A memory is like a tapestry, woven with the images, scents, emotions, sounds and tactile sensations experienced by the person at that particular time. If one small fiber of that tapestry is pulled, the entire fabric can come to the forefront of the person’s mind once more. The smell of hot dogs on the grill might flood a child with memories of last year’s 4th of July barbeque. Lilacs in bloom might remind a woman of her garden wedding ceremony, held in early June. It’s remarkable how one tiny detail can bring an entire day into sharp focus.
People with post-traumatic stress disorder (PTSD) are almost too good at recalling vivid details like this, and the memory their brain serves up is far from pleasant. In fact, for a person with PTSD, almost everything the person encounters during the course of a day reminds him or her of one specific moment in time, and often, that moment was truly horrible. Over time, a person with PTSD becomes consumed with a terrible memory, unable to control the playback.
The disorder begins with some form of trauma. According to the American Academy of Family Physicians, trauma that is prolonged and associated with an intense level of fear is more likely to cause PTSD than transient episodes of trauma that the user gets through without being frightened. Participating in, or witnessing, these events could lead to PTSD:
- Natural disasters
- Terrorist attacks
- Severe physical illnesses
- Unexpected death of a loved one
An article published in the journal Current Opinion in Psychiatry suggests that 15 to 25 percent of people who endure a significant trauma will go on to develop PTSD. The authors acknowledge that many people heal on their own, without any form of medical intervention, but they also state that some people do need help in order to heal.
Some researchers suggest that people who enter brief counseling periods right after they experience trauma can prevent PTSD from developing. For example, a study published on PubMed found that providing just one counseling session to survivors of trauma, right after the trauma occurred, was beneficial. The researchers note, however, that more studies should be performed in this area in order to give a more solid understanding of why these brief interventions were helpful.
It’s also possible that people with other mental illnesses such as depression or anxiety disorders are at higher risk for developing PTSD. These mental illnesses can interrupt mental functioning, and some people develop obsessive thought patterns during the course of these diseases. Having obsessive thoughts could simply make PTSD worsen. And, having another mental illness could just weaken the resolve, and make it easier for PTSD symptoms to take hold, and then take over.
Some people develop PTSD symptoms immediately after the event. Others repress their symptoms for months or even years. In either case, most people with PTSD report feeling overwhelmed with memories of the event. They may drift into memories multiple times during the day, even when they don’t want to think about what has happened, and at night, they may relive the event over and over in vivid detail. Some people even act out their dreams, jumping out of bed, kicking and yelling.
During the day, the person might seem withdrawn and isolated, refusing to discuss the event or any memories that may be coming to the surface. Underneath that calm and smooth exterior, however, the person might be on high alert, with a racing pulse and tense muscles, waiting to spring into action.
These symptoms might also appear with PTSD, according to Mental Health America:
- Chronic pain or recurrent headaches
- Stomach upset or diarrhea
- A feeling of tightness or burning in the chest
- Panic attacks (the sudden onset of a pounding heart, sweating, dizziness and a feeling of impending doom)
Some people with PTSD express their symptoms to their doctors, their families and their friends. Other people develop a severe mistrust of others through the course of their disease, and they may be reluctant to express any sort of problem.
Impact of PTSD
For people living with PTSD, suicide is a real and present risk. It can be difficult for the person to experience the same horrible memories, day after day, and feel as though the mind has spun completely out of control. For these people, suicide begins to seem like a reasonable option. People who have PTSD and symptoms of major depression face an even higher risk of suicide. According to a study published in the American Journal of Psychiatry, 80 percent of people studied who had both PTSD and depression had thoughts of suicide. This is an alarming number, and it underscores why PTSD treatment is so very important.
PTSD can also impact the lives of the family members of the person with the disorder. In fact, according to the American Psychological Association, PTSD is one of the mental health conditions most likely to result in relationship problems. The person with PTSD may not sleep with his or her partner, as the nightmares may become too frightening for the partner to witness. The couple may fight frequently, as the person with PTSD may have trouble controlling his or her anger. As fears about security grow, the person with PTSD may undertake excessive precautions to keep children safe, and this could result in parental arguments.
A person with PTSD may also have trouble holding down a job or interacting with friends. The person may avoid leaving the house, for fear of experiencing a panic attack or an unwelcome memory in front of other people. The person may be unable to express emotion, and may seem flat and boring to others, which could also increase isolation.
A Diagnosis of PTSD
Some people with PTSD experience all of the classic signs of the disorder, and they’re able to clearly articulate what has happened and how it has impacted them during their daily lives. Other people may not demonstrate all of the same symptoms, or they may deny that they have any symptoms at all. It can seem as though obtaining an accurate diagnosis of PTSD is difficult, if not impossible.
The United States Department of Veterans Affairs recognizes this difficulty, and has written extensively on the topic. The organization suggests that some doctors are more qualified to spot the disease, due to advanced training and experience, and people who think they have PTSD are more likely to get an accurate diagnosis if they take their time in choosing a provider that has this sort of experience and expertise. The organization suggests that patients ask their doctors these questions before agreeing to be tested for PTSD:
- Have you dealt with patients who have experienced a trauma similar to mine?
- Have you performed at least 10 trauma assessments?
- Have you completed a formal training program in PTSD?
- Do you hold a professional membership in an organization that specializes in PTSD?
- How do you assess PTSD in your patients?
In a typical PTSD diagnosis appointment, the provider will ask the person to complete a written questionnaire about his or her symptoms. The person might also be asked to describe how he or she is feeling now, and how he or she felt before the event occurred. No machines are used, no blood is taken and no other invasive tests are performed. The patient just tries to answer honestly, and the provider listens closely. This doesn’t mean, however, that the test is entirely subjective. According to an article published in the Journal of Traumatic Stress, providers use a 17-point grading system called the PTSD Symptom Scale when they’re reviewing the interview notes and the patient’s self-test. People who reach above a certain threshold on this scale have the disease, while others who do not reach above that scale do not obtain a diagnosis of PTSD.
After the Diagnosis
When the patient has a firm diagnosis of PTSD, he or she will talk to the provider at length about the treatment types available to help control symptoms and restore the person to wellness. Often, according to an article published in the journal Australian Family Physician, psychotherapy techniques can help the person learn to experience triggers without experiencing negative memories. It’s hard work, and it involves a significant amount of patient coaxing by the therapist and willingness to experiment by the patient, but the results can be dramatic.
People who have been medicating the symptoms of PTSD through the use of drugs or alcohol might need more intensive therapies. In fact, these people might need to enter an inpatient program like the one we offer at Axis. Here, they can step away from the stress and triggers of the outside world and focus on their thought patterns, their coping skills and their healing. Contact us today for more information on our program.