Posttraumatic stress disorder (PTSD)

     PTSD has been known by many names in the past, such as shell shock during the years of World War I and combat fatigue after World War II. One of the most famous incidents was General George Patton’s slapping of a couple of soldiers during World War II. But, PTSD does not just happen to combat veterans. 
     It is a psychiatric disorder that can occur not just with combat veterans, but also in people who have experienced or witnessed a traumatic event such as a natural disaster, a terrorist attack, serious accidents, life-threatening illnesses, physical abuse and sexual assault during childhood or adulthood. Abuse can be especially traumatic for children...see THIS article in Psychology Today.
     A traumatic event that precedes the onset of PTSD can be experienced either directly or indirectly by an individual. Learning how a loved one died a violent death, or watching someone be assaulted, are examples of indirect trauma. A trauma often threatens a person's sense of self, world, and future, causing trauma-exposed individuals to experience substantial emotional distress. 
     In the United States it is estimated that 61 percent of men and 51 percent of women have experienced at least one trauma during their lifetime. Fortunately, only 8 percent of men and 20 percent of women develop PTSD. 
     With time most people recover, usually within about three months. Common reactions following a traumatic event include intense fear and anxiety, re-experiencing the trauma through intrusive memories and nightmares, avoidance of trauma reminders, irritability and anger, loss of interest in pleasurable activities, difficulty sleeping, feelings of guilt and shame, disrupted relationships, decreased interest in sex, impaired concentration, and activation of other traumatic or negative memories. 
     Individuals who are sexually assaulted develop PTSD at much higher rates than individuals who experience other types of noncombat traumas.  But, any traumatic event can be a watershed moment that creates a discontinuity between someone's pre- and post-traumatic life. At its worst, the trauma will cause prolonged symptoms of PTSD that affect an individual's day-to-day well-being. 
     PTSD symptoms are organized into four subgroups: intrusive symptoms, avoidance symptoms, negative alterations in cognition and mood, and alterations in arousal and reactivity. 

Intrusion Symptoms: 
* Unwanted, distressing memories of the event 
* Recurring trauma-related nightmares 
* Flashbacks – involuntary and vivid re-experiencing of the experience 
* Intense emotional distress and/or noticeable physiological reactions to reminders

Avoidance Symptoms: 
* Persistent avoidance of thoughts and memories related to the trauma 
* Persistent avoidance of external reminders of the trauma (e.g. avoiding the location or people that are that reminders of the trauma. 

Negative Alterations in Cognitions and Mood: 
* A complete lapse in memory of or a feeling of blacking out for parts of the trauma. 
* Perpetual negative expectations about everything Continuous blame of self or others about the traumatic event 
* Persistent negative emotional state and/or the inability to experience positive emotions 
* Loss of interest or participation in significant activities or activities once interested in 
* Feelings of detachment from others and feeling others cannot relate or understand the experience. 

Alterations in Arousal and Reactivity: 
* Easily irritable or angry 
* Reckless or self-destructive behavior 
* More alert 
* Easily startled
* Problems with concentration 
* Difficulties sleeping 

     It is also common for individuals to suffer from depression and some turn to alcohol, drugs or medication to cope with the distress. 

     Acute Stress Disorder is a related condition. It occurs in reaction to a traumatic event, just as PTSD does, and the symptoms are similar. However, the symptoms occur between three days and one month after the event. 
     People with acute stress disorder may relive the trauma, have flashbacks or nightmares and may feel numb or detached from themselves. These symptoms cause major distress and cause problems in their daily lives. 
     About half of people with acute stress disorder go on to have PTSD. An estimated 13 to 21 percent of survivors of car accidents develop acute stress disorder and between 20 and 50 percent of survivors of assault, rape or mass shootings develop it. 

Five Ways To Cope With PTSD
U.S. Department of Veteran Affairs National Center for PTSD