PTSD Clinic

What is Posttraumatic Stress Disorder (PTSD)?

Post traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

• Combat or military exposure
• Child sexual or physical abuse
• Terrorist attacks
• Sexual or physical assault
• Serious accidents, such as a car wreck.
• Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.

After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

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What are the symptoms of PTSD?

Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

There are four types of symptoms: reliving the event, avoidance, numbing, and feeling keyed up.

1.) Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event.Triggers might include:

• Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
• Seeing a car accident, which can remind a crash survivor of his or her own accident
• Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped

2) Avoiding situations that remind you of the event:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.

• A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
• A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
• Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

3) Feeling numb:
You may find it hard to express your feelings. This is another way to avoid memories.
" You may not have positive or loving feelings toward other people and may stay away from relationships

• You may not be interested in activities you used to enjoy
• You may forget about parts of the traumatic event or not be able to talk about them.

4) Feeling keyed up (also called hyperarousal):
You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:

• Suddenly become angry or irritable
• Have a hard time sleeping
• Have trouble concentrating
• Fear for your safety and always feel on guard
• Be very startled when someone surprises you

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What do we know about PTSD and the Military?

If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTSD.

Experts think PTSD occurs:

• In about 30% of Vietnam veterans, or about 30 out of 100 Vietnam veterans.
• In as many as 10% of Gulf War (Desert Storm) veterans, or in 10 veterans out of 100.9
• In about 6% to 11% of veterans of the Afghanistan war (Enduring Freedom), or in 6 to 11 veterans out of 100.
• In about 12% to 20% of veterans of the Iraq war (Iraqi Freedom), or in 12 to 20 veterans out of 100.
• Currently, about 15% of all military personnel in Iraq are women. Women in the military are at higher risk for exposure to sexual harassment or sexual assault than men.

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war.

Among veterans using VA health care, about:
" 23 out of 100 women (23%) reported sexual assault when in the military
" 55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military

Even though military sexual trauma is far more common in women, over half of all veterans with military sexual trauma are men.

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What are other common problems?

People with PTSD may also have other problems. These include:

• TBI: Approximately 15% of U.S. Army soldiers, surveyed after a year-long deployment to Iraq, reported an injury that involved loss of consciousness or altered mental status. More than 40% of these soldiers, with TBI, met the criteria for PTSD.
• Alcohol problems: Between 12- 15 % of active duty, reserve and National Guard soldiers, returning from Iraq, reported alcohol problems although less that 1% were referred for help.
• Suicide: The suicide rate for veterans is about 7 times higher than the baseline risk in the general population. State data (45 states) reported that in 2005 veterans were 2 times as likely to commit suicide than non-veterans. Veterans had a rate of 18.7 - 20.8 suicides per 100,000. In Veterans, aged 20-24, had a suicide rate 2-4 times higher than non-veterans of the same age. Non-veterans (20-24 years of age) had a suicide rate of 8.3 per 100,000 while same aged veterans had a suicide rate of 22.9 - 31.9 per 100,000.
• Aggression: Moderate husband-to-wife aggression occurred in approximately 11 to 13% of couples and severe aggression in 2.5 to 4.5%.

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What treatments are available?

When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better.

There are good treatments available for PTSD. Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or Eye Movement Desensitization and Reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.

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What can I do if I think I have PTSD?

If you think you have PTSD, it's important to get treatment. Treatment can work, and early treatment may help reduce long-term symptoms.

If you think you have PTSD:

• Talk to your family doctor.
• Talk to a mental health professional, such as a therapist.
• If you're a veteran, contact your local VA hospital or Vet Center.
• Talk to a close friend or family member. He or she may be able to support you and find you help.
• Talk to a religious leader.

Many people who might need assistance with something like the symptoms of PTSD are afraid to go for help.

• 1 out of 5 people say they might not get help because of what other people might think.
• 1 out of 3 people say they would not want anyone else to know they were in therapy.

A study that's been done of soldiers coming home from Iraq found that only 4 in 10 service members with mental health problems said they would get help. Some of the most common reasons they gave were:

• Worried about what others would think
• Thought it might hurt their military career
• Might be seen as weak
  

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