“Post-Traumatic Stress Disorder (PTSD), is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.”http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Our mind and body are equipped with a flight or fight response that happens when we are exposed to a stressful situation. If we are able to either flee or fight back, the traumatic stress usually disappears and we resume our normal life. If we are not able to flee or fight back, and the trauma exists over a long period of time, PTSD may develop. When the trauma is extremely severe, the instinctive response may be to freeze.http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Some examples of PTSD are:

• People in stressful jobs like fire fighters and police personnel end up quitting short of retirement because of horrific nightmares and chest pains.
• A child who has experienced the trauma of surgery becomes hyperactive.
• A good student who loses a close relative no longer is interested in school or school work, is failing classes, and doesn’t want to participate in any activities outside the home since the death.
• A political refugee who was tortured gets in a fight at a bar and is put in jail. He states all he can remember about the fight is smelling something that reminded him of the prison that tortured him.
• War veterans often have nightmares of combat and awake screaming many years after getting out of the service.
• A woman who becomes overly protective of her child because she was molested when she was a child.
• A man suffering from anxiety and panic attacks seeks the help of a psychotherapist.
• A boy who shows signs of molestation begins sticking objects like crayons and pencils into the tail region of his stuffed animals.http://www.healing-arts.org/tir/n-r-rothschild.htm#PTSD_diagnosis

This article on How to Diagnose Post-Traumatic Stress Syndrome will discuss the human limbic system, statistics and causes for PTSD, and some of the symptoms that are associated with it. For information on treatment, please read How to Treat Post-Traumatic Stress Syndrome.

Located in the center of the brain between the cortex and the brain stem is our limbic system. It regulates behaviors for survival and expression of emotions. In addition to processing memory, its main functions deal with eating, reproduction and our instincts for flight or fight.http://www.healing-arts.org/tir/n-r-rothschild.htm#PTSD_diagnosis

Our limbic system has a relationship with the Autonomic Nervous System (ANS), which regulates our smooth muscles and viscera, has two branches: the Sympathetic branch (SNS) and the Parasympathetic branch (PNS). These two branches balance each other out. When one is activated, the other is suppressed. The SNS becomes aroused during stress and causes things such as rapid heart rate and breathing, and high blood pressure. The PNS decreases heart rate and breathing, and lowers blood pressure.http://www.healing-arts.org/tir/n-r-rothschild.htm#PTSD_diagnosis

The limbic system releases hormones when there is trauma and tells the body to get ready to defend. This activates the SNS and the body is prepared for flight or fight (or[freeze). The increased breathing and heart rate increase the oxygen supply which sends blood into the muscles so the body is ready for rapid movement. It can even cause the body to freeze when death is imminent or the trauma is extended over a period of time. During the freezing state, “time slows down and there is no fear or pain.” It can also increase the chance of survival because it lessens the impact or causes the attacker to think the victim is dead. These responses are instinctive and are a result of reflex, not thought.http://www.healing-arts.org/tir/n-r-rothschild.htm#PTSD_diagnosis

PTSD occurs when the ANS stays aroused and does not return to normal. The body responds like the trauma is still occurring. Two parts of the limbic system are the amygdala and the hippocampus which are involved with memory and response of trauma. Belief is that the amygdala stores terrifying and horrific memories and becomes very active during trauma. The hippocampus stores our memories in the correct perspective. It has been found, however, that during trauma, it is suppressed and being inactive does not allow the memories to be stored in the past so they often invade the present. This is believed to be the cause of flashbacks that occur and the event gets relived.http://www.healing-arts.org/tir/n-r-rothschild.htm#PTSD_diagnosis

Statistics

While the average person has a 7-8% likelihood of developing PTSD in their lifetime, rape and combat victims have a 10-30% chance of developing PTSD. Women are twice as likely to suffer from PTSD. Minority races also have a greater likelihood than Caucasians to develop the disorder. It is believed the rate is higher because they have a tendency to “blame themselves, have less social support, and an increased perception of racism.” In addition, different ethnic groups express distress in different ways.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

Approximately 50% of individuals that go to outpatient mental health clinics suffer from PTSD. It is not necessary to be present at a traumatic event to suffer from PTSD. This fact was evident after the terrorist attacks on the twin towers.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

PTSD statistics in children and teens reveal that up to more than 40% have endured at least one traumatic event, resulting in the development of PTSD in up to 15% of girls and 6% of boys. On average, 3%-6% of high school students in the United States and as many as 30%-60% of children who have survived specific disasters have PTSD. Up to 100% of children who have seen a parent killed or endured sexual assault or abuse tend to develop PTSD, and more than one-third of youths who are exposed to community violence (for example, a shooting, stabbing, or other assault) will suffer from the disorder.”http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

Causes

Any life-threatening event, any event that damages the well being of a person or causes fear, may cause PTSD. These events could be witnessing or experiencing a physical injury] from an accident or attack. Being kidnapped or tortured, getting a life threatening medical diagnosis, being in a natural disaster or war, being the victim of a rape, robbery, assault, sexual attack or abuse, can all be causes of developing PTSD. Divorce and unemployment may also cause the onset of PTSD. Even if PTSD does not occur from these events, alcohol, tobacco or marijuana use may occur.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

Although not all individuals who have been traumatized develop PTSD, there can be significant physical consequences of being traumatized. For example, research indicates that people who have been exposed to an extreme stressor sometimes have a smaller hippocampus (a region of the brain that plays a role in memory) than people who have not been exposed to trauma. This is significant in understanding the effects of trauma in general and the impact of PTSD specifically since the hippocampus is the part of the brain that is thought to have an important role in developing new memories about life events.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

If someone with PTSD does not get treatment, it can cause higher risk for other disorders later in life. Sexually abused children may develop borderline personality disorders or a very complex PTSD. Mothers who suffer from untreated PTSD may put their baby at risk for developing PTSD later in life. They may have medical problems or problems with reproduction. In students, it can also hamper social and emotional development, and affect their ability to learn.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

The longer the event endures, the severity of the trauma, the lack of social support, and having emotional problems before the event, the higher the risk for developing PTSD. Those at higher risk may be women, children and adolescents, individuals with learning disabilities and those experiencing violence in the home.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

Doctors, nurses, medics, firefighters and other emergency personnel often take disaster-preparedness training which prevents or lessens the effect of traumatic events and increases personal safety. There are also medications which can help prevent PTSD if given to the person shortly after the traumatic event.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

In order to get a diagnosis of PTSD, there are three groups of symptoms that must be present:

- Re-experiencing the event from troublesome memories or having flashbacks caused by those memories, nightmares about the trauma that recur, and/or reliving the trauma by dissociative means.

- Developing a phobia or avoiding people, places or experiences that are a reminder of the trauma, and emotional responses that have become numb.

- Experiencing signs of hyperarousal such as sleep problems, inability to concentrate, irritability, anger, difficulty remembering things, blackouts, increased startle response, and hypervigilance to threat.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

The following is a detailed list of the three types of symptoms:

Re-experiencing the traumatic event:
- Intrusive, upsetting memories of the event
- Flashbacks (acting or feeling like the event is happening again)
- Nightmares (either of the event or of other frightening things)
- Feelings of intense distress when reminded of the trauma
- Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

PTSD symptoms of avoidance and emotional numbing:
- Avoiding activities, places, thoughts, or feelings that remind you of the trauma
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Feeling detached from others and emotionally numb
- Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

PTSD symptoms of increased arousal:
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance (on constant “red alert”)
- Feeling jumpy and easily startled

Other common symptoms of post-traumatic stress disorder:
- Anger and irritability
- Guilt, shame, or self-blame
- Substance abuse
- Depression and hopelessness
- Suicidal thoughts and feelings
- Feeling alienated and alone
- Feelings of mistrust and betrayal
- Headaches, stomach problems, chest pain.http://helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

At least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned. PTSD is considered of chronic duration if it persists for three months or more.” In children it may be a little different where instead of re-experiencing the trauma, it may come from repeated play instead of memories, and distressing dreams are not usually of the traumatic event but more of a general content. The symptoms that must be present for diagnosis are the same as for adults except they must last for a period of one month and cause impairment or distress that is significant.http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

The content in this page is not a substitute for professional medical advice. If you think you have Post Traumatic Stress Disorder, please consult your doctor.