Post-traumatic stress disorder (PTSD) is an anxiety disorder that
can develop after exposure to a terrifying event or ordeal in which
grave physical harm occurred or was threatened. Traumatic events
that can trigger PTSD include violent personal assaults such as
rape or mugging, natural or human-caused disasters, accidents, or
military combat. PTSD can be extremely disabling.
Military troops who served in the Vietnam and Gulf
Wars; rescue workers involved in the aftermath of disasters like
the terrorist attacks on New York City and Washington, D.C.; survivors
of the Oklahoma City bombing; survivors of accidents, rape, physical
and sexual abuse, and other crimes; immigrants fleeing violence
in their countries; survivors of the 1994 California earthquake,
the 1997 North and South Dakota floods, and hurricanes Hugo and
Andrew; and people who witness traumatic events are among those
at risk for developing PTSD. Families of victims can also develop
the disorder.
Fortunately, through research supported by the National Institute
of Mental Health (NIMH) and the Department of Veterans Affairs (VA),
effective treatments have been developed to help people with PTSD.
Research is also helping scientists better understand the condition
and how it affects the brain and the rest of the body.
Many people with PTSD repeatedly re-experience the ordeal
in the form of flashback episodes, memories, nightmares, or frightening
thoughts, especially when they are exposed to events or objects
reminiscent of the trauma. Anniversaries of the event can also trigger
symptoms. People with PTSD also experience emotional numbness and
sleep disturbances, depression, anxiety, and irritability or outbursts
of anger. Feelings of intense guilt are also common. Most people
with PTSD try to avoid any reminders or thoughts of the ordeal.
PTSD is diagnosed when symptoms last more than 1 month.
About 3.6 percent of U.S. adults ages 18 to 54 (5.2 million people)
have PTSD during the course of a given year. About 30 percent of
the men and women who have spent time in war zones experience PTSD.
One million war veterans developed PTSD after serving in Vietnam.
PTSD has also been detected among veterans of the Persian Gulf War,
with some estimates running as high as 8 percent.
PTSD can develop at any age, including in childhood. Symptoms typically
begin within 3 months of a traumatic event, although occasionally
they do not begin until years later. Once PTSD occurs, the severity
and duration of the illness varies. Some people recover within 6
months, while others suffer much longer.
Research has demonstrated the effectiveness of cognitive-behavioral
therapy, group therapy, and exposure therapy, in which the patient
gradually and repeatedly relives the frightening experience under
controlled conditions to help him or her work through the trauma.
Studies have also shown that medications help ease associated symptoms
of depression and anxiety and help promote sleep. Scientists are
attempting to determine which treatments work best for which type
of trauma.
Some studies show that giving people an opportunity to talk about
their experiences very soon after a catastrophic event may reduce
some of the symptoms of PTSD. A study of 12,000 schoolchildren who
lived through a hurricane in Hawaii found that those who got counseling
early on were doing much better 2 years later than those who did
not.
Co-occurring depression, alcohol or other substance abuse, or another
anxiety disorder are not uncommon. The likelihood of treatment success
is increased when these other conditions are appropriately identified
and treated as well.
Headaches, gastrointestinal complaints, immune system problems,
dizziness, chest pain, or discomfort in other parts of the body
are common. Often, doctors treat the symptoms without being aware
that they stem from PTSD. NIMH encourages primary care providers
to ask patients about experiences with violence, recent losses,
and traumatic events, especially if symptoms keep recurring. When
PTSD is diagnosed, referral to a mental health professional who
has had experience treating people with the disorder is recommended.
People who have suffered abuse as children or who have had other
previous traumatic experiences are more likely to develop the disorder.
Research is continuing to pinpoint other factors that may lead to
PTSD.
It used to be believed that people who tend to be emotionally numb
after a trauma were showing a healthy response, but now some researchers
suspect that people who experience this emotional distancing may
be more prone to PTSD.
NIMH and the VA sponsor a wide range of basic, clinical, and genetic
studies of PTSD. In addition, NIMH has a special funding mechanism,
called RAPID Grants, that allows researchers to immediately visit
the scenes of disasters, such as plane crashes or floods and hurricanes,
to study the acute effects of the event and the effectiveness of
early intervention.
Studies in animals and humans have focused on pinpointing the specific
brain areas and circuits involved in anxiety and fear, which are
important for understanding anxiety disorders such as PTSD. Fear,
an emotion that evolved to deal with danger, causes an automatic,
rapid protective response in many systems of the body. It has been
found that the body's fear response is coordinated by a small structure
deep inside the brain, called the amygdala. The amygdala, although
relatively small, is a very complicated structure, and recent research
suggests that different anxiety disorders may be associated with
abnormal activation of the amygdala.
The following are also recent research
findings:
• In brain imaging studies, researchers have found that the
hippocampus—a part of the brain critical to memory and emotion—appears
to be different in cases of PTSD. Scientists are investigating whether
this is related to short-term memory problems. Changes in the hippocampus
are thought to be responsible for intrusive memories and flashbacks
that occur in people with this disorder.
• People with PTSD tend to have abnormal levels of key hormones
involved in response to stress. Some studies have shown that cortisol
levels are lower than normal and epinephrine and norepinephrine
are higher than normal.
• When people are in danger, they produce high levels of natural
opiates, which can temporarily mask pain. Scientists have found
that people with PTSD continue to produce those higher levels even
after the danger has passed; this may lead to the blunted emotions
associated with the condition.
Research to understand the neurotransmitter systems
involved in memories of emotionally charged events may lead to discovery
of medications or psychosocial interventions that, if given early,
could block the development of PTSD symptoms.
National Institute of Mental Health (NIMH)
Office of Communications
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or 1-866-615-NIMH (6464), toll-free
TTY: 301-443-8431; FAX: 301-443-4279
FAX 4U: 301-443-5158
E-mail: nimhinfo@nih.gov
Web site: http://www.nimh.nih.gov/
For additional information on PTSD, visit the Web site for the National
Center for Post-Traumatic Stress Disorder of the Department of Veterans
Affairs at: http://www.ncptsd.org/
Information on Surviving Bipolar.Com or Community of
Hope forums is intended as an informational tool only and should not
be relied upon as and are not a substitute for consultation with your
counselor, therapist, doctor, psychiatrist or other health care provider.
. Consult your healthcare professional regarding health issues and advice
on treatment. Views and contributions expressed and posted to Surviving
Bipolar.Com or Community of Hope forums, are the views of the poster
and not necessarily the views of Mariant Enterprises, Inc., Surviving
Bipolar.Com or Community of Hope forums. To view our complete disclaimer
CLICK HERE.
