Post-Traumatic Stress Disorder (PTSD) can have a profound impact on anyone because it only takes a single traumatic event for the condition to manifest itself.
Most people are able to process and move on from past trauma within a few weeks or months even if it initially causes distress.
But PTSD is different and can begin to take shape in unexpected ways for others. Traumatic memories may often lay dormant for months, years, even decades before being triggered, coming to the fore through a host of symptoms that won’t subside or go away on their own with time and make it difficult to process trauma.
Because our psyches are often so vulnerable to the effects of trauma, PTSD afflicts more people than we might realize. According to the National Center for PTSD, about six out of every 100 people (6% of the U.S. population) will develop PTSD in their lives, accounting for 13 million people just a few years ago.
PTSD is treatable, and it starts with understanding why and how it happens. Keep reading for more insight into PTSD treatment and how you can begin taking the steps to recover.
What Is PTSD?
PTSD is a mental health condition that can develop after either experiencing or simply witnessing a traumatic or life-threatening event or a history of events.
With PTSD, someone’s natural response system is unable to cope with trauma and subsequent mental health problems. Even when the traumatic moment has passed, someone with PTSD will continue to feel stressed or frightened; their nervous systems overtaxed as if to tell the mind and the body to remain on constant high alert. This can take shape in a number of different ways for someone living with PTSD, like upsetting memories of the traumatic event, nightmares or avoiding the people, places or stark reminders of the traumas.
Although these stress responses may sometimes come and go without warning, with periods of dormancy, PTSD can adversely affect your day-to-day life. Living with PTSD can also influence the development of other related mental health disorders like anxiety and depression.
What Causes PTSD?
There are several different types of traumatic moments in life we can live through, but many of them won’t trigger the onset of PTSD. Specifically, an experience or event leading to PTSD needs to be severe and significant enough to overwhelm and infringe on your ability to process and move on from what’s happened.
“To be at risk for PTSD, the trauma must be a shocking and dangerous event that you see or that happens to you,” says the National Center for PTSD. “During this type of event, you think that your life or others’ lives are in danger.”
Some notable examples of traumatic experiences that can lead to PTSD may include:
- War and combat/military service are prevalent sources of PTSD among veterans. (Prior to the naming of Post-Traumatic Stress Disorder, the condition was called the now-politically incorrect shell-shock.)
- Physical or sexual assault or abuse (childhood and adult)
- Verbal or emotional abuse
- Bullying
- Seeing or being involved in a serious accident, like a car crash or house fire
- Natural disasters, like earthquakes, wildfires, tornadoes or floods
- Acts of terrorism
- An injury or unexpected death of a loved one
- Receiving a serious, grave medical diagnosis
“PTSD starts at different times for different people,” notes the Substance Abuse and Mental Health Services Administration (SAMHSA). “Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later.”
Just how PTSD develops, SAMHSA adds, may depend on:
- How serious the trauma was
- If it was a singular or chronic event
- One’s proximity or placement to the trauma
- Their relationship with either the victim or person responsible for the trauma
How Is PTSD Diagnosed?
A proper PTSD diagnosis must be made by a qualified mental health professional, like a counselor, therapist, psychologist or psychiatrist. They’ll be able to evaluate your symptoms, your history with trauma and the role that PTSD plays in your current life.
To arrive at a diagnosis, a clinician refers to a set of eight clinical criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM manual:
The first part to exploring a PTSD diagnosis, you must have either witnessed, experienced or learned about a trauma-based event that involved actual or threatened death, serious injury or sexual violence. This can also include repeated or extreme exposure to graphic details of the traumatic event (often part of the job for first responders, police or military personnel).
Your trauma symptoms must be intrusive and appear in your daily life enough to cause significant enough distress to qualify for a PTSD diagnosis. This can include anything from recurring, distressing memories, dreams or nightmares of the traumatic event, flashbacks (also known as dissociative reactions) powerful enough to feel as if you’re reliving the event in that waking moment, or psychological and physical distress from reminders of the trauma.
You may find yourself actively trying to avoid or steer clear of anything remotely associated with the traumatic experience(s). It could be internal reminders, like distressing memories, thoughts or feelings, no matter how ephemeral or enduring; or external reminders, like people, places, conversations, activities, objects or situations that trigger pain.
Trauma can sometimes be impactful enough to make significant cognitive changes to the brain. Under this fourth criterion for a PTSD diagnosis, your trauma will need to have changed or altered how you see yourself and the world around you. This could result in persistent, distorted or catastrophic beliefs about you and others (examples could include “I’m a bad person,” “The world is a dangerous, unsafe place” or “Nobody can be trusted”), blaming yourself for the outcome of the trauma (“The abuse wouldn’t have happened if I didn’t anger them”) or feeling fear, horror, anger, guilt or shame. Likewise, symptoms consistent with depression, like detaching or estranging yourself from others or a loss of interest in activities you once enjoyed, are commonplace.
With PTSD, your external behavior is affected alongside your cognition. Your body’s stress response system remains on intense alert and may be exhibited through irritability and angry outbursts, reckless or self-destructive behavior, hypervigilance (a state of always being “on guard”), being easily startled, trouble concentrating, or being unable to fall or stay asleep.
To receive a PTSD diagnosis, your signs and symptoms (culled from criteria B, C, D and E) must have lasted for more than one month.
The negative experiences that trauma has posed on your life must cause significant distress in various areas of life — from socially to professionally to academically and in your daily life.
Finally, a clinician evaluating you for PTSD must make sure that the trauma symptoms fitting all the DSM-5 criteria aren’t on account of effects brought on by medication, substance abuse or an underlying medical issue.
Post-Traumatic Stress Disorder Symptoms
Everyone’s experience with a traumatic event is uniquely their own and can follow a narrative that shapes how they think, feel, act and perceive their reality. However, in tandem with the DSM-5 criteria, the signs and symptoms of PTSD are generally grouped into four main groups:
Intrusive Thoughts and Memories
Trauma can compel you to involuntarily and unwantedly re-experience a traumatic event in a host of ways. In the waking hours of the day, your mind may keep replaying recurrent, upsetting memories of the event. Without warning, intrusive thoughts and flashbacks can come unexpectedly, vivid episodes where one feels like the trauma is happening all over again, in the moment. Flashbacks are often triggered by exposure to certain sensory stimuli, like people, places, sounds or smells.
Trauma can also affect you during the non-waking hours. PTSD sufferers often experience nightmares of their trauma. Disorienting and often disturbing, recurring bad dreams can affect your sleep and create the sense that there’s no relief from traumatic memories.
Avoidant Behavior
Just as someone suffering from PTSD can be reminded of their traumatic past in a myriad of ways, they may also go to great lengths and expense to avoid it at whatever cost. Avoidance can take many shapes and can happen as both conscious and unconscious attempts to stay away from anything that reminds one of their trauma.
You might avoid internal reminders such as trying not to think, remember or talk about the event. This can go hand in hand with averting external, tangible reminders like people, places, activities or situations that conjure a traumatic memory. Combined, it can cause someone with PTSD to become closed off and lead to social isolation as just one way to avoid addressing their trauma.
Negative Thoughts and Feelings
Trauma exposure can profoundly alter one’s beliefs about themselves, others and the world. And PTSD can reinforce this type of negative thinking. “PTSD results from shattered beliefs about the self (e.g., the self is worthy) and the world (e.g., the world is meaningful and benevolent),” notes one study. This can take shape in a few ways. You might have persistently negative and distorted thoughts and opinions about your own value that can lead to harsh self-criticism or blaming others for the traumatic event. These changes in thinking and mood can be accompanied by a myriad of feelings like fear, anger, guilt or shame.
PTSD often results in selective memory — someone suffering from the condition may incorrectly remember details from the traumatic experience or forget important details that can create a cognitive bias about the trauma. Likewise, an estrangement from others and an inability to experience positive emotions or enjoy activities you once loved are depressive symptoms that also tend to accompany this cognitive shift common to PTSD.
Hyperarousal and Reactivity
This fourth symptom of PTSD aligns with the DSM-5 criterion E outlined earlier. Because trauma can be so powerfully affecting cognitively, it can also create behavioral effects, too, that make it difficult to relax or feel safe, even in everyday situations. Someone with PTSD may always display a state of hyperarousal and hypervigilance, that state of being constantly on edge or on guard for danger. It’s a safeguard our nervous systems create to protect us from past trauma but anticipating future threats, even when there is none.
Reactivity can reveal itself in a few ways. In some people with PTSD, it could be irritable behavior and angry outbursts in inappropriate situations. In others, much like in a personality disorder, it might be reckless or self-destructive behavior. Another reactive symptom of PTSD is the tendency to be easily startled, which can exacerbate problems with concentration and sleep.
Treatment for PTSD
PTSD treatment carries one primary goal — to help you regain a semblance of control in your life. Different types of therapy can help and, in some cases, medication may become complementary to effective treatment.
Therapy for PTSD
The main type of PTSD treatment is talk therapy for PTSD, where you’ll sit one-on-one with a therapist or counselor, or sometimes in a group setting with others in recovery at a mental health facility. But there are also therapeutic variations and alternatives that are research-driven and outcome-based, effective in treating PTSD and trauma disorders:
Trauma-Focused Cognitive Behavioral Therapy (CBT)
What is CBT? It’s one of many types of talking therapies for mood and personality disorders, substance and drug use disorders and a host of other mental health and addiction issues. It works with the notion that psychological challenges are rooted in faulty, negative or disordered ways of thinking and unhelpful, learned behavior patterns. CBT helps you to recognize and be mindful of one’s disordered thinking, and by adjusting your mindset, you’ll not only begin to feel better about yourself but act accordingly in more positive ways that serve you well.
For PTSD, this means CBT can give you the insight to identify and change painful thinking patterns associated with your trauma, in a safe environment free of danger or harm. The benefit of therapy is that traumatic memories are addressed, not ignored. You’ll gain a better understanding of them, resolve your relationship with them and know how to move forward — and most importantly, be armed with coping skills whenever triggers or reminders may arise.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a therapy specially designed for trauma disorders like PTSD, to reduce the emotional charge of traumatic experiences, memories and symptoms until they have no more control over you. In EMDR, your therapist will have you move your eyes in a certain way — such as following a light or pen back-and-forth — which research has found helps to desensitize a person to their trauma and help them process and reprocess their view on it.
Eye Movement Desensitization and Reprocessing EMDR has been a leading trauma therapy because, like CBT, it empowers you to make use of your brain’s own natural healing processes and mechanisms, even for the most traumatic memories.
Exposure Therapy
Some therapies are tailored for specific symptoms of a mental illness, and for trauma and PTSD, exposure therapy is meant to do just that. By helping you gradually address avoidant behaviors (criterion C of the DSM-5 diagnosis list on this page) that result in burying or repressing your trauma, you can gently confront and process them and reduce their emotional weight.
Exposure therapy can take a few forms, like revisiting the traumatic memory by visualizing and talking about it during a session (imaginal exposure) or gradually re-engaging with the real-world situations, people, objects or triggers you’ve been avoiding (in vivo exposure). According to the American Psychological Association, the goal is to help you habituate yourself to the trauma; extinguish your negative associations with it; bolster your inner ability to confront your trauma; and process it fully.
Acceptance and commitment therapy (ACT)
Part of the reason a therapy like ACT is so important in the continuum of PTSD care is enabling you to make peace with the past. So often, mental health challenges cause us to either deny our psychological issues or resign ourselves to them. ACT seeks to make amends with this cognitive dissonance by helping you to accept painful trauma instead of eliminating it and commit to making changes in your life in alignment with your values.
ACT works primarily through what’s called the psychological flexibility model. Through a process called defusion, your therapist helps you to accept and detach yourself from traumatic memories. Then, working to remain present and see yourself as a whole, complete person not defined by your trauma, you’ll begin to identify what’s truly important to you and take committed action to meet and exceed your goals.
Dialectical behavioral therapy (DBT)
DBT is another type of talk therapy mainly aimed at people with personality disorders who struggle to manage their emotions. But DBT is also used to treat PTSD, since intense emotional dysregulation is often part of dealing with trauma — feelings of fear, dread, anger, irritability or being closed off to people or places.
DBT is actually an outgrowth of CBT since it works to put you in charge of reframing your emotional responses to trauma. You can expect four main parts to DBT therapy: mindfulness to stay grounded, distress tolerance to manage and mitigate emotions in triggering moments, emotional regulation to become more aware and awake to your emotions at all times and better interpersonal effectiveness to build — and rebuild — better relationships.
Medication for PTSD
Apart from therapy, medication is a second component to a treatment plan for PTSD:
Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are two of the most commonly prescribed antidepressants for a host of mental health conditions, including PTSD. Both work to increase levels of certain neurotransmitters in the brain — namely serotonin and norepinephrine — responsible for mood regulation.
Since depressive symptoms, like withdrawing from family, friends or activities you once enjoyed, are common to PTSD sufferers, starting an antidepressant regimen during PTSD treatment can ease your mood, better facilitate therapy and make recovery easier. If you’re prescribed an SSRI, some brand names you may receive from the pharmacy are Prozac, Paxil or Zoloft; and for SNRIs, Cymbalta, Pristiq or Fetzima.
The hypervigilance symptomatic to PTSD is a type of anxiety response that lends itself to treatment with anti-anxiety medicine. The most widely used type is called a benzodiazepine, a sedative that acts like antidepressants by increasing availability of a neurotransmitter called gamma-aminobutyric acid. GABA helps calm down the nervous system and makes it less active in moments when a flashback, nightmare or trigger creates feelings of fear, panic or dread.
Benzodiazepines have high potential for side effects, dependence, addiction and overdose, so if you’re prescribed one by a psychiatrist (like Xanax or Klonopin), treatment is designed to be short term. Always take no more than the recommended dosage as instructed.
Prazosin is an antihypertensive traditionally prescribed to treat hypertension, or high blood pressure. But it’s also used to help reduce bad dreams and nightmares linked with PTSD. Studies show that 70% to 80% of PTSD sufferers cope with trauma-related sleep disruptions; “people with PTSD develop recurrent nightmares and hyperarousal that in turn lead to insomnia,” notes a study on the use of prazosin for PTSD.
PTSD-related nightmares are thought to be fueled by an abundance of norepinephrine. Taking prazosin works to decrease those neurochemical levels in the central nervous system to allow for better sleep and mood regulation, which can translate to being more rested, awake and alert for therapy during your waking hours of the day.
The Link Between Addiction and Trauma
There’s an indelible connection between trauma, PTSD and addiction. Research links higher rates of substance abuse in PTSD sufferers, with the National Center for PTSD noting that over four in 10 adults, or 45% of people, with PTSD have issues with drugs and alcohol.
Many people with PTSD may turn to alcohol or drugs as a type of self-medication to cope with stress and PTSD symptoms left unaddressed and untreated — a way to numb painful emotions when triggers arise or to suppress hyperarousal or hypervigilance.
Like any substance, this might initially provide some relief or take an edge off but become harmful in the long term. When one becomes dependent, and then addicted to a substance, it can ultimately worsen one’s PTSD and create a co-occurring disorder (the existence of a mental illness and addiction at the same time).
Dual Diagnosis Treatment for PTSD and SUD
Since co-occurring disorders share such a strong connection and overlap with each other, clinically they’re addressed on a single treatment track called a dual diagnosis. It’s necessary because one condition can undermine progress made on the other, so dual diagnosis treatment makes sure that both PTSD and a substance use disorder are focused on simultaneously.
Treatment usually begins with a period of detoxification to wean oneself off a substance until all withdrawal symptoms have passed. Through some of the therapies and medications mentioned above, you might engage in CBT or DBT after detox that focuses on both PTSD and a co-occurring addiction.
Studies show at least a 50% dual diagnosis treatment success rate in people with a co-occurring disorder.
PTSD Treatment at Aliya Health Group
Signing up for PTSD treatment is a brave step toward taking accountability for your own recovery. We pledge and promise to offer a comprehensive continuum of care (a top-to-bottom treatment course that is tailored to and addresses all your needs) and a holistic approach that embraces you, as a whole, complete person.
It also means a chance to heal yourself from PTSD through the power of your own cognitive abilities, but also with the help and support of mental health professionals like counselors, therapists, addiction specialists, social workers and even other peers in recovery with you — a support group to lean on from detox to therapy and beyond.
Intensive, Trauma-Informed Care for PTSD
Some people who enter treatment for PTSD call for a higher level of care — their symptoms may be more severe or a co-occurring disorder is present.
Through our treatment programs, from residential rehab (where you live on-site at our facility for a time) to day programs like intensive outpatient or partial hospitalization (enabling you to return home after the day’s treatment ends), we know that for healing to happen, a more intensive structure needs to be balanced with giving you respect and empowering your recovery with safety, trust and support.
Treatment For PTSD and Trauma Near Me
According to the World Health Organization, up to 40% of those with PTSD recover within a year of seeking treatment. However, the WHO says that only one in four people seek trauma treatment, with reasons ranging from skepticism that PTSD can be treated or a lack of availability of services.
Aliya Health Group’s mission is to meet you where you are and to break down those barriers. You can recover from PTSD at one of our mental health facilities across the United States. Whether you’re searching for mental health in New Jersey or in one of our other locations, mental health treatment — compassionate, caring and outcome-driven treatment — is available close to home, trauma-focused and built for your recovery.
We know you have questions, so if you’re ready to take the first step, our admissions specialists are here to help. We’re on call, 24/7/365 and can talk about mental health services for PTSD, explain your treatment options, verify your insurance and more. Contact us today.
What is PTSD? – PTSD: National Center for PTSD
How Common is PTSD in Adults? – PTSD: National Center for PTSD
Psychiatry.org – What is Posttraumatic Stress Disorder (PTSD)?
PTSD (Post-Traumatic Stress Disorder): Symptoms & Treatment
Post-Traumatic Disorder – What is PTSD? | SAMHSA
Trauma Reminders: Triggers – PTSD: National Center for PTSD
Changes in Negative Beliefs Following Three Brief Programs for Facilitating Recovery After Assault
What Cognitive Bias Is and How To Overcome It
Post-traumatic stress disorder (PTSD) – Diagnosis and treatment – Mayo Clinic
What is Cognitive Behavioral Therapy?
Dialectical Behavior Therapy (DBT): What It Is & Purpose
Antidepressants: Selecting one that’s right for you – Mayo Clinic
Prazosin (oral route) – Side effects & dosage – Mayo Clinic
Integrated Treatment for Co-Occurring Disorders: Building Your Program