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Post-traumatic stress disorder

PTSD

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that involved the threat of injury or death.

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Post-traumatic stress disorder

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Causes

Health care providers do not know why traumatic events cause PTSD in some people, but not in others. Your genes, emotions, and family setting may all play roles. Past emotional trauma may increase your risk of PTSD after a recent traumatic event.

With PTSD, the body's response to a stressful event is changed. Normally, after the event, the body recovers. The stress hormones and chemicals the body releases due to the stress go back to normal levels. For some reason in a person with PTSD, the body keeps releasing the stress hormones and chemicals.

PTSD can occur at any age. It can occur after events such as:

Symptoms

There are 4 types of PTSD symptoms:

1. Reliving the event, which disturbs day-to-day activity

2. Avoidance

3. Hyperarousal

4. Negative thoughts and mood or feelings

You may also have symptoms of anxiety, stress, and tension:

Exams and Tests

Your provider may ask how long you have had symptoms. PTSD is diagnosed when you have had symptoms for at least 30 days.

Your provider may also do a mental health exam, physical exam, and blood tests. These are done to look for other illnesses that are similar to PTSD.

Treatment

Treatment for PTSD involves talk therapy (counseling), medicines, or both.

TALK THERAPY

During talk therapy, you talk with a mental health professional, such as a psychiatrist or therapist, in a calm and accepting setting. They can help you manage your PTSD symptoms. They will also guide you as you work through your feelings about the trauma.

There are many types of talk therapy. One type that is often used for PTSD is called desensitization. During therapy, you are encouraged to remember the traumatic event and express your feelings about it. Over time, memories of the event become less frightening.

During talk therapy, you may also learn ways to relax, such as when you start to have flashbacks.

MEDICINES

Your provider may suggest that you take medicines. They can help ease your depression or anxiety. They can also help you sleep better. Medicines need time to work. DO NOT stop taking them or change the amount (dosage) you take without talking to your provider. Ask your provider about possible side effects and what to do if you experience them.

Support Groups

Support groups, whose members are people who have similar experiences with PTSD, can be helpful. Ask your provider about groups in your area.

Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition.

Resources for more information include:

Anxiety and Depression Association of America -- adaa.org

National Institute of Mental Health -- www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

US Department of Veterans Affairs -- www.ptsd.va.gov

Outlook (Prognosis)

PTSD can be treated. You can increase the chance of a good outcome:

When to Contact a Medical Professional

Although traumatic events can cause distress, not all feelings of distress are symptoms of PTSD. Talk about your feelings with friends and relatives. If your symptoms do not improve soon or are making you very upset, contact your provider.

Seek help right away if:

Related Information

Depression
Stress and your health
Alcohol use and safe drinking
Substance use

References

American Psychiatric Association. Trauma- and stressor-related disorders. In: American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:265-290.

Dekel S, Gilbertson MW, Orr SP, Rauch SL, Wood NE, Pitman RK. Trauma and posttraumatic stress disorder. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 34.

Lyness JM. Psychiatric disorders in medical practice. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 397.

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Review Date: 3/26/2018  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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