Mental Health and Illness
Trauma and Posttraumatic Stress Disorder (PTSD)
Please note that the information provided on these websites is intended for educational purposes only and is not a substitute for medical advice. If you are experiencing difficulty with any symptoms listed here, please consult with a healthcare provider for proper diagnosis and treatment.
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can occur after experiencing or witnessing a traumatic event. Trauma can involve actual or threatened death, serious injury, or sexual violence. PTSD can affect people of all ages, races, and genders.
Diagnosis of PTSD
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides the following criteria for the diagnosis of PTSD:
-
Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
-
Directly experiencing the traumatic event(s).
-
Witnessing, in person, the traumatic event(s) as it occurred to others.
-
Learning that the traumatic event(s) occurred to a close family member or close friend.
-
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders).
-
-
Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
-
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
-
Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
-
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
-
Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
-
Marked physiological reactions in response to reminders of the traumatic event(s).
-
-
Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
-
Avoidance or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
-
Avoidance or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
-
-
Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
-
Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
-
Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "No one can be trusted," "The world is completely dangerous," "My whole nervous system is permanently ruined").
-
Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame themselves or others.
-
Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
-
Markedly diminished interest or participation in significant activities.
-
Feeling detached or estranged from others.
-
Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
-
-
Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
-
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
-
Reckless or self-destructive behavior.
-
Hypervigilance.
-
Exaggerated startle response.
-
Problems with concentration.
-
Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep).
-
-
Duration of the disturbance (Criteria A-E) is more than 1 month.
-
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
-
The disturbance is not attributable to the physiological effects of a substance or another medical condition.
-
The disturbance is not better explained by a brief psychotic disorder, acute stress disorder, borderline personality disorder, or another dissociative disorder.
To meet the criteria for a diagnosis of PTSD, a person must have experienced a traumatic event and must exhibit a certain number of symptoms from each of the five categories mentioned above. The severity of symptoms can vary widely among individuals, and the diagnosis is typically made by a mental health professional trained in diagnosing and treating PTSD. PTSD is treatable, and effective treatments can include therapy, medication, and self-care strategies.
Treatment for PTSD
Psychological treatment for PTSD typically involves a range of evidence-based therapies that aim to help individuals process the traumatic experience, reduce distressing symptoms, and improve overall quality of life. Here are some common components of psychological treatment for PTSD:
-
Psychoeducation: This involves providing information about PTSD and its symptoms, including how it develops and how it can be treated. Psychoeducation can help individuals gain a better understanding of their condition and develop realistic expectations for recovery.
-
Cognitive restructuring: This involves helping individuals identify and challenge negative thoughts and beliefs related to the traumatic event, such as self-blame or feelings of helplessness. By replacing these negative thoughts with more positive and realistic ones, individuals can begin to regain a sense of control over their thoughts and emotions.
-
Exposure therapy: This involves gradually exposing individuals to the memories, thoughts, and situations associated with the traumatic event in a safe and controlled environment. By doing so, individuals can learn to tolerate the distressing feelings that arise and develop new coping skills.
-
Accelerated Resolution Therapy (ART) and/or Eye Movement Desensitization and Reprocessing (EMDR): This is a form of therapy that involves guiding individuals through a series of eye movements or other bilateral stimulation while they focus on traumatic memories or other distressing thoughts or sensations. ART and EMDR have been found to be effective in reducing symptoms of PTSD. ART can also assist the brain with “replacing” distressing or traumatic imagery.
-
Mindfulness-based interventions: These can include meditation, breathing exercises, and other mindfulness techniques that help individuals focus on the present moment and reduce feelings of anxiety and distress.
-
Interpersonal therapy: This focuses on addressing the social and interpersonal problems that may have developed as a result of PTSD, such as difficulties in relationships or feelings of isolation. Interpersonal therapy can help individuals rebuild social connections and develop healthy communication and coping skills.
Overall, psychological treatment for PTSD is tailored to the individual's specific needs and symptoms. A mental health professional trained in treating PTSD can help individuals identify the most effective treatment options and develop a personalized treatment plan.
Exposure therapy
Exposure therapy is a common component of psychological treatment for PTSD, and there are several different types of exposure treatments that may be used to help individuals overcome the symptoms of PTSD. Here are some examples:
-
Prolonged Exposure Therapy (PE): PE involves repeated exposure to the traumatic memories, thoughts, and situations associated with the traumatic event in a controlled and safe environment. The individual is asked to revisit the traumatic event through recounting the details of the event and describing associated thoughts and feelings. The therapist may also use virtual reality exposure, in which the individual is exposed to simulated versions of the traumatic event. Through this process, the individual gradually learns to tolerate and manage the distressing emotions associated with the traumatic event.
-
Cognitive Processing Therapy (CPT): CPT is a type of cognitive-behavioral therapy that focuses on helping individuals identify and challenge negative thoughts and beliefs related to the traumatic event. The individual works with the therapist to identify patterns of negative thinking and replace them with more realistic and helpful thoughts.
-
Virtual Reality Exposure Therapy (VRET): VRET involves using virtual reality technology to create simulations of the traumatic event. The individual is exposed to these simulations in a controlled environment, allowing them to experience the traumatic event in a safe and controlled way.
-
Imaginal Exposure Therapy: This involves guided imagery in which the individual is asked to imagine the traumatic event and associated thoughts and emotions in a safe and controlled environment. The therapist guides the individual through the process, providing support and helping them to manage any distressing emotions that arise.