Post-Traumatic Stress Disorder (PTSD)

What is PTSD?

Post-traumatic stress disorder, or ‘PTSD’, is a mental health problem that you may get by going through a harmful, scary or stressful event (known as ‘trauma’ or ‘traumatic events’).[1]These events may include serious accidents, family violence, bullying, rape, war or natural disasters.[2,3] It is normal to feel very worried and afraid during and after such events. These feelings usually go away with time, but with PTSD they are stronger and keep coming back.[4]People with PTSD relive the traumatic events through uncontrollable thoughts, flashbacks and memories.[1] This may lead to trouble with their family relationships or friendships, and difficulties dealing with daily life.[5]

What are the symptoms of PTSD?

Not everyone with the symptoms listed below will have PTSD. They may be caused by other mental health conditions. But if you have any symptoms, it is important to get them checked by your doctor.

 

To have PTSD, your symptoms should have lasted for at least one month.[1] Symptoms of PTSD can be very different from person to person, but usually fall under these categories:[1–6,9]

Reliving the traumatic events:

  • Nightmares
  • Vivid flashbacks or intrusive memories that make you feel like the event is happening right now
  • Uncontrollable thoughts or images of the traumatic event
  • Physical symptoms like a fast heartbeat, sweating or trembling

 

Avoiding thoughts, memories or feelings:

  • Staying away from anything that reminds you of the traumatic event, such as a place or object
  • Trying to avoid thinking, remembering or feeling anything about the event

 

Alertness and feeling ‘on edge’ (hyperarousal):

  • Reacting strongly when anything reminds you of the traumatic event (or for no reason)
  • Feeling as if there is always danger close by (hypervigilance)
  • Being easily startled
  • Being easily upset and having bursts of anger
  • Having trouble sleeping and finding it difficult to relax in general
  • Having difficulty concentrating

Changes in thinking (cognition) and mood:

  • Not being able to remember important parts of the traumatic event
  • Negative thoughts, feelings or beliefs about yourself or others, such as ‘I am a bad person’ or ‘No one can be trusted’
  • Loss of interest in activities you used to enjoy

 

In children younger than 6 years old symptoms may also include:

  • Wetting the bed after having learnt to use the toilet
  • Not being able to talk or forgetting how to
  • Acting out the traumatic event when playing
  • Becoming very clingy with a parent or another grown-up

 

Older children and teenagers tend to have symptoms similar to those of adults.[1]

What are the different types of PTSD?

[3,6,7]

  • PTSD
  • Delayed on-set PTSD
  • Complex PTSD
Learn more about Post-Traumatic Stress Disorder

What causes PTSD? Who is at risk of PTSD?

You may get PTSD by going through a harmful, scary or stressful event.[1] It might be something that happened to you or to someone close to you.[4] Some examples of events that may cause  PTSD include:[3,4,6,8]

 

  • Serious accidents, such as car crashes

 

  • War or a terrorist attack

 

  • Natural disasters, such as wildfires and or earthquakes

 

  • Domestic or child abuse

 

  • Violent personal attacks, including rape, robbery, kidnapping or torture

 

  • Bullying, including racism and homophobia

 

  • Losing someone close to you

 

Factors that are known to increase the chance of a person developing a disorder are called ‘risk factors’. Having a risk factor does not mean that you will definitely get the disorder, but the more risk factors you have can make it more likely.

 

People of all ages can get PTSD, but females are more likely to get PTSD than males.[8–10] Other risk factors for PTSD are.[1,4,8]

 

  • Facing trauma again and again, or over a long period of time
 
  • Not having enough support from your family, friends or other people in your life
 
  • Having a job that can expose you to traumatic events, such as a firefighter or soldier
 
  • Having difficult childhood experiences
 
  • Having a personal history of anxiety or depression
 
  • Having a parent with a mental health condition

How is PTSD diagnosed?

You should visit your doctor if your symptoms last more than 4 weeks after a traumatic event.[1,3] If your doctor thinks you might have PTSD, they will talk to you about your symptoms to get as much information as possible.[3] They will ask if you have gone through a traumatic event recently or at any time in the past.[3] They will also ask if you are experiencing nightmares or flashbacks about the event.[3]

 

If your doctor finds that you may have PTSD and could benefit from treatment, they will refer you to a mental health professional.[3]

What are the stages of PTSD?

You can get PTSD at any point in your life after a traumatic event.[9] Symptoms of PTSD usually show up within 3 months following the traumatic event.[9] How long PTSD symptoms last and how serious they can become can be very different from one person to another.[9] Going through stressful times may also cause symptoms of PTSD to come back after they have eased off.[9] Some people with PTSD can have symptoms that won't go away for months or years, without a break.[9] Roughly half of people with PTSD are symptom-free within three months.[9]

What treatment options are available for PTSD?

People should always be asked to speak to their doctor about treatment options for them. Treatment of PTSD depends on the severity of the disorder.[8] Other things that are considered  when deciding on treatment are your age, overall health, what treatments have been tried before and your personal choice.[4]

 

The main treatments for PTSD are talk therapy (known as ‘psychotherapy’), medicine or a combination of both.[8] 

 

Talk therapy (psychotherapy)

 

Talk therapy involves talking with a mental health professional in a safe environment.[1,4]This may be a one-on-one session or a group session with others who have faced similar events.[1] There are many different kinds of talk therapy that can help people with PTSD.[1,2] You and your mental health doctor can choose which type is best for you. PTSD is often treated with the following types of talk therapy:

 

  • Cognitive behavioral therapy (CBT). This type of therapy can help you by changing your negative emotions and thoughts related to the traumatic event.[8] Sometimes, a person with PTSD may create ideas and beliefs in their minds after a traumatic event, such as ‘the world is a dangerous place’ or ‘I am a bad person’.[8] Their memories of the event may be different from how it actually happened[1] Your therapist will help you understand and confront your harsh feelings and thoughts around the traumatic event.[3,4,8] CBT can help you cope with the fear and bad memories by changing how you feel and think about what happened.[8,11]

 

  • Prolonged exposure therapy. This type of therapy can help you deal with fear related to the traumatic event.[11] Your therapist will bring you into contact with situations that may remind you of what happened.[11] This may happen through imagination, writing, or even going to the actual place where it all happened.[1] These tools can help you to lessen your reactions over time and cope with your feelings.[1,4]

 

Medicines

 

The most commonly prescribed medicines for PTSD are antidepressants.[11] These medicines can help with feelings of worry, anger, sadness or emotional numbness.[1] Other medicines are also given to people with PTSD for more specific symptoms, such as trouble sleeping and bad dreams.[1]

What is the outlook for a person with PTSD?

Clinical trials (which can also be called ‘research studies’) are designed to look at how safe an experimental treatment is and how well it works. Researchers are working hard to learn more about PTSD.

As researchers learn more about PTSD, clinical trials will be set up to look at potential new treatments. 

If you would like to know more about Roche sponsored clinical trials or are interested in taking part in a clinical trial, speak to your doctor or visit the Roche ForPatients clinical trials page link.

References and further resources

1. National Institute of Mental Health. Post-Traumatic Stress Disorder. Accessed 19 Nov 2022. Available from: Link

2. American Psychiatric Association. Posttraumatic Stress Disorder (PTSD). Accessed 19 Nov 2022. Available from: Link

3. National Health Service. Post-traumatic stress disorder (PTSD). Accessed 19 Nov 2022. Available from: Link

4. John Hopkins Medicine. Posttraumatic Stress Disorder (PTSD). Accessed 19 Nov 2022. Available from: Link

5. U.S. Department of Veterans Affairs. PTSD: National Center for PTSD: Relationships. Accessed 19 Nov 2022. Available from: Link

6. Mind. Post-traumatic stress disorder (PTSD). Accessed 19 Nov 2022. Available from: Link

7. Mental Health UK. Post-Traumatic Stress Disorder (PTSD). Accessed 20 Nov 2022. Available from: Link

8. Shalev A, Liberzon I, Marmar C. Post-Traumatic Stress Disorder. N Engl J Med. 2017 June 22;376(25):2459-2469. Available from: doi:10.1056/NEJMra1612499

9. World Health Organization. 6B40 Post traumatic stress disorder. International Classification of Diseases (11th ed.). Accessed 20 Nov 2022. Available from: Link

10. Olff M. Sex and gender differences in post-traumatic stress disorder: an update. Eur J Psychotraumatol. 2017 Sep 29;8(sup4):1351204. Available from: doi:10.1080/20008198.2017.1351204

11. Kirkpatrick, H. A., & Heller, G. M. Post-Traumatic Stress Disorder: Theory and Treatment Update. The International Journal of Psychiatry in Medicine. 2014 July 9;7(4), 337–346. Available from: Link

 

 

 

 

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