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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Post-Traumatic Stress Disorder

What is it?

Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops after experiencing or witnessing a traumatic event in which there is the threat of injury or death. Examples of such events include violent attacks (being mugged or raped, for instance); serious car accidents; child abuse; natural disasters, such as earthquakes and floods; and war. The fear associated with the event persists, and sufferers tend to relive the trauma through nightmares or flashbacks. They also typically avoid situations or circumstances that remind them of the trauma. PTSD can develop at any age. Symptoms may follow the event or may not occur until months—or even years, as is often the case with child abuse— after the trauma. Not everyone who experiences a traumatic event develops PTSD. However, some studies indicate that up to 58 percent of people involved in a situation in which there was a serious threat of injury may develop PTSD. Factors that contribute to the development of the disorder include a history of other psychological conditions, such as depression and anxiety, and a poor social support system. Treatment for PTSD is most successful when symptoms occur soon after the tragedy and treatment is initiated early in the course of the disorder.

What Causes It?

  • Experiencing or witnessing a traumatic event, particularly one caused by another person, such as a physical attack, or child abuse. Those who have experienced previous traumatic events are more vulnerable to the condition.
  • People with a history of depression or anxiety may be more prone to PTSD. In addition those with alcohol or drug abuse problems may be more susceptible to the disorder.
  • In older people, social isolation and the loss of loved ones may cause previously unresolved symptoms of PTSD to reappear.

Prevention

  • Social support, good health, being married, and having financial security are factors that make a person less likely to experience PTSD following a traumatic event.
  • Early treatment may help prevent more chronic forms of PTSD.

Diagnosis

  • A diagnosis of PTSD is made when a person experiences several symptoms of the disorder after witnessing or experiencing a traumatic event. For PTSD to be diagnosed, symptoms must persist for longer than a month and seriously affect one's social or occupational functioning.

How to Treat It

  • Psychotherapy, particularly cognitive-behavioral therapy, may help the patient work through the traumatic experience and relieve associated symptoms of anxiety.
  • Relaxation techniques, such as deep breathing, may be recommended.
  • Antidepressant medications, which include the selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase (MAO) inhibitors, and tricyclic medications, are effective in treating PTSD. A combination of medication and psychotherapy is often recommended.
  • Antiadrenergic drugs, commonly used to treat high blood pressure, may be prescribed to treat certain symptoms of PTSD, such as outbursts of anger, an exaggerated startle response, and nightmares.
  • Patients may benefit from group therapy or support groups.
  • Underlying substance abuse should be treated for patients to receive the full benefit of treatment for PTSD.

When to Call a Doctor

  • Call a mental health professional if you have lingering feelings of anxiety or depression following a traumatic experience, or if symptoms of PTSD are impacting work and personal relationships.