Post-traumatic stress disorder was first identified in soldiers in the 1970s. Today, we know that anyone who has suffered trauma can develop post-traumatic stress disorder or complex post-traumatic stress disorder. PTSD or C-PTSD are devastating anxiety disorders that can destroy lives. Here are the causes, symptoms and treatment.
Post-traumatic stress disorder (PTSD) usually occurs in people who have suffered trauma such as:
- war (military or civilian)
- an accident, usually involving loss of life or danger to life
- disaster such as fire or flood
- sexual assault
- loss of a loved one
- violent robbery
- other significant traumatic event
Complex post-traumatic stress disorder (C-PTSD) happens when a person experiences ongoing or multiple types of trauma, such as:
- physical or sexual abuse
- abject poverty
- school or workplace bullying
- childhood trauma
- other long-term traumatic events
PTSD can appear in children or adults. Children in foster care have shown a high incidence of post-traumatic and complex post-traumatic stress disorder.
Although 50-90% of people experience trauma at least once in a lifetime, only about 8% develop PTSD or C-PTSD. The differences between PTSD and C-PTSD are primarily the root cause and the methods of treatment. Symptoms of both are similar, although re-victimization and loss of sense of self are usually characteristic of C-PTSD.
Symptoms of Post-Traumatic Stress Disorder
According to the American Psychiatric Association, a person may have PTSD or C-PTSD if “the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning.” If symptoms persist for fewer than thirty days, the condition is diagnosed as acute stress disorder.
Common symptoms of post-traumatic stress disorder or complex post-traumatic stress disorder may include:
- anxiety and panic attacks
- inner rage and frustration
- intense feelings of guilt or shame
- clenching or gnashing the teeth
- lack of emotional control
- feelings of helplessness
- loss of self-worth
- loss of sense of self (C-PTSD)
- personality changes
- avoidance and emotional numbing
- impaired memories of the traumatic event(s)
- sleep disorders
- eating disorders
- sexual dysfunction
- hypervigilance (a state of anxiety where the body is constantly on alert)
- exaggerated startle response
- addiction, such as alcoholism or drug abuse
- flashbacks (re-experiencing the event(s), especially in the morning, or while intoxicated)
- blunted blood pressure response
- thousand-yard stare (a detached, numb, distant look)
- anti-social behavior
- criminal behavior
- phobias such as claustrophobia (fear of closed spaces) or agoraphobia (fear of open spaces)
- chronic depression
- thoughts of suicide, or suicide attempts
- re-victimization (for instance, a person abused as a child may keep having abusive relationships) – C-PTSD
Symptoms of PTSD usually arise within three months of the trauma, but in some cases can take years to appear.
Treatment of Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder
Treatment of PTSD and C-PTSD involves a combination of methods, depending on the individual. A physician may prescribe anti-depressant or anti-anxiety medication, especially for patients just beginning treatment. In the long run, psychological methods such as cognitive behavior therapy or exposure therapies may be more effective than medication.
Eye movement desensitization and reprocessing (EMDR) is a structured form of psychotherapy that may help resolve past, present, and future aspects of distressing memories. In EMDR, the emotional, sensory, and cognitive components of the memory may be altered, so the patient begins to remember the event in a less traumatic perspective.
Exposure therapy allows the patient to re-experience the event under controlled conditions, and work through the trauma. The patient may work one-on-one with a counselor, and may also attend group therapy.
There’s no one medication for PTSD or C-PTSD. Different types of medication may target different symptoms. Selective serotonin reuptake inhibitors such as fluoxetine and sertraline have proven effective. Some specific drug treatments for PTSD or C-PTSD may include:
- Clonidine – startle response, hypervigilance and hyperexcitability
- Prazosin – nightmares
- Carbamazepine – mood and aggression
- Topiramate – flashbacks and nightmares
- Zolpidem – sleep disorders
- Risperidone (antipsychotic) – dissociation, mood and aggression
- Nefazodone (antidepressant) – sleep disturbance, depression, anxiety, sexual dysfunction
- Propranolol (beta blocker) – hyperarousal and sleep disorders
- Amitriptyline – avoidance, distress
- Valproic Acid (mood stabilizer) – irritability, aggression, and impulsiveness
Addiction is common in PTSD and C-PTSD patients. Recovery might include drug or alcohol rehabilitation.
Treatment usually takes about six months to a year. Treatment time may vary depending on the individual. Relapse may occur, but in most cases, a person treated for PTSD or C-PTSD can recover and begin to enjoy a normal life.