Posttraumatic Stress Disorder (PTSD) is a troubling condition that can occur days, weeks, or often even months after exposure to a highly traumatic event. If left untreated, those with PTSD risk suffering with symptoms that can persist and even worsen over time.

People who are afflicted with posttraumatic stress disorder (PTSD) suffer from pronounced symptoms of distress after experiencing or witnessing a traumatic event such as military combat, rape or other criminal assault, child abuse, natural disasters, or catastrophic accidents that prompted intense fear, helplessness, or horror. These profound feelings of disturbance persist at least a month and cause significant distress or compromise in social, occupational, or other important areas of functioning.

PTSD can occur immediately after the initial traumatizing incident or it can have a delayed onset in which the symptoms begin to surface many months later.

Symptoms of PTSD

Symptoms of posttraumatic stress disorder include:

• Persistently re-experiencing the event through intrusive thoughts, dreams, or flashback episodes



• Intense distress when exposed to cues that symbolize or resemble the event



• Avoiding stimuli associated with the event and numbing general responsiveness by: avoiding thoughts, feelings, conversation, activities, places, or people associated with the trauma



• Having an inability to recall important aspects of the trauma



• Lack of interest in participating in regular activities



• Feeling irretrievably detached from others



• A restriction of the normal range of emotions, often including the inability to have loving relationships



• Exaggerated and easily provoked startle response



• Difficulty sleeping



• Irritability or angry outbursts



• Difficulty concentrating



• Sense of foreshortened future



• Feelings of guilt about the event

What Causes PTSD?

Posttraumatic stress disorder has frequently been referred to as "shell shock" or "battle fatigue syndrome." While the exact cause of PTSD is as yet unknown, it is clear that a person with PTSD must have experienced a profoundly distressing event, such as a natural disaster, assault, combat, or serious accident and it is also understood that the disorder tends to be more severe when the stressor involves deliberate human malice, as opposed to a twist of fate or bad luck.

Recent findings from Harvard researchers describe how children from violent homes are especially susceptible to PTSD. A child's vulnerability and helplessness amidst the daily violence and dangerous discord of their family life can be as traumatizing as if they'd experienced war or a natural disaster.

Because not all people who experience a serious stressor develop PTSD, other variables, such as personality and biology, may play a role in who does or does not get the disorder.

Susceptibility to Co-Occuring Mental Disorders

PTSD is associated with increased liklihood of co-occurring mental disorders. In a large-scale study, 88% of men and 79% of women with PTSD met criteria for another mental disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9%), major depressive episode (47.9%), conduct disorder (43.3%), and drug abuse and dependence (34.5%). The disorders most frequently comorbid with PTSD among women were major depressive disorder (48.5%), simple phobia (29%), social phobia (28.4%) and alcohol abuse and dependence (27.9%).

PTSD's Impact On Psychosocial Functioning

PTSD also makes a significant impact on psychosocial functioning, independent of comorbid conditions. This can include problems in family and other interpersonal relationships, employment, and involvement with the criminal justice system.

Physical Symptoms Associated With PTSD

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD.

What is the Course of PTSD?

Most people who are exposed to a traumatic stressor experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that among individuals who go on to develop PTSD, roughly 30% develop a chronic form that persists throughout an individual's lifetime.

The course of chronic PTSD usually has periods of exacerbation and remission or decrease, although for some individuals symptoms may persist at an unremitting, severe level. Some older veterans who report a lifetime of no or only mild symptoms have experienced symptom exacerbations following retirement, severe medical illness in themselves or a loved one, or exposure to reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events).

How Common is PTSD?

An estimated 7.8% of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to have the disorder. About 3.6% of U.S. adults, ages 18 to 54 (5.2 million people), have PTSD during the course of a given year. This represents a small proportion of those who have experienced a traumatic event at some point in their lives (60.7% of men and 51.2% of women reported having experienced at least one traumatic event).

The traumatic events commonly associated with PTSD are:

For Men:
Rape, combat exposure, childhood neglect, and childhood physical abuse.

For Women:
Rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.

About 30% of the men and women who have spent time in war zones experience PTSD. An addition 20% to 25% have had partial PTSD at some point in their lives. Thus, more than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high as 8%.

Treating PTSD

PTSD is treated by a variety of forms of psychotherapy and drug therapy. While there is no definitive treatment, some treatments appear to be quite promising, especially cognitive-behavioral therapy, group therapy, and exposure therapy, in which the individual repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma.

Studies have also shown that medication along with therapy can provide effective treatment. Medications can help ease associated symptoms of depression and anxiety and help ease sleep. Recent findings on the biological changes associated with PTSD have spurred new research into drugs that target these biological changes, which may lead to much increased medication efficacy.