Treatment Centers

Posttraumatic Stress Disorder, or PTSD, is a medical diagnosis. It is given when trauma-related symptoms persist and interrupt daily life. Considered an Anxiety Disorder, it is treated with a variety of approaches from counseling and relaxation techniques to psychiatric services and medications. Some with PTSD are distressed enough to require intensive support and therapy in an inpatient setting. Intensive outpatient programs and occasional mental health appointments are two other ways in which individuals with this disorder receive treatment. The approach, frequency of services and combination of techniques used will depend upon the types and severity of symptoms present since the acuity of symptoms can vary widely. Symptoms can fluctuate in intensity and the degree of impairment caused by them over the course of the disorder. Typically, increased life stressors will increase PTSD symptoms for a time. As symptoms fluctuate, treatment frequency and techniques may change in order to meet an individual’s needs for management of life stressors and PTSD symptoms.

Exposure

PTSD is caused by exposure to various types of trauma. A direct, first-hand experience, for example, such as assault victimization, involvement in accidents, having a life-threatening illness or being involved in natural or man-made disasters can cause the type of severe trauma reaction seen in PTSD. Witnessed events can as well. Watching the plight of others who are in danger, or who are seriously injured or killed, can also cause PTSD. A third type of exposure occurs for some through learning about traumatic events that others have experienced. Typically, the types of trauma experienced in Posttraumatic Stress Disorder would be considered overwhelming and traumatic for anyone exposed to them.

Fear, Helplessness and Horror

Traumatic exposure causes severe emotional and psychological effects such as intense fear, helplessness and horror. In PTSD-related trauma, one is abruptly confronted with overwhelming life circumstances and adverse consequences that induce trauma symptoms. Exposure to the following can result in PTSD:

• the possibility of one’s own serious injury or loss of physical integrity (extreme violation)
• the possibility of one’s own death
• one’s own actual serious injury or loss of physical integrity
• the possibility of another’s serious injury or loss of physical integrity
• the possibility of another’s death
• another’s actual serious injury or loss of physical integrity
• another’s death

Types of Symptoms

Posttraumatic Stress Disorder manifests as clinically significant and persisting trauma symptoms for more than one month. Symptoms of the disorder are grouped into three major categories. These are:

• symptoms of re-experiencing the trauma
• numbing or avoidance symptoms
• hyperarousal symptoms

Re-experiencing

A central characteristic of this disorder is a re-experiencing of the traumatic event. This usually occurs with distressful memories and intrusive thoughts (unwanted thoughts that occur spontaneously as if ‘intruding’). Both of these symptoms, if severe enough, will interfere with usual concentration, decision-making, problem-solving, mood stability, sense of well-being, performance and participation in daily events. They are considered clinically significant if they interfere with important areas of functioning such as the performance of one’s usual social, occupational or family roles and routines. Distressful memories and intrusive thoughts can also interrupt sleep, affect appetite and interfere with other types of self-care and health maintenance activities. If severe and persistent enough, these cognitive symptoms can occur in all life situations. In that case, all realms of normal functioning are seriously affected.

Traumatic events are also re-experienced in dreams or nightmares. The trauma may be relived in dreams that replay actual events or in dreams and nightmares that relate to the trauma in more symbolic and exaggerated ways. Fear, helplessness and/or horror are usual reactions to such dreaming. These types of trauma symptoms can cause an individual to have chronically inadequate sleep and to resist sleep altogether.

Another form of re-experiencing is commonly called flashbacks. These are intense experiences of reliving trauma while awake. They are brief periods of dissociation in which the past event seems to be occurring in the present. Flashbacks are disorienting and very distressful experiences. The fear, helplessness and/or horror of the original situation are vividly relived and some will respond to them as if the trauma is actually happening again. These are called dissociative experiences because one is abruptly separated or detached (dissociated) from the actual present situation and events.

Numbing and Avoidance

Trauma symptoms can manifest as ‘shutting down’ or unresponsiveness to one’s current experience. “Numbing’, or dulled emotions and sensations, cause a lack of interest and diminished participation in usual interactions and activities.

Avoiding reminders of the traumatic event also occurs in PTSD. One may actively avoid discussing the event and try to avoid memories, thoughts and feelings about the trauma. Avoidance can significantly interrupt the daily routine as some individuals will seclude themselves, withdrawing from interactions and usual activities or go to other great lengths to avoid reminders of the trauma.

Hyperarousal

A state of increased arousal is typical in PTSD. Elevated levels of fear, distrust, watchfulness (hypervigilance) and anxiety are usual symptoms. Wakefulness, physical agitation, irritability and being easily startled are common manifestations of arousal that persist and interrupt usual functioning. Hyperarousal symptoms are symptoms of alertness and increased energy experienced in situations of danger. In PTSD, these continue well past the time of actual danger.

Types of Posttraumatic Stress Disorder

There are three different types of Posttraumatic Stress Disorder or PTSD. Each is a distinct medical diagnosis. Various times of onset and duration of trauma symptoms are indicated by the specific diagnoses. The three types of this disorder are:

• Acute Posttraumatic Stress Disorder
• Chronic Posttraumatic Stress Disorder
• Posttraumatic Stress Disorder with Delayed Onset

Acute

The acute type of Posttraumatic Stress Disorder involves symptoms of re-experiencing, avoidance and hyperarousal that last less than three months.

Chronic

The chronic type of Posttraumatic Stress Disorder involves symptoms of re-experiencing, avoidance and hyperarousal that persist for three months or longer.

Delayed Onset

In the delayed onset type of Posttraumatic Stress Disorder symptoms of re-experiencing, avoidance and hyperarousal begin after at least six months have passed since the traumatic event.