Post-traumatic stress disorder, or PTSD, is a condition often associated with war veterans, rape victims and children who have suffered abuse or neglect. But this condition can strike anyone. It can even be triggered by natural events, such as childbirth or death of a parent.
The key factor is whether the person perceives an event as a trauma.
“Ultimately it depends how terrifying or upsetting the event was to you,” says Henry Ford psychologist Philip J. Lanzisera, Ph.D. So if two people are in the exact same car accident, for example, one person could develop PTSD and the other won’t, depending on a combination of factors including genetics, previous history and how they view the incident.
It’s normal to have lingering memories after an upsetting event. You might experience difficulty sleeping, withdraw from friends and family, or feel on edge in the days and weeks after a triggering event. That’s not PTSD. Instead, PTSD sets in if you’re still suffering weeks, months or even years after the event.
Here, Dr. Lanzisera answers your frequently asked questions about this debilitating mental health condition:
Q: What is PTSD?
A: People who develop PTSD show a consistent pattern of changes in the brain that are different from those who do not develop the disorder. Symptoms last for 30 days or more and include each of these four key features:
- Reliving the event. When you have PTSD, you tend to relive the event in your mind, whether through flashbacks or triggering memories. You may also experience intrusive nightmares or an inability to change negative thoughts.
- Avoidance. With PTSD, you avoid situations and things that remind you of the traumatic event. If you’ve been in a terrible car accident, you might avoid driving. If you witnessed a school shooting, you might avoid going back to school. And if you’ve experienced sexual assault, you might avoid situations that place you alone with a member of the opposite sex.
- Emotional change. When you’re suffering from PTSD, jitters, anxiety, and irritability are commonplace. You might be on the lookout for danger at every turn. You might feel hyperaware of every sound. You may have trouble sleeping, concentrating and relaxing.
- Negative impact on relationships. You may find yourself shying away from relationships or even feeling negative feelings toward people you love. You may also avoid sharing the traumatic experience, even with the people who are closest to you.
Q: How common is PTSD?
A: Experts estimate that about 7 or 8 percent of Americans suffer from PTSD at some point in their lives. Locally, up to 40 percent of individuals in the Detroit metropolitan community have experienced an event that could trigger PTSD, according to a study published in the Archives of General Psychiatry about trauma in urban populations. About 25 percent of that 40 percent will actually develop the condition.
Q: Who is most at risk of developing PTSD?
A: PTSD can happen to anyone. People with a personal or family history of anxiety or depression are more likely to develop the condition, and women are more likely than men to experience it. Of all traumatic experiences, sexual assault and combat are among the most likely to produce PTSD. What happens after a trauma also impacts how a person processes it. Chronic stress can increase the risk of developing PTSD, while solid social support can make it less likely.
Q: What are some signs and symptoms I should look for in loved ones?
A: The signs and symptoms of PTSD aren’t the same for everyone. While some symptoms usually begin within a few days of the traumatic event, they can appear months or even years later. Symptoms may also come and go over many years. If your troubling symptoms last for more than 30 days, interfere with your sleep and daily activities, and cause you great distress, you might have PTSD. The only way to know for sure is to meet with a mental health provider.
In children, identifying PTSD can be more challenging. Look for indications of social withdrawal, problems in school or an increase in argumentativeness.
Q: What are the most effective treatments for PTSD?
A: Doctors often treat PTSD with a combination of psychotherapy and medications, such as selective serotonin reuptake inhibitors (SSRIs), which are typically used as antidepressants. In general, it’s best to avoid benzodiazepines for PTSD treatment. Not only are they ineffective for core PTSD symptoms, but they can also be addictive.
The most effective treatment for PTSD is psychotherapy that involves two key components:
- Exposure: Therapy for PTSD must include some form of exposure to traumatic memories, feelings, thoughts and daily activities. So, if you’re afraid of driving, you might start by sitting in a car with the engine off and slowly progress until you can drive down the street. This gradual process allows you to gain control over the thoughts, feelings and behaviors related to the experience.
- Cognitive processing: Cognitive processing helps you learn how to change your thoughts and feelings about the traumatic experience. You learn to understand what the event means to you in terms of safety, power and control and change unhelpful thoughts and behaviors.
Escaping the Trauma
The key to living with PTSD is learning that the world hasn’t changed, but your thoughts and reactions to it have. To reset the brain, you have to stay in the situation and learn to be calm inside of it.
“If you have disturbing thoughts and feelings or triggering memories and flashbacks about an event for more than 30 days, talk to a mental health professional,” says Dr. Lanzisera. “Getting treatment as soon as possible after a trauma can help prevent PTSD symptoms from getting worse.”
If you or someone you know has suicidal thoughts, call the National Suicide Prevention Line at 1-800-273-TALK (1-800-273-8255). To reach the Veterans Crisis line, dial that same number and press 1.
Dr. Philip J. Lanzisera is a psychologist who specializes in treating patients with anxiety and depression, trauma-related disorders and pain-related disorders. He sees patients at Henry Ford locations in Detroit, Clinton Township and Troy.