Basic overview of PTSD
When someone is faced with a frightening situation, their brain normally goes into "high-alert" mode, so the person will be ready to respond if needed.
After a very frightening experience, or if someone experiences dangerous or frightening things many times, their brain may get "stuck" in this "high-alert" mode.
When this happens, a person may struggle with painful thoughts or feelings, and can sometimes develop a type of mental illness called “Post-Traumatic Stress Disorder” (PTSD)
In a person with PTSD, their brain may think they are in danger even if they are safe. This can cause them to become easily startled or scared by things that aren't actually dangerous.
The brain also may have trouble managing the memories of what happened, because they are connected to such strong emotions. A person with PTSD may find that their memories of what happened are "fuzzy," or the memories may come rushing back when the person does not want them to (in nightmares or daytime “flashbacks”).
PTSD can change someone’s day-to-day moods; they may feel sad, guilty, isolated, or irritable, in ways that they did not before.
People with PTSD may also find that it is difficult to sleep or focus on other things. Occasionally, the memories of the experience are so painful that the mind needs to "disconnect" in order to protect itself. Someone may have the sensation that they aren't really in their own body, or that the world around them isn't actually “real” at all.
Treatment for PTSD can be very helpful. Even though painful memories can never be erased, treatment can help them become part of a person’s “past,” and stop them from causing so much pain in the present.
More information on PTSD
Exposure to a major stressor
Post-traumatic stress disorder is a condition that may develop after someone is exposed to a major stressor (i.e. a traumatic event). The DSM-V* defines PTSD-inducing stressors as actual or threatened death, serious injury, or sexual violence. However, research has shown that people may develop symptoms of PTSD after a wide range of experiences (such as sudden separation from a close loved one). People may develop PTSD after experiencing or witnessing an event directly, but in some cases, simply learning about an event that has happened to someone else may result in PTSD.
Symptoms of PTSD
Symptoms of PTSD fall into four major categories. Everyone’s experience of PTSD is unique, and no two cases will look exactly alike.
Intrusion symptoms
The first category is referred to as “intrusion symptoms.” This refers to the fact that many people with PTSD will find themselves thinking about their traumatic experience even when they are not trying to do so. This can take the form of intrusive memories, flashbacks (when a person feels as though they are truly re-experiencing the event), or strong involuntary emotional reactions when reminded of the trauma. Intrusive symptoms can be very distressing; they are not under a person’s control, and may make it difficult for them to remain present in the moment when they are doing other things.
Avoidance
The second category of symptoms is called “avoidance.” Many people with PTSD find that they will try to avoid things that remind them of the trauma (either thoughts, feelings, or things in the external environment), in order to avoid the significant pain associated with these reminders.
Negative alterations in mood or cognition
The third category is called “negative alterations in mood or cognition,” and it refers to the fact that PTSD can often affect someone’s emotions and thought patterns in a broad way, which can have an impact on many areas of life. This is a particularly important category to understand, because while much of the public discourse around PTSD focuses on the intrusive symptoms, it is often the mood-related symptoms that cause the most distress for people suffering from PTSD. Some people begin to feel depressed, and have a difficult time taking pleasure in things they once enjoyed. For many people, connecting emotionally to others becomes far more difficult, and they may start to feel profoundly isolated. Their perspective on the world may shift; sometimes people with PTSD will start to feel more negatively about themselves or other people, and they may also place undue blame on themselves or others for what happened. Additionally, some people may find that they have problems remembering the specifics of what happened during the event, which can be very distressing.
Alterations in arousal or activity
The fourth and final category is called “alterations in arousal or activity.” This essentially refers to the sense of being on “high alert” that is referred to in the comic. People suffering from PTSD often describe feeling “wired” or “on edge,” even when no obvious threat is in front of them. They may be constantly on the lookout for potential danger, and may become startled easily (by things such as loud noises, or being snuck up on). They may also be more irritable or aggressive than previously. Many people may have difficulty sleeping or concentrating.
Dissociative symptoms
Additionally, some individuals will experience “dissociative symptoms” as part of their PTSD. Dissociation can be thought of as the mind’s way of protecting itself from overwhelming feelings. During a traumatic situation, the mind may “disconnect” itself from the present moment, in order to avoid becoming overwhelmed; this is known as “dissociation.” During dissociation, a person may feel as though the situation they are in isn’t really “real,” or they may even feel that they are observing themselves from the outside, rather than existing within their own body. For some people with PTSD, they continue to dissociate even when they are safe; this condition is referred to as the “dissociative subtype” of PTSD.
Getting support
Because many of the symptoms of PTSD can be subtle, it is often difficult for individuals suffering from PTSD and their loved ones to recognize that the struggles they are having may be connected to their trauma. This can lead to strained relationships and difficulties at work, which may further worsen someone’s self-esteem. For this reason, it is extremely important that people who have experienced trauma and are struggling with any of these symptoms seek professional support. Group therapy for PTSD is also available in many areas, which can be especially helpful in decreasing feelings of isolation and disconnectedness. Many resources are available to support families of those suffering from PTSD, as well.
***If you or someone you know is having thoughts about hurting yourself or someone else, call 911 or go to the nearest emergency room immediately. Individuals who are experiencing suicidal thoughts may also call the National Suicide Prevention Lifeline at 1-800-273-8255***
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*Information related to specific diagnostic criteria is based on the DSM. For a complete, formal description of diagnostic criteria, please consult the original text:
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.