While typically associated with soldiers who have been in military combat, any event that causes fear and stress can trigger post-traumatic stress disorder (PTSD). A natural disaster such as Superstorm Sandy or an earthquake, or a crisis such as the Boston Marathon bombing or 9/11, can spark an incident of PTSD. Sexual or physical abuse or a serious accident can also be responsible for an episode.
PSTD isn’t always necessarily the result of a direct harm to the person who suffers the disorder. PSTD can develop when a person witnesses an event that affected a loved one or even strangers. People who watched the events of 9/11 unfold on television with no direct connection to the incident or people involved in it experienced PTSD.
Causes of PTSD
As with many mental health issues, the reasons that some people develop PTSD and others who experience the same or similar trauma do not, is complex.
While being harmed in a violent incident or observing a violent event can cause PTSD in nearly anyone, an increasing number of scientists are researching the role that genes play in how we react to and form memories of fearful events.
PTSD research has focused on stathmin, a protein needed to form fear memories. In one study, mice with a higher level of stathmin were more likely than normal mice have an exaggerated response after exposure to a fearful experience.
A lack of gastrin-releasing peptide, a signaling chemical in the brain released during emotional events, can cause some people to form greater and more lasting fear memories. Researchers have also found a version of the 5-HTTLPR gene, which controls levels of serotonin, which can fuel the fear response.
A family or personal history of mental health risks, such as an increased risk of anxiety and depression, can impact the likelihood of experiencing PTSD episode. Other factors include the way that your brain regulates the chemicals and hormones that your body produces in response to stress. Temperament also plays a role.
Symptoms in children can be different than adults. Some children who are suffering PTSD will regress, sometimes wetting the bed or being unable to talk when they have mastered these tasks prior to the event.
Symptoms of PTSD
While post-traumatic stress disorder symptoms typically surface within three months of a traumatic event, they may not appear until years after the event in some people. Post-traumatic stress disorder symptoms are generally grouped into three types:
• intrusive memories
• avoidance and numbing
• increased anxiety or emotional arousal (hyperarousal)
Symptoms of intense memories are those that people typically associate with the disorder — flashbacks, such as reliving the event for a minute or even a day, and having nightmares.
Avoidance and emotional numbing may include memory problems, hopelessness, difficulty concentrating and avoiding once enjoyable activities. Personal relationships are also affected, and sufferers often keep people at a distance and don’t form new connections.
People with PTSD will often steer clear of places, events or situations that remind them of the experience for fear of having a flashback and being unable to control their actions.
Anger and irritability, often unprovoked, fall into the anxiety and emotional arousal category of symptoms. Guilt, being easily startled and abusing alcohol or drugs can also be symptoms.
To be clinically diagnosed with PTSD, a person must have at a least one re-experiencing symptom, three avoidance symptoms and two hyperarousal symptoms over the course of a month.
Addiction and PTSD
Many people with PTSD turn to drugs and alcohol as a way of numbing the pain of the trauma they have experienced. A large portion of those with PTSD will turn to alcohol as a way to temporarily replace the feelings experienced by the brain’s naturally produced endorphins, according to the journal Alcohol Research & Health. The body produces endorphins as a response to a traumatic experience. Coming down from the “endorphin high” has some of the same symptoms as withdrawal from drugs or alcohol.
PTSD is typically treated with a combination of talk therapy and medications. Mental health care providers trained in PTSD treatment develop an individualized plan for their clients or patients.
Psychotherapy, which can take place individually or in a group setting, can last six to 12 weeks. Family, friends and sometimes co-workers can be brought in to help understand the person’s behavior and its effect on various aspects of their lives. Cognitive behavioral therapy, which has the person confront their fears directly, is sometimes used, depending on the trauma.
Medications such as sertraline (Zoloft) and paroxetine (Paxil) are sometimes prescribed as part of the treatment for PTSD. They are antidepressants that can help control sadness, anxiety and anger. Sleep aids, antipsychotics and other antidepressants may also be prescribed.
Engaging with a group of individuals who have gone through the same experiences, such as support groups for veterans, can also help those affected by PTSD.