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Post-traumatic stress disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.
Anyone who has gone through a life-threatening event can develop PTSD. These events can include:
After the event you might find that you are thinking a lot about what happened, avoiding reminders about the event, and thinking negative thoughts about yourself and the world.
After going through a traumatic event, you may:
PTSD symptoms can change your behavior and how you live your life. You may pull away from other people, work all the time, or use drugs or alcohol. You may find it hard to be in relationships, and you may have problems with your spouse and family. You may become depressed. Some people with PTSD also have panic attacks, which are sudden feelings of fear or worry that something bad is about to happen.
Children can have PTSD too. They may have the symptoms above and symptoms that depend on how old they are. As children get older their symptoms are more like those of adults.
If you think you have PTSD, it's important to get treatment. Treatment can work, and early treatment may help reduce long-term symptoms.footnote 1, footnote 2
If you think you have PTSD:
If you have thoughts about hurting yourself or someone else, call 911, 1-800-273-TALK (suicide hotline), or go to a hospital emergency room.
All people with PTSD have personally experienced—or have experienced through others—a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.footnote 3
Many people who go through a traumatic event don't get PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:
PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. About half of people who develop PTSD get better at some time. But other people who develop PTSD always will have some symptoms.footnote 4
If you have symptoms of PTSD, counseling can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships. It is never too late to get professional help or other forms of support that can help you manage the symptoms of PTSD.
Reminders and anniversaries of the event can make symptoms worse.
The most effective treatments for PTSD are:footnote 5, footnote 6
You may need to try different types of treatment before finding the one that helps you. Your doctor will help you with this. These treatments may include other types of medicines and other forms of counseling, such as group counseling. If you have other problems along with PTSD, such as overuse of alcohol or drugs, you may need treatment for those also.
Treatment can help you feel more in control of your emotions, have fewer symptoms, and enjoy life again.
One Man's Story:
"I can't turn my brain off. Sometimes I stay up all night. The bad part is not staying up, but what's going through my head. I can't stop it."—Marvin
Read more about Marvin.
Health Tools help you make wise health decisions or take action to improve your health.
Living with PTSD:
PTSD and veterans:
Telling others about having post-traumatic stress disorder (PTSD) is hard. But for the following people, it's part of recovering.
Read what they say about how PTSD felt, how it affected their families, and how treatment is helping them get better.
Marvin and his family survived Hurricane Katrina on a neighbor's rooftop.
"I have visions of being up on the roof and going through it all over again. I just keep seeing the water coming up and up."—Marvin
Tim is an Iraq war veteran and former medic.
"When I came home, so much had changed for me on a day-to-day basis. I just couldn't communicate the same."—Tim
Read Tim's story.
Ron is a Vietnam veteran who has had PTSD symptoms for decades.
"Whenever I was under extreme stress, it would come back and slam me."—Ron
Read Ron's story.
Symptoms of post-traumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.
PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you may have PTSD.
Even if you always have some symptoms, counseling can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.
Most people who go through a traumatic event have some symptoms at the beginning but don't develop PTSD.
There are four types of symptoms:
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
You may find it hard to express your feelings. This is another way to avoid memories.
You may be alert and on the lookout for danger. This is known as increased emotional arousal. It can cause you to:
Other symptoms also may include:
"People don't understand the emotion tied to flashbacks. It's like it's happening all over again, and you're having the same physiological reactions."— Marvin
Children can have PTSD too. They may have the symptoms listed above and/or symptoms that depend on how old they are. As children get older, their symptoms are more like those of adults.
If you think you or a loved one has symptoms of PTSD, see your doctor right away. Fill out this form(What is a PDF document?) and take it to your doctor. Treatment can work, and early treatment may help reduce long-term symptoms.footnote 2
If you were in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to post-traumatic stress disorder (PTSD).
Other things about a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems.footnote 7 These things include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face.
Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war.
Many veterans don't seek treatment for PTSD. You may feel that treatment won't help, or worry about what people will think. Your military background may add other pressures that keep you from seeking treatment. You may feel that it will hurt your career, or that those in your unit will lose faith in you. You may fear that your unit will see you as weak.
"Being in the Guard now is like a mandatory support group, because they've all been there too."—Tim
There are many types of treatment for post-traumatic stress disorder (PTSD). You and your doctor will discuss the best treatment for you. You may have to try a number of treatments before you find one that works for you.
A type of counseling called cognitive-behavioral therapy and medicines known as SSRIs appear to be the most effective treatments for PTSD.footnote 2 Treatment can help you feel more in control of your emotions and result in fewer symptoms, but you may still have some bad memories.
Counseling means talking with a therapist on your own or in a group about the traumatic event and PTSD. You will talk with your therapist about your memories and feelings. This will help you change how you think about your trauma. You will learn how to deal with painful feelings and memories, so you can feel better.
There are different types of counseling for PTSD. Several types of therapy have been shown to be effective in treating PTSD. These therapies are:
Finding a therapist you trust is important. A good therapist will listen to your concerns and help you make changes in your life. Your doctor can help you find one. If you are a veteran, the VA is a good place to start. Churches sometimes offer services that help people get counseling. Or you can call your state Health and Welfare office.
SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective. SSRIs include fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).
"It's hard to let people in on your private thoughts. A professional is a great listener, and if you can let them in, when you talk about your flashbacks, they understand that they're not some random thoughts."—Marvin, 58
Your doctor also may suggest you try other types of medicines and other forms of counseling.
If you are using medicine, take it exactly as prescribed. Call your doctor if it's not helping your symptoms or if the side effects are very bad. You and your doctor will decide what to do.
Unfortunately, many people don't seek treatment for PTSD. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.
Treatment can make your symptoms less intense and stop them from coming back. It can help you connect with your family, friends, and community. Many people get better with treatment.
If you need help deciding whether to see your doctor, see some reasons why people don't get help and ways to overcome them.
When you first see your therapist, he or she will ask questions about the traumatic event causing PTSD and how severe your symptoms are. You may want your spouse, your partner, or a close family member to come with you. This person can help your doctor understand your symptoms and can help your therapist understand what you've been going through. Being with someone you trust helps you relax.
If you have other problems along with PTSD, such as overuse of alcohol or drugs, you also may need treatment for those problems.
Recovery from PTSD does not mean forgetting the past trauma. It does mean that you learn how to not have the bad physical and emotional reactions in response to memories so that you can fully live your life. Recovery is not a cure. It helps you believe that you can reach your goals and learn new things to help yourself. It helps you gain self-confidence and respect for yourself.
"I'm a much more peaceful person now. I sleep so much better."—Ron
Coping is about dealing with your symptoms. When you cope with your symptoms in a positive way, you often feel more in control. You accept what the traumatic event did and take steps to improve your life.
Negative coping skills are certain ways you may try to deal with your symptoms and problems that cause more harm than good. These are quick fixes that don't improve your situation in the long run. They include drinking too much, avoiding others, and lashing out.
There are times when you may need a shoulder to cry on or a ride to the doctor. You may want to learn more about PTSD or talk with others who have PTSD. You need people who understand what you are going through and will help you and care about you. This is your support network.
Support takes many forms. You can find it in seminars and groups led by professionals, in groups made up of others with PTSD, and in your relationships with family and friends.
Post-traumatic stress disorder (PTSD) doesn't always occur alone. Other medical conditions often occur with it, such as:
"I didn't know why I needed to drink or wanted to drink. But Vietnam was never very far away when I did."—Ron
Post-traumatic stress disorder (PTSD) can harm your relationships with your family and community. Feelings of anger and depression and not wanting to deal with people can make it hard to connect with them. Pay attention to how you act with your family and try not to pull away. Your relationships can make a big difference in your recovery from PTSD.
Here are things you can do to help yourself, your family, and your community better understand and deal with PTSD.
Your family and community are part of your recovery. Do as much as you can to work with them. With knowledge, your family and community can better help you.
"Talking about it with my wife is getting easier. The more I talk about it with people, the better."—Tim
Read more about Tim.
Some people with PTSD are also depressed. For information on how to help with this, see:
Your family and community are part of your recovery. Do as much as you can to work with them. With this knowledge, your family and community can better help you.
CitationsCahill SP, et al. (2009). Cognitive-behavioral therapy for adults. In EB Foa et al., eds., Effective Treatments for PTSD: Practice Guidelines From the International Society for Traumatic Stress Studies, 2nd ed., pp. 139–222. New York: Guilford Press.Bisson J (2010). Post-traumatic stress disorder, search date March 2009. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.Hollander E, Simeon D (2008). Anxiety disorders. In RE Hales et al., eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 565–607. Washington, DC: American Psychiatric Publishing.Johnson DC, et al. (2008). Posttraumatic stress disorder and acute stress disorder. In MH Ebert et al., eds., Current Diagnosis and Treatment in Psychiatry, 2nd ed., pp. 366–377. New York: McGraw-Hill. Forbes, D, et al. (2010). A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress, 23: 537–552.Department of Veterans Affairs (2010). VA/DoD Clinical Practice Guideline: Management of Post-Traumatic Stress, version 2.0. Available online: http://www.healthquality.va.gov/post_traumatic_stress_disorder_ptsd.asp.Wright KM, et al. (2012). Alcohol problems, aggression, and other externalizing behaviors after return from deployment: Understanding the role of combat exposure, internalizing symptoms, and social environment. Journal of Clinical Psychology, 68(7): 782–800.Davidson J, et al. (2006). Treatment of posttraumatic stress disorder with venlafaxine extended release. Archives of General Psychiatry, 63(10): 1158–1165.Other Works ConsultedAbramowicz M, ed. (2006). Drugs for psychiatric disorders. Treatment Guidelines From the Medical Letter, 4(46): 35–46. Johnson DC, et al. (2008). Posttraumatic stress disorder and acute stress disorder. In MH Ebert et al., eds., Current Diagnosis and Treatment in Psychiatry, 2nd ed., pp. 366–377. New York: McGraw-Hill. National Institute of Drug Abuse (2009). Principles of Drug Addiction Treatment: A Research-Based Guide, 2nd ed. (NIH Publication No. 09 4180). Available online: http://www.drugabuse.gov/PDF/PODAT/PODAT.pdf.Sadock BJ, et al. (2007). Posttraumatic stress disorder and acute stress disorder. In Kaplan and Sadock's Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry, 10th ed., pp. 612-622. Philadelphia: Lippincott Williams and Wilkins. U.S. Department of Veterans Affairs (2011). PTSD and problems with alcohol use. A National Center for PTSD fact sheet. Available online: http://www.ptsd.va.gov/public/pages/ptsd-alcohol-use.asp.
ByHealthwise StaffPrimary Medical ReviewerAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerJessica Hamblen, PhD - Post Traumatic Stress Disorder
Current as ofJanuary 15, 2016
Current as of: January 15, 2016
Author: Healthwise Staff
Medical Review: Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Jessica Hamblen, PhD - Post Traumatic Stress Disorder
To learn more about Healthwise, visit Healthwise.org.
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