms
- At least two hyperarousal symptoms
Treatment of PTSD
Effective treatment after PTSD symptoms develop is critical to recovery and improved quality of life. Recommended treatment varies depending on the person’s symptoms and needs. The main treatment options include psychological counseling that can include expressive therapies such as narrative, art and play therapy, as well as medication or eye movement desensitization and reprocessing (EMDR). These treatments may be used individually or in combination, in consultation and collaboration with the client and the mental health treatment team.
Lisa A. Kim, MA, LISW
Lisa helps adults and children with a variety of challenges, including post-traumatic stress disorder (PTSD), sexual abuse, domestic violence, emotional/behavioral/learning issues and more. In addition to a Master's degree from the University of Chicago's School of Social Service Administration and a Bachelor's degree in Psychology from San Francisco State University, Lisa also has advanced training in eye movement desensitization and reprocessing (EMDR).