Posttraumatic Stress Disorder

By Sylvia K. Neal, LCSW, MSW © 2007

Posttraumatic Stress Disorder (PTSD) is the psychological reaction following exposure to an extreme traumatic stressor. According to the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) the “experience must involve actual or threatened death, serious physical injury, or a threat to physical and/or psychological integrity”. However, “for children, sexually traumatic events may include developmentally inappropriate sexual experiences with or without threatened or actual violence or injury”.

Traumatic events that are experienced directly can include:

• military combat
• violent personal assault (sexual assault, physical attack, robbery, mugging)
• childhood physical, emotional or sexual abuse, including extreme or prolonged neglect
• being kidnapped, being taken hostage
• terrorist attack
• torture
• incarceration as prisoner of war or in a concentration camp
• natural or manmade disasters
• severe automobile accidents
• diagnosis of a life-threatening illness

PTSD symptoms can include but are not limited to the following:

• Nightmares
• Flashbacks
• Intrusive thoughts or memories
• Emotional detachment
• Insomnia
• Dissociation
• Numbing of feelings
• Avoidance of reminders
• Distress when exposed to triggers
• Irritability
• Hypervigilance
• Memory loss
• Excessive startle response
• Clinical depression
• Anxiety
• Loss of appetite

In addition to PTSD causing psychological responses, research is also indicating that PTSD can cause chemical changes in the brain. PTSD triggers a response chemically in the brain to release stress hormones like adrenaline, much like a flight or fight response. Unlike a normal adrenaline response, these chemicals continue to release in the brain, making it difficult for someone with PTSD to not be in a heightened state of arousal and awareness. What researchers have found is that PTSD can alter and disrupt brain chemistry.

PTSD is both treatable and curable. If you think you have PTSD or have a loved one that you think may have PTSD, seek professional help from a clinician that is experienced in treating PTSD.

References:

• Diagnostic & Statistical Manual of Mental Disorders (4th ed., text revision) (2000). Washington, DC: American Psychiatric Association.
• van der Kolk, MD (2003), The neurobiology of childhood trauma and abuse, Child and Adolescent Psychiatric Clinics, 12, pp. 293 – 317.