A couple of months ago, a guy who'd been threatening Joe for a while pulled a gun on him as he was walking home. Luckily, the police arrived and no one was hurt. But lately Joe has been feeling on edge. Sudden noises make him jump, and he's changed the route he takes. The worst part is that he can't stop thinking about it, even when he's trying to do something else. In fact, he finds it tough to concentrate at all these days, and things he used to love — like playing games online or getting together with his band — just don't seem like much fun anymore.
Sometimes after experiencing a traumatic event — one that's especially frightening in a life-or-death kind of way — people have a strong and lingering stress reaction known as posttraumatic stress disorder.
What Is Posttraumatic Stress Disorder?
Posttraumatic stress disorder (PTSD) is a very strong stress reaction that can develop in people after a traumatic event. Usually it involves directly experiencing the event, such as a serious car accident, a natural disaster like an earthquake, personal assaults and abuse, terrorist attacks and military combat.
You don't have to be hurt to experience PTSD. Witnessing any type of personal or environmental disaster, or being threatened with an assault can lead to PTSD. Usually that's because of the intense feeling of fear, helplessness, or horror that goes with these things.
It's normal to be super-stressed after going through something traumatic. Strong emotions, jitters, and trouble sleeping, eating, or concentrating may all be part of a normal and temporary reaction to an overwhelming event. So might frequent thoughts and images of what happened, nightmares, or fears. Getting the right care and support after a traumatic experience can help these symptoms run their course and subside in a few days or weeks and allow a person to move on.
But PTSD is different. When someone has PTSD, the symptoms of stress are intense and last for longer than a month. For some people, the symptoms of PTSD begin soon after the trauma, but others have a delayed response.
What Are the Symptoms of PTSD?
Whether it occurs right after the trauma or later on, PTSD has certain characteristic symptoms that usually develop within 3 months of the traumatic event. People generally experience some or all of these symptoms:
- reliving the traumatic event. Many people with PTSD have nightmares, flashbacks, or disturbing mental images about the trauma.
- avoiding reminders of the trauma. People with PTSD may avoid people, places, or activities that remind them of the stressful event. They may also avoid talking about what happened.
- emotional numbness. Many people with PTSD feel numb or detached; they may not feel same as before or the same way about other people or the world. This could be caused by the overproduction of certain chemicals that block sensation during extreme stress.
- hypervigilance. People with PTSD may be easily startled, on edge, jumpy, irritable, or tense. This may be due to high levels of stress hormones in the body. Difficulty concentrating and trouble sleeping may also be part of this hyper-alert state.
Who Develops PTSD?
People of any age — kids, teens, and adults — can develop PTSD. But not everyone who experiences a serious trauma develops it. In fact, most people do not. Many recover from life-threatening traumas (after a normal reaction to the stressful event and the right support) without having a lasting problem. This ability to cope and bounce back is called resilience.
What makes some people more resilient to extremely stressful events when others have trouble coping? Researchers have found that certain things can help someone to be more resilient and recover faster from trauma. Everything from someone's belief in his or her ability to overcome problems to the types of hormones a person's body produces may play a role in resilience to stress. It is also really helpful to have friends, family, or a counselor to talk to. Support groups also are good places to vent about thoughts and feelings.
The intensity or circumstances of a trauma can influence a person's vulnerability to PTSD, too. National disasters like the terrorist attacks of 9/11 or the 2007 shooting at Virginia Tech can cause widespread anxiety, regardless of whether the person was there or not. In some cases, seeing these events and the traumatic images portrayed on TV and the Internet can lead to symptoms of PTSD.
How Is PTSD Treated?
PTSD usually doesn't just go away on its own. Without treatment, symptoms can last for months or years, or they may come and go in waves. Getting treatment and support can make all the difference.
Mental health professionals (such as psychologists, psychiatrists, and counselors) who specialize in treating anxiety problems are usually experienced in working with people who have PTSD. Therapy for PTSD may involve gradually talking it through in a safe environment and learning coping skills that help with anxiety, fear, or panic. This can include relaxation techniques that help people with PTSD reset their stress response and techniques to resolve other problems, such as sleeping difficulties. Sometimes medications can help reduce symptoms of anxiety, panic, or depression in certain people.
Healing From Trauma
Sometimes people avoid seeking professional help because they're afraid that talking about an incident will bring back memories or feelings that are too painful. It can be difficult to talk about a traumatic event at first, but doing so in a safe environment with the help and support of a trained professional is the best way to ensure long-term healing. Working through the pain can help reduce symptoms like nightmares and flashbacks. It can also help people avoid potentially harmful behaviors and emotions, like extreme anger or self-injury.
So how do you find the right therapist or counselor for you? The best way is to ask a parent or adult you trust for help. People who are close to you know you well and understand your needs. (Having a support system of family and friends is key to recovering from PTSD.) A doctor or school counselor may also be able to help you find a mental health professional who specializes in anxiety problems. And there are lots of resources available to help locate therapists in your area.
Turning to a professional for help in overcoming PTSD doesn't mean you're weak and it doesn't mean you're crazy. PTSD is like any other illness: The body's systems aren't working properly and treatment is needed to fix the problem. In the case of PTSD, the stress response system isn't switching off as it should. A stress system that is faulty or over-vigilant is like a motor running for too long and can lead to burnout (such as the inability to study or enjoy activities). A therapist can help someone deal with the feelings of guilt, shame, or anger that may accompany PTSD — and discover inner strengths that can promote healing.
PTSD can be treated successfully. Some people learn that in the process of healing from trauma they discover strengths they didn't know they had, or a support network that they didn't know was there. Others find that treatment helps them develop new insights into life and how to cope with other problems.
Reviewed by: Michelle New, PhD
Date reviewed: April 2007
Originally reviewed by D'Arcy Lyness, PhD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.