destruction of the World Trade Center, the violent
attack on the Pentagon, and the crashes of hijacked
aircraft have impacted all of our lives. These
attacks upset our basic sense of safety. You
may now be experiencing feelings of shock, disbelief,
anger, and anxiety. You may have trouble concentrating,
or feel overwhelmed by your emotions. All of
these feelings are normal reactions to traumatic
events. With the support of friends, family,
faith communities and counselors, most of us
will be able to get back into the routines of
our lives within a few weeks.
However, some people face situations
that are so traumatic that they may become unable
to cope and function in their daily lives. They
may become so distressed by memories of the
trauma -- memories that won't go away -- that
they begin to live their lives trying to avoid
any reminders of what happened to them.
A person who still feels this
way months after a traumatic experience took
place may be suffering from Posttraumatic Stress
Disorder, or PTSD, a serious and common health
condition. For these people, getting beyond
the trauma and overcoming PTSD requires the
help of a professional. Untreated PTSD is associated
with an extremely high rate of medical and mental
health service use, and possibly the highest
per-capita cost of any psychological condition.
But there is help
and there is hope.
PTSD is a long-term problem
for many people. Studies show that 33-47 percent
of people being treated for PTSD were still
experiencing symptoms more than a year after
the traumatic event. Without treatment many
people continue to have PTSD symptoms up to
ten years after the traumatic event.
What are the symptoms
PTSD symptoms are divided into
three categories. People who have been exposed
to traumatic experiences may notice any number
of symptoms in almost any combination. However,
the diagnosis of PTSD means that someone has
met very specific criteria. The symptoms for
PTSD are listed below.
Intrusive Re-experiencing (re-living the event)
People with PTSD frequently
feel as if the trauma is happening again. This
is sometimes called a flashback, reliving experience
or abreaction. The person may have intrusive
pictures in his/her head about the trauma, have
recurrent nightmares or may even experience
hallucinations about the trauma. Intrusive symptoms
sometimes cause people to lose touch with the
"here and now" and react in ways that
they did when the trauma originally occurred.
For example, many years later a victim of child
abuse may hide trembling in a closet when feeling
threatened, even if the perceived threat is
People with PTSD work hard
to avoid anything that might remind them of
the traumatic experience. They may try to avoid
people, places or things that are reminders,
as well as numbing out emotions to avoid painful,
overwhelming feelings. Numbing of thoughts and
feelings in response to trauma is known as "dissociation"
and is a hallmark of PTSD. Frequently, people
with PTSD use drugs or alcohol to avoid trauma-related
feelings and memories.
Symptoms of psychological and
physiological arousal are very distinctive in
people with PTSD. They may be very jumpy, easily
startled, irritable and may have sleep disturbances
like insomnia or nightmares. They may seem constantly
on guard and may find it difficult to concentrate.
Sometimes persons with PTSD will have panic
attacks accompanied by shortness of breath and
Who gets PTSD?
PTSD can affect anyone at any
age who has been exposed to a traumatic event
where he/she experienced terror, threat (or
perceived threat) to life, limb or sanity and
his/her ability to cope was overwhelmed. Conservative
estimates show that 9-10 percent of the general
population has PTSD. Among people who were victims
of specific traumatic experiences (rape, child
abuse, violent assaults, etc.), the rate of
PTSD is 60-80 percent.
Unfortunately, it is common
for those with PTSD to avoid treatment. Also,
it is common for those who do seek treatment
to be misdiagnosed. Because PTSD often occurs
at the same time as other physiological and
mental health disorders, PTSD symptoms may be
masked or difficult to identify. Examples of
common co-occurring conditions are depression,
substance use/dependence and bipolar disorder.
Trauma survivors may also experience headaches,
chest pain, digestive or gynecological problems
as well. However, there is a growing number
of clinicians who are skilled at recognizing
PTSD and still others who are specializing in
treatment of traumatic stress disorders. If
you think you might have PTSD you should seek
professional help for a thorough physical and
mental health assessment.
Can PTSD be treated?
Yes. A person who has survived
a traumatic event will probably never feel as
if the event didn't happen, but the disruptive,
distressing effects of PTSD are completely treatable.
Depending on the source of the trauma (manmade
vs. natural), the nature of the trauma (accidental
vs. purposeful), and the age of the victim at
the time of the trauma, treatment strategies
may vary. Treatment involves both managing symptoms
and working through the traumatic event. Most
experts agree that psychotherapy is an important
part of recovery. Medications can help reduce
some symptoms allowing psychotherapy to be more