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Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is an anxiety condition that may occur after a person experiences a traumatic event or if the person witnesses another person’s experience of a traumatic event.  ‘Traumatic events’ are defined as an experience in which a person is at risk of serious injury or death due to violence or an accident.

The following symptoms must be present for a diagnosis of PTSD to be made.

Symptoms of PTSD can also occur even if a person does not experience the traumatic event him or herself.  Anxiety symptoms can occur if a person learns that a traumatic event occurred to a close family member or close friend.  Anxiety symptoms can also occur if a person is exposed to repeated or extremely aversive and upsetting details of a traumatic event(s).

PTSD is an anxiety disorder and therefore shares similar symptoms of anxiety with other anxiety conditions (for example, panic attacks).  However, PTSD also involves unique symptoms such as recurrent, involuntary and intrusive distressing memories of the traumatic event(s).  Recurrent distressing dreams in which the content and/or emotions in the dream are related to the traumatic event.

Other symptoms of PTSD include ‘flashbacks’ in which the individual feels or acts as if the traumatic event(s) were recurring.  Flashback’s may include images of the traumatic event coming to mind or memories of particular sounds or smells also experienced at the time of the traumatic event.  A person who experiences PTSD may also feel intense emotional distress when reminded of the traumatic event.  Reminders of the event usually involve something related to the event itself.  For example, a person who hears screeching car tyres may be reminded of a traumatic car accident they once witnessed and this results in intense anxiety or panic.

Reminders of a traumatic experience can trigger intense anxiety and emotional distress.  Many people consequently exert great effort to avoid distressing memories, thoughts or feelings that are closely related to the event.  Sometimes this is done through efforts to avoid external reminders (e.g., people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts or feelings associated with the traumatic event.

Some of the following symptoms must be present for a diagnosis of PTSD to be made, however it’s possible that not all of the following symptoms will be present for people diagnosed with PTSD.

People who experience PTSD often also report an inability to remember an important aspect of the traumatic event.  They may also develop some persistent and exaggerated negative beliefs or expectations about themselves, others, or the world (e.g., “I am bad”, “no one should ever be trusted”).  Biased thoughts and beliefs may be associated with an excessive or inaccurate tendency to blame him or herself or others for the traumatic event.

Persistent negative emotions (e.g., fear, horror, anger, guilt or shame) may be experienced even after some months or years of the traumatic event.  Some people with PTSD may have a markedly diminished interest in or participation in significant activities (e.g., socialising, holidaying, hobbies) or they may feel detached or estranged from others.  Many people with PTSD also describe a persistent inability to experience positive emotions (e.g., love, happiness etc).

People diagnosed with PTSD may also experience irritable behaviour and angry outbursts (with little or no provocation) typically expressed through verbal or physical aggression toward people or objectsReckless or self-destructive behaviour (e.g., excessive alcohol use) and an exaggerated startle response (i.e., a person may be ‘jumpy’ and be easily scared by sudden changes in their environment like an unexpected loud noise).  Some people experience ‘hyper-vigilance’, which is an intentional focus on the ‘goings on’ and activities around them to scan for danger and keep themselves safe, while others may have difficulties with maintaining concentration, attention or focus.  People who experience PTSD may also report sleep disturbance (e.g., difficulty falling asleep, staying asleep or restless sleep).

A diagnosis of Post-Traumatic Stress Disorder is only made if the symptoms last longer than one month and also if it causes significant distress or impairment in a persons ability to engage socially, occupationally or in another important area of functioning.

As with other conditions, PTSD is only diagnosed if it’s clear that legal or illegal drug use is not causing the excessive fear and other symptoms of anxiety.

None of the following symptoms need to be present for a diagnosis of PTSD to be made, however it’s possible that some or all of the following symptoms will be present for people diagnosed with PTSD.

Some people diagnosed with PTSD also experience ‘Depersonalisation’.  They experience the persistent or recurrent feeling of being detached from their mental processes or body, as if they are an outside observer.  For example, feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly.  Others may experience ‘Derealization’, which is the persistent or recurrent experience of unreality of surroundings.  For example, the world around the individual is experienced as dreamlike, distant or distorted.

While these symptoms can be quite scary to experience it’s important to remember that they are understandable reactions to an abnormal event.  If you experience any of the above symptoms you can rest assured that you haven’t ‘gone crazy’.  You’re experiencing difficulties adjusting to an unusual event most people are lucky enough to avoid in life, and it’s because of this that you may be experiencing any or all of the above symptoms.

Disclaimer:  The information covered on this website is for educational purposes only.  Other disorders including Panic Disorder and Generalised Anxiety Disorder can share symptoms in common with PTSD, so it’s important to speak with your GP or a psychologist about your concerns to clarify what you’re experiencing and to receive appropriate treatment.  A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist.  Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself.

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