Understanding PTSD: A look at the condition, how to treat it
Published Thursday, December 5, 2013 3:28PM EST Last Updated Friday, December 6, 2013 6:27AM EST
Soldiers patrol the outskirts of Spin Boldak, near the Afghanistan border with Pakistan, in 2009. (AP / Emilio Morenatti)
What is PTSD?
PTSD, or post-traumatic stress disorder, is an anxiety disorder that develops as a reaction to either an actual or imagined threat of death, injury or sexual violence.
Dr. David Clark, a professor of psychology at the University of New Brunswick in Fredericton, says PTSD can develop after someone experiences a trauma directly, or from witnessing the trauma happening to someone else.
"Even learning about something traumatic happening to someone close to you can lead to PTSD," Clark says.
Dr. Katy Kamkar, a clinical psychologist at the Centre for Addiction and Mental Health in Torontosays the symptoms can be broken into three categories:
Re-experiencing symptoms: This involves memories of the trauma returning in flashbacks and nightmares; intense physical reactions to reminders of the event, such as heart-pounding, shortness of breath, nausea, etc. Feelings of anger and guilt are also common.
Avoidance symptoms: Those with PTSD often try to avoid thoughts or conversations related to the trauma. They might also avoid places and people that are reminders. This often leads to a loss of interest in activities; feeling detached from other people or feeling emotionally numb.
- Increased arousal: Hyper-vigilance, or feeling constantly "on guard" or jumpy is typical in those with PTSD. Others might have difficulty falling or staying asleep, irritability or outbursts of anger and difficulty concentrating.
Aren't such reactions normal after a trauma?
Most people experience the symptoms of PTSD in the hours and first days after a trauma, says Clark. "So we think it's a normal reaction; it's the brain's way of dealing with trauma," he says.
"For most people, though, the symptoms start to disappear within a few weeks or months after the trauma. But it's in those in whom the symptoms persist that we're most worried about, because then it starts to interfere in their ability to work and relate to others and so on."
Some people can experience delayed-onset PTSD, in which they think they're fine, but then become overwhelmed by symptoms six months or more after the trauma.
Why do some develop PTSD and others don't?
A lot of research has gone into this question, says Clark. He says there seem to be two key factors: one is the nature of the trauma; very traumatic events are particularly toxic, he says. As well, the number of traumatic events a person experiences is important. So the more traumas one experiences, the higher the risk of developing PTSD. That is why police, military members and paramedics are at higher risk.
Is there a cure?
Clark says there isn't really a cure for PTSD. There are good ways for patients to manage the condition and improve their mental health so they can get back to their lives. But he says it often remains a struggle for some time.
"It's hard for people to understand PTSD until you've gone through a trauma or seen a loved one with PTSD," says Clark. "They truly suffer, and they want to get better."
How is it treated?
Cognitive-behavioural therapy and group therapy led by therapists experienced in a particular type of trauma have shown to be the most promising treatments for PTSD.
Exposure therapy, in which the patient is asked to gradually relive the trauma under controlled conditions, is another way to confront the trauma and can also be beneficial.
As well, there are medications that can help with the depression and anxiety that often accompany PTSD.
Kamkar says in trauma-focused cognitive behavioural therapy, patients are taught to recognize and understand their reactions to the trauma. They are also taught anxiety management techniques.
And they are taught how to approach their own thoughts and beliefs associated with distress.