What is post-traumatic stress disorder?
Memories are an important part of life. They tell the story of who we are and what has happened to us. Good memories comfort us. Think of how happy you feel when you remember something special, like a favorite vacation, or something simple, like your grandmother's chocolate chip cookies. Most of us have bad memories, too. How do you feel when you remember a terrible argument with your sister or a relative's funeral? Are you sad? Angry? Confused? We may think about these bad memories at different times. But we can still go on with our everyday activities.
But some people have bad memories of a very different sort. These memories are of terrible, overwhelming, and shocking events over which they had no control. These events are called traumas
. Traumas can be natural disasters like floods, earthquakes, and tornadoes. They can be terrible events like wars, fires, or plane crashes. They can be personal assaults like rape, mugging, robbery, or kidnapping. Traumas can also be physical injuries like a painful broken bone or a fall. A loved one being in the hospital is traumatic, as is a frightening event like a fire. Seeing something bad happen to someone you care about can be traumatic, too, even if you weren't physically hurt. Anything that upsets a person deeply is a trauma and can bring on post-traumatic stress disorder, or PTSD.
Memories of events like these do not go away so easily. In fact, many people who go through traumas develop emotional and physical problems that can last a long time. If their problems last more than a month, they may be diagnosed with PTSD.
For many years, PTSD was called "shellshock". It was thought to be a condition that affected only people who fought in wars. But over the years, doctors have learned that people who are exposed to death, violence, accidents, abuse, or natural disasters can have many of the same emotional and physical problems as war veterans. More than 5 million people in the United States suffer from PTSD every year. Girls and women are more likely to develop PTSD than boys and men, although we're not sure why this is true. back to top
How do I know if I have it?
Not everyone who has been through a trauma gets PTSD. Some people may have difficulties for a short time, and then they're back to normal again. We still don't know exactly why some people get PTSD and others don't. What we do know is that someone who has been the victim of a trauma once before or someone who already has a psychological problem is more likely to get PTSD. We also know that PTSD is usually more severe if the person got hurt by another person, rather than by a natural disaster like an earthquake or a terrible accident.
Trauma does not have to mean that something bad happens to you. Watching a horrible trauma happen to someone else is traumatic in itself and can cause PTSD. Sometimes people get PTSD if someone they love went through a trauma, even if they didn't witness it. back to top
What are the symptoms?
PTSD can happen days, weeks, or even years after an event. One of the most common symptoms of PTSD is "flashbacks." A person who is having a flashback believes that the traumatic event is actually happening to them all over again. Sometimes they see certain images or hear certain sounds. Sometimes they smell or feel something very intense.
People with PTSD may also have trouble falling asleep, or they stay awake because of terrible nightmares or scary thoughts. These symptoms happen most often when the person is reminded of the trauma in some way. Anniversaries of the event can also trigger symptoms. That's why many people with PTSD try very hard to avoid thinking about or doing anything that reminds them of the trauma. (Unfortunately, that's not a good long-term plan. Until you get treatment, the symptoms are in danger of returning and taking over your daily life.)
A person with PTSD may also be startled easily and feel nervous and jumpy. They may feel as though they are always watching out for something to happen. PTSD can cause a person to have drug
problems. It can cause trouble with friends, poor grades, and missed school days. A person with PTSD might feel hopeless and powerless. It can even cause depression
and suicidal thoughts
If a trauma happens to you, you may have a hard time trusting adults for a while because you may feel disappointed that they couldn't stop the trauma from happening. You may feel guilty that you were unable to prevent the trauma, or that you survived a disaster, but your friends or family did not. back to top
What if the trauma lasts a long time?
If you have been abused for many years, or if you have grown up in a country or community where you have been surrounded by violence day after day, you may feel some additional symptoms. You may spend all your time worrying that another incident is going to happen. You may have a lot of different feelings at once—anger, rage, sadness, and fear. This could lead you to take out your feelings on others. Or you may push down all your feelings so that it looks to others as if you don't feel anything at all. People feel these things after a single traumatic event sometimes, too.
If you've been sexually abused, then you may try to stay away from all boys. Or you may try to get yourself into dangerous sexual situations, hoping that reliving the trauma will help you get over it. This won't work. And you will feel much worse about yourself. Besides, you could get physically abused or contract sexually transmitted diseases
. That would only add to your problems. back to top
Do any other illnesses have similar symptoms?
If you are experiencing some of these symptoms, but haven't been through major trauma or abuse, then you probably don't have PTSD. But you may have an equally serious problem such as depression, anxiety
, attention-deficit hyperactivity disorder
, obsessive-compulsive disorder
, or some other illness. These problems are very treatable, and you'll feel much better if you make an appointment with a mental health professional as soon as possible. back to top
What can I do about it?
There are many ways to treat PTSD. The best thing is to prevent it by getting help within hours or days of the trauma. This often happens when there is, for example, a school shooting or some kind of natural disaster. Therapists and other health care professionals will come into the community for a few days—or longer—and meet with individuals and with groups of people. Their goal is to answer questions and to help people talk about their feelings. These "interventions," as they are called, help not only with your immediate difficulties, but can prevent further problems from developing.
When immediate treatment is not possible, there are still many ways that you can get help for PTSD. It is important to remember that some people recover from the illness within a few weeks or months. Others will take longer to heal.
Most people benefit from individual psychotherapy
. By talking with a therapist, you are better able to understand the illness and its effects on your daily life and relationships. You can also learn how to cope with your symptoms and develop other ways of responding to stressful situations.
could also help you heal. You and the therapist will work together to identify the negative or unhealthy thought patterns. You will learn how to change those patterns so that your symptoms are less likely to occur. For instance, someone may realize that dark clouds do not necessarily mean that another hurricane is coming. Or they may realize that just because a classmate is angry doesn't mean there will be another school shooting.
helps you learn new ways of dealing with the stresses that make your symptoms worse. Sometimes, a certain technique called "exposure therapy" is used. Here's how it works. First, your therapist teaches you some relaxation techniques. Then, you list the situations that make you anxious and rank them from least fearful to most fearful. Then your therapist will ask you to imagine or experience the least frightening on your list, while you do your deep relaxation exercises. As your anxiety lessens in that situation, then he or she moves to the next most fearful one. Eventually, you will be able to do or imagine the worst thing on your list, without the anxiety. This technique MUST be done very carefully with a trained mental health professional. Don't try to do it by yourself or with a friend. It could make you feel worse.
can help your family members understand the symptoms of your illness and learn new ways of responding to them. In family therapy, people also work to improve communication. That's because talking openly about problems is one of the best ways to solve them. Studies have shown that it is much easier to recover from PTSD if you have good family support.
can be very useful for people who have PTSD. Survivors of a trauma come together, on a regular basis, to share their experiences and feelings. This can be very powerful because people realize that they are not alone with their feelings. They can give each other support through the difficult times because they understand so well what the others are experiencing.
Medications can also help with some of the symptoms of PTSD, such as fear, anxiety, and sleep problems. Antidepressants
and antianxiety medications
are the most commonly used medications for PTSD. Easing your symptoms can help you make more progress in therapy.
Remember that all medications can cause side effects, like nausea, dry mouth, and constipation. Or they can be dangerous if they are mixed with other medications or with drugs or alcohol. Your health care provider should talk with you about these risks. Often if the first medicine you try does not help, your health care provider may recommend trying another one. Remember that it can take a few weeks before you begin to feel the medicine working.
Your health care provider, along with you and your parents, will decide whether you need medication and what kind to try first. Never take a medication that a friend offers you. And never give—or sell—one to someone else. That's dangerous—and it's against the law! back to top
Does post-traumatic stress disorder ever cause other illnesses?
It is very common for people with PTSD to develop at least one other psychological illness such as depression
, alcohol/substance abuse
, panic disorder
, or other anxiety disorders
. Your mental health professional will ask you all kinds of questions to find out whether you have any of these—in addition to PTSD. If so, he or she will treat you for all the problems at the same time. back to top