What is Post-Traumatic Stress Disorder PTSD?


By David Joel Miller.

Would you know PTSD if you experienced it?

What is? Series

PTSD
Photo courtesy of Pixabay.com

PTSD is something that we hear a lot about, but most people have only a general idea what it involves.  PTSD was first recognized in returning military veterans. It has since been recognized in children who were abused, in cases of domestic violence, as the result of sexual assaults as well as the result of other traumas. While each case of PTSD is unique, they have many features in common.  Many people with PTSD may also have one or more other psychiatric disorders, some of which are likely the result of traumatic incidents. Below is a list of the features that professionals use to identify PTSD.

PTSD involves a specific trauma.

Something has happened or there was a high risk it would happen.  This trauma involved death, possible serious bodily injury, or a sexual assault. This event needs to happen to you or someone close to you, not just be something you saw on the television.  This event was either violent or sudden and unexpected.

Also included in the definition of a trauma below, are the effects which dealing with the incident has on first responders or other emergency personnel.

This traumatic event keeps forcing its way back into your life.

Part of PTSD symptoms are the recurrent memories of the event.  You may have nightmares about what happened or things connected to that event.  Some people with PTSD experience spacing out or dissociation.  You may also experience flashbacks and in these times it can feel like the event is happening again.

These recurrent intrusive memories are easily triggered.  Both internal triggers, thoughts and feelings, and external triggers, people, places, and things, may bring back the memory.

People with PTSD try to avoid reminders.

There are all kinds of ways to avoid being reminded of something that has happened. You may avoid going to certain places or events. People may turn to drugs, alcohol or other distractions.  They may try to avoid having feelings, or other thoughts about the incident.

Sometimes the brain does this job for you.  You may find that there are periods of time for which you have no memory. Some people describe this as having a blackout or amnesia.  They may avoid activities which are in any way connected to these unpleasant memories.

Behavior changes when you experience Post-Traumatic Stress Disorder.

People with this disorder often become irritable and angry.  They may become either self-destructive or reckless.  Part of this condition is having an exaggerated startle response.  In the aftermath of the trauma, people may develop poor concentration and impaired sleep.  Someone with PTSD may stop engaging in activities that used to be fun, they detach from others and may say that they just can’t feel happy.  These behavioral changes are also characteristic of depression, and the two disorders often occur together.

PTSD can cause cognitive changes.

In the aftermath of trauma, it is common for people to blame themselves.  They may tell themselves that if they hadn’t been there, or had been more careful, it would not have happened.  Negative thought patterns may develop.  People begin to feel bad about themselves, other people, and the future.  These cognitive changes can result in developing depression.

PTSD needs to last a while and not be something else.

This condition is expected to last more than a month after the stressor.  As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem we’re likely to think this is something other than PTSD.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

For more on this topic see Trauma- and Stressor-Related Disorders. 

See Recommended Books.     More “What is” posts will be found at “What is.”

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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4 thoughts on “What is Post-Traumatic Stress Disorder PTSD?

  1. It is somewhat problematic to describe mental disorders as though they are ‘real things’ rather than social construct a based on a slowly evolving and minimal evidence base.

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    • Not sure what you are saying here. Sounds like a semantical argument. Is “love” or “hope” a real thing? How about “life” or “death?” All words are symbols to represent something. Our understanding of love and life and death are all “social constructs.”
      Mental illnesses are defined “syndromes” which have a specific group of characteristics. To receive a diagnoses, you need to have symptoms that impair your ability to work, go to school, have relationships or cause you distress. I think anyone with depression or anxiety or PTSD knows that they feel badly and wishes that feeling would change regardless of the name we call their issue.
      Our current diagnostic labels do not generally imply a cause. Changing the label does not change the reality. What we now call PTSD has been called “shell shock” battle fatigue” and so on. When we see these symptoms in non-military clients we could call it “aversive childhood experiences” as your blog appears to do or battered wife syndrome” or a number of other things.
      Changing the name of unpleasant truths has not altered the reality and finding the cause may give us someone to blame but it does not mean we know how to change things for that person. Yes, the evidence base continues to evolve but the evidence is hardly minimal. People who report symptoms we currently call Depression, anxiety or PTSD run into the tens of millions.
      Thanks for your contribution to the discussion.

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  2. I’m not saying that the problems don’t exist, that’s a jump! Feeling badly in a variety of ways is reported by people and we should believe them. It’s just that we need to recognise the limitations of DSM V or any current system of categorisation. Those categorisations are social constructs, we can see this as they change so much! A problem with diagnostic labels unlike medical diagnoses, us the usually medical diagnosis do have a cause. PTSD is relatively unusual because the is clearly an event which causes the harm. This means that if you are interested in preventing PTSD, ACEs matter – a lot. Thanks for reading the blog. It’s not focussing on the same things as your blog, and so doesn’t really describe things very well I not too happy with it yet to be honest.

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    • I would agree that the new DSM-5 is far from perfect. It along with the ICD will continue to be revised. From my point of view, it would be a mistake to think that medical diagnosis is all that certain. When we talk about acute illnesses, broken legs or a tuberculosis infection the diagnosis is more precise. These days 75% of what doctors’ treat are chronic illnesses, high blood pressure, obesity, type two diabetes. The International classification of Diseases is getting revised along with the DSM. Thanks for commenting and good luck on your blog.

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