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Post Traumatic Stress Disorder (PTSD) is an anxiety disorder resulting from experiencing an event in which one feels his / her life is in jeopardy, or is completely horrified and overwhelmed at what they are encountering. Such events can include natural disasters, automobile accidents, physical attack, rape, combat experiences, or upon learning of events without actually experiencing them such as learning of a death, or mass causalities such as the 911 attacks.

PTSD is an anxiety disorder that affects about 7.7 million or 3.47% of American adults. It may occur at any age. PTSD is often accompanied by depression, substance abuse, or one or more other anxiety disorders.

Post-traumatic stress disorder (PTSD) develops after a terrifying ordeal that involved physical harm or the threat of physical harm. Of Learning of a horrific overwhelming event such as the death of a loved one. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones, acquaintance or strangers. 

PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as physical assault, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods, tornados, hurricanes, or earthquakes.

People with PTSD may startle easily, become emotionally numb (especially in relation to people with whom they used to be close), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are often very difficult. 

Most people with PTSD repeatedly relive the trauma in their thoughts during the day and in nightmares when they sleep. These are called flashbacks. Flashbacks may consist of images, sounds, smells, or feelings, and are often triggered by ordinary occurrences, such as a door slamming or a car backfiring on the street. A person having a flashback may lose touch with reality and believe that the traumatic incident is happening all over again.

At this time it is not exactly clear as to why, but not every traumatized person develops PTSD. Symptoms usually begin within 3 months of the incident but occasionally emerge years afterward. They must last more than a month to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

Symptoms Include:

Re-experiencing (flashbacks, thoughts which force their way into your mind even if you don't want them to, nightmares or night terrors and other sleep related problems, as well as experiencing physical symptoms such as shaking hands, racing thoughts, and pounding heart.

Always being on guard, as if ready to fight, run or freeze, difficulty staying focused, or difficulty concentrating, poor short term memory, anger problems, avoiding going around things that remind you of the trauma, difficulty recalling specific details, panic attacks.

PTSD Symptoms—for DSM-IV-TR diagnosis, must have:

1.      a significant event,

2.      followed by persistently reexperiencing the event,

3.      persistent avoidance of stimuli associated with the event/trauma,

4.      and symptoms of hyperarousal. 

These symptom clusters can take the following forms:

Intrusion (Re-experiencing)

Fixation on trauma images, frequently triggered by environmental (& internal) cues

Flashbacks—persistent reliving of trauma, recurring nightmares

Hyperarousal

Sxs of generalized anxiety, startle response

Sleep disturbances ( wake up in a cold sweat) 

Phobias/fears of trauma-related triggers, hypervigilence  

Irritability (with PTSD most emotions can quickly turn into anger)

Constriction (Numbing out/Negative sxs of PTSD)—persistent avoidance sxs:

Withdrawal, avoidance (difficulty going around things that remind yourself of the trauma)

Emotional shutdown, blunting of affect  (emotional numbness)

Other reactions to severe trauma (especially chronic repetitive trauma)

Emotional effects/Alterations in affect regulation

Persistent dysphoria/depression

Chronic suicidal preoccupation (looking for a way to die)

Self-injury (sometimes this can be literal, other times extreme risk taking behavior "I'm not going to kill myself; I'm going to make God do it") 

Inhibitions or explosive anger (or alternating between these)

Distortions in cognitive “schemas” and self-perceptions:

Safety issues/Preoccupation with danger

Hypervigilence => Always on guard 

May limit contacts to avoid fears/”unique vulnerability”

Self-esteem alterations

Feels deserving of bad treatment, intrinsic “badness”

Self as evil, “damaged goods”  (don't deserve the good stuff)

Dependence-Independence conflicts

Hatred for any personal weakness/intolerance for feelings 

Self-reliance at any cost (contingency plans for everything)

Sees vulnerability as despicable

Disruptions in interpersonal relationships

Trust issues (either totally trust, or do not trust at all....Completely safe, or completely dangerous)

Power issues (often use anger )

Intimacy issues (hard to get close to anyone)

                               Transient psychotic symptoms

Derealization, depersonalization, illusions, hallucinations

Somatic effects

Physiological dysregulation

Somatization of emotions

After Treatment

                             See a reversal of the above, in well managed state (Not looking for a way to die like before treatment; now looking for a 

                             way live)

                            PTSD is not unlike other chronic illnesses such as diabetis, it has not cure at this time, but can be well managed or poorly 

                            managed. The difference between well managed and poorly managed is night and day.

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