Post-Traumatic Stress Disorder (PTSD) is a delayed reaction that occurs at least one month after facing a traumatic event. The symptoms of the disorder are severe and can disrupt daily life, significantly impacting one’s health.
What is Post Traumatic Stress Disorder (PTSD)?
Post Traumatic Stress Disorder (PTSD) is also known as stress disorder after trauma. This term refers to a chronic delayed reaction that occurs in people who have faced a serious stress-causing event. The typical symptoms of the disorder are intrusive recollections, avoidance, and hyperarousal, which can cause significant disruption to both health and life.
PTSD is classified as an anxiety disorder or a stress-related disorder. Although PTSD also causes significant anxiety, experts now believe that this condition should be classified as a stress-related disorder. Like other mental illnesses, the incidence of PTSD is twice as high in women as in men, but there is no difference in race, nationality, or economic status.
A study by Dr. Jonh Adam conducted in New York City showed that about 6% of patients with PTSD-related symptoms were associated with pre-1975 war. Among them, 60% occurred after about 1 month, 27% had a late onset after 6 months, and all patients had symptoms that progressed over 3 months. In particular, the number of patients with symptoms of PTSD within 40 years accounted for 60% of the population. In contrast, the incidence of PTSD in the general population is 0.8-1%.
This study, along with large studies from universities in the United States, shows that PTSD is a chronic disease that has serious effects on health and quality of life. If actively treated, patients can stabilize their lives, but about 9% of cases have to live with the disease for a lifetime.
Symptoms of Post Traumatic Stress Disorder
Post Traumatic Stress Disorder (PTSD) is characterized by 3 main groups of symptoms: re-experiencing (or intrusive recollection), avoidance, and hyperarousal. The symptoms of the disorder are usually easily recognizable and mostly occur after an event of trauma from 1-6 months.
Symptoms of re-experiencing (unintentional intrusive recollection):
- Nightmares or frightening dreams about the event or experience. These dreams can feel very real and can cause the individual to experience distress, fear, and panic, as if they were actually witnessing the event again.
- Being haunted by repeated thoughts about the event. These thoughts can appear involuntarily and cause intense emotions and feelings.
- Collecting and reading a lot of material related to the traumatic event.
- Experiencing psychological and physiological reactions similar to those experienced during the event if there are situations or stimuli that remind the individual of the traumatic event.
- In severe cases, there may be illusions, hallucinations, or flashbacks.
- Trying to avoid thinking about or discussing the traumatic event (including related things).
- Avoiding situations or stimuli that remind the individual of the traumatic event.
- Trying to avoid answering questions from others about the traumatic event. The individual may even react strongly if asked to describe the event and their feelings about it.
- Living in isolation, withdrawing from others, and sometimes exhibiting signs of depression (apathy, sadness, loss of appetite, insomnia, reduced interaction with family and friends, confinement to their room, etc.).
The symptoms of post-traumatic stress disorder (PTSD) include:
- Insomnia, difficulty falling and staying asleep, and recurring nightmares.
- Hypervigilance, always being on guard and alert for potential danger, even in safe situations. This can be seen through a suspicious gaze, scanning the environment, and a hunched or tense body posture.
- Startling easily, even at small noises.
- Difficulty controlling emotions, including anger and irritability, and a lack of positive emotions.
- Decreased concentration and memory problems, sometimes including dissociative amnesia where parts of the traumatic event are forgotten but others are vividly remembered.
- Pain in various parts of the body due to heightened sensitivity and tension in the nervous system, without any physical cause found.
- Emotional numbness and a feeling of detachment from surroundings, especially when triggered by memories.
- Negative thoughts about oneself, loved ones, and the future, sometimes including distorted beliefs about the cause and aftermath of the traumatic event.
- Feeling disconnected from loved ones and a sense of loneliness.
- Engaging in reckless behavior, such as drinking excessively or driving recklessly, for some patients with PTSD.
- Children with PTSD may display tantrums, crying, and reenactment of the traumatic event through play.
These symptoms may develop within weeks to months after the traumatic event but typically do not last longer than six months. They are only considered PTSD if they occur at least one month after the event and significantly disrupt daily functioning. In cases of poor recovery, PTSD may become chronic and increase the risk of developing other mental health disorders.
Causes of stress disorder after trauma
Stress is considered a direct cause of post-traumatic stress disorder (PTSD), and is often very severe. However, not everyone who experiences the same event will develop PTSD. In addition to stress, factors such as personality traits, chronic stress, and high levels of pressure in life have been identified as increasing the risk of developing PTSD.
When faced with stress, the body increases production of cortisol and norepinephrine. Norepinephrine stimulates the body’s systems, leading to symptoms such as numbness, cold extremities, increased respiration, elevated blood pressure, increased heart rate, etc. However, this condition can also affect blood circulation and cause insufficient blood supply to other organs (except the heart and lungs), resulting in body aches, loss of appetite, insomnia, etc.
In addition, increased norepinephrine also decreases serotonin levels – a neurotransmitter that has a calming and soothing effect on the mood. This phenomenon exacerbates negative emotions. This is also why most patients with psychiatric disorders have an imbalance of neurotransmitters.
In addition to norepinephrine, stress also increases cortisol levels. In essence, this hormone is necessary for the body, but excessive levels can damage brain cells. Specifically, increased cortisol leads to cell degeneration in the hypothalamus, leading to decreased concentration and memory loss. Additionally, increased cortisol has been linked to hallucinations, delusions, and other symptoms of PTSD.
Severe stress is a direct cause of post-traumatic stress disorder after trauma. However, PTSD only develops after traumatic events if certain risk factors are present, such as:
The genetic factor plays a role in PTSD. Individuals with chronic and constant stress and pressure are at a higher risk of developing PTSD and other stress-related disorders. Life events that cause sadness and lead to accumulated tension also increase the risk of developing stress-related disorders.
Personality traits are also important in the pathogenesis of PTSD. Those who have unstable emotions, easily agitated, anxious, tense, sensitive, and insecure are more susceptible to trauma. On the other hand, individuals with a sense of responsibility, resilience, and adaptability are less likely to develop PTSD and other stress-related disorders.
Poor physical health and weakness also contribute to the development of stress-related disorders after trauma. Those who have experienced traumatic events in childhood are at higher risk of developing stress-related disorders due to existing psychological sensitivity and vulnerability.
Professionals who constantly witness traumatic events such as traffic police, firefighters, and doctors are also at higher risk of developing PTSD.
Psychological issues, substance abuse, alcoholism, social isolation, and few friends are also risk factors for developing stress-related disorders.
There are many stressful events in life. However, PTSD only occurs after witnessing or experiencing terrifying events such as:
- Those who have been raped and sexually abused
- Individuals who have witnessed human losses in war
- Those who have experienced physical assault or abuse
- Individuals facing life-threatening situations such as kidnapping, assassination, and torture
- Victims of serious traffic accidents and natural disasters
- Those who have experienced complications during pregnancy, such as miscarriage, stillbirth, or infant death, and individuals who have witnessed heinous crimes and atrocities committed by others.
3. Subjects at risk
- Category I victims are those who are directly affected and suffer significant losses from the event.
- Category II victims are the relatives and friends of the victim. Many parents, for example, are susceptible to PTSD when they learn that their children have been abused or sexually assaulted.
- Category III victims include rescue workers such as firefighters, people who provide assistance to victims of traffic accidents, doctors and surgical staff who perform surgeries, and so on.
- Category IV victims are other members of the community.
- Category V victims are those who experience anxiety and distress when thinking about traumatic events.
- Category VI victims are those who are coincidentally involved in the disaster.
Among these categories, groups I and II are at high risk of developing stress-related disorders, including post-traumatic stress disorder (PTSD).