What is Post-traumatic Stress Disorder?

“Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.” – Kahlil Gibran

When an individual experiences a traumatic stressor, a wide array of distressing symptoms may arise.  Depending upon one’s individual physiology, temperamental disposition, and life experiences, very different responses may occur as the result of trauma.  The Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR) explains that an individual who develops Post-traumatic Stress Disorder (PTSD) responds to trauma with “intense fear, helplessness, or horror.”

Many people consider such responses to trauma to be normal responses to abnormal situations.  Does it really seem surprising that someone who experiences a horrific natural disaster, witnesses a violent crime, or experiences sexual assault will respond with “intense fear, helplessness, or horror?”  People who experience traumatic events find ways to manage and cope with distressing symptoms in the best way possible, although it is not always an easy task for people to simply “bounce back” from trauma.  The longstanding effects of trauma can last a lifetime, especially when unacknowledged or untreated.

Diagnostic Criteria for PTSD

Individuals who meet diagnostic criteria for PTSD persistently reexperience the traumatic event in one or more of the following ways:

• Intrusive or recurrent distressing memories of the event (e.g., images or thoughts)
• Persistent recurring nightmares of the event
• Feeling or acting as if the traumatic event is being currently experienced (e.g., dissociative flashbacks, hallucinations, or illusions)
• Intense psychological distress when exposed to internal or external reminders of the traumatic event
• Heightened physiological reactivity when exposure to internal or external reminders of the traumatic event

Another tendency of individuals experiencing PTSD is to persistently avoid stimuli associated with the trauma through at least three of the following:

• Efforts made to avoid thoughts or feelings associated with the traumatic event
• Efforts made to avoid activities, people, or places associated with the traumatic event
• Unable to recall important aspects of the traumatic event
• Markedly diminished interest/participation in important activities
• Sense of detachment/estrangement from others
• Restricted range of emotional expression
• Sense of a lack of a foreseeable future

People with a diagnosis of PTSD tend to experience symptoms of increased arousal as indicated by two or more of the following:

• Trouble falling/staying asleep
• Irritable mood/outbursts of anger
• Difficulty with concentration
• Hypervigilance
• Exaggerated startle response

For someone suffering from PTSD, these symptoms persist for at least one month and cause significant distress and difficulty in multiple areas of functioning (e.g., social, occupational, educational).  The severity of symptoms and length of time that PTSD persists depends on a wide range of factors, including but not limited to: individual physiology, personality, family history, childhood experiences, preexisting mental disorders, and severity of/proximity to the traumatic event.

There is no “one way” that PTSD manifests itself any more than there is “one type” of person who is more likely than another type to develop symptoms of PTSD.  Trauma ranges from mild to severe and the same trauma event can be experienced as mild or severe dependent upon individual characteristics.

The long-lasting effects of trauma can impact a person’s intrapersonal and interpersonal functioning for a lifetime.  For some people, long-term effects of a traumatic event may be limited to jumping or gasping when someone unexpectedly enters a room or may be as severe as persistent intrusive thoughts and nightmares that prevent basic functioning.

There are many empirically supported treatments currently used in the treatment of PTSD.  Research does indicate that prevalence of PTSD increases with repeated exposure to traumatic events.  This means that people who have been exposed to multiple traumatic events over time are more likely to develop severe symptoms of PTSD and are less likely to experience spontaneous remission of PTSD.

While only a mental health professional can diagnose you with PTSD, it is worthwhile to trust your own intuition about how you believe that any past traumatic experiences impact your mental and emotional functioning.  Trauma is sensitive, personal, and painful.  It can be terrifying to even remember traumatic events, much less discuss them openly with another person.

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This article is for information purposes only and is not intended for self-diagnosis or as a substitute for consultation.  If you have questions about PTSD or any other mental health issue described above, consult with a mental health professional.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

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