Post-Traumatic Stress Disorder (PTSD): Symptoms and Treatment of Stress Disorder

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.
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Avoidance symptoms:

  • 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:

  1. Insomnia, difficulty falling and staying asleep, and recurring nightmares.
  2. 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.
  3. Startling easily, even at small noises.
  4. Difficulty controlling emotions, including anger and irritability, and a lack of positive emotions.
  5. Decreased concentration and memory problems, sometimes including dissociative amnesia where parts of the traumatic event are forgotten but others are vividly remembered.
  6. Pain in various parts of the body due to heightened sensitivity and tension in the nervous system, without any physical cause found.
  7. Emotional numbness and a feeling of detachment from surroundings, especially when triggered by memories.
  8. Negative thoughts about oneself, loved ones, and the future, sometimes including distorted beliefs about the cause and aftermath of the traumatic event.
  9. Feeling disconnected from loved ones and a sense of loneliness.
  10. Engaging in reckless behavior, such as drinking excessively or driving recklessly, for some patients with PTSD.
  11. 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.

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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.

2.Risk factors

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:

How to treat post-traumatic stress disorder

People with anxious, weak, and dependent personalities are at increased risk for post-traumatic stress disorder

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).

Post-traumatic stress disorder and its effects on health and life

Post-traumatic stress disorder (PTSD) can cause more serious effects than other stress-related disorders, such as acute stress reaction and adjustment disorders. The symptoms of PTSD disrupt daily life and make it difficult for patients to learn and work as they did before. In addition, excessive sensitivity can make patients feel isolated, detached, and lose connections with those around them.

Individuals with PTSD may face conflicts in relationships if they do not receive understanding and support from others. Gradually, patients may choose to live in isolation, use alcohol or drugs to forget the traumatic event. Most people with PTSD who do not receive treatment also have to cope with depression, anxiety disorders, and eating disorders.

Similar to other mental disorders, PTSD also increases the risk of physical health problems such as high blood pressure, diabetes, neck and shoulder pain, and insomnia. Without intervention, these conditions can cause physical deterioration and decrease life expectancy. In some cases, patients may attempt suicide in an attempt to alleviate their pain and the haunting memories of the traumatic event.

Diagnosing PTSD

PTSD is diagnosed based on clinical symptoms according to DSM-5 or ICD-10 criteria. These criteria help to determine the diagnosis and differentiate it from other mental disorders that may cause similar symptoms.

Symptoms of post-traumatic stress disorder (PTSD) are more severe than other stress-related disorders. In addition, the hallucinations, illusions, and perceptual disturbances in PTSD patients are diagnosed differently from dissociative disorders, psychotic disorders, and other mental illnesses.

Treatment methods for PTSD

PTSD requires early treatment to prevent complications. In some cases, symptoms tend to decrease over time without treatment. However, if left untreated, symptoms may reoccur, causing disruptions in daily life and long-term personality changes.

PTSD occurs due to changes in brain physiology and psychological trauma from family and social factors. Therefore, treatment requires multiple methods, including pharmacotherapy and psychotherapy. In addition, support from family and the community plays a significant role in recovery.

  1. Pharmacotherapy

Similar to other mental disorders, PTSD patients also have a neurochemical imbalance in the brain. Therefore, doctors will prescribe certain medications to alleviate symptoms. As mentioned, severe stress causes a significant decrease in serotonin levels, leading to PTSD symptoms. Therefore, the preferred medication is selective serotonin reuptake inhibitors.

Types of medication used in the treatment of post-traumatic stress disorder (PTSD):

Selective serotonin reuptake inhibitors (SSRIs): This group of medications helps to increase the concentration of serotonin in the brain, thereby reducing the symptoms of PTSD. In addition to SSRIs, patients may also be prescribed SNRIs – medications that inhibit the reuptake of serotonin and norepinephrine. However, this group of medications has a similar efficacy to SSRIs but carries a higher risk of side effects, so it is less commonly used.

Tricyclic antidepressants: Cases where SSRIs are not effective may be prescribed tricyclic antidepressants. This group of medications affects multiple neurotransmitters, so they are more effective. Among them, amitriptyline is the most effective and has the fewest side effects.

Antipsychotic medication: Antipsychotic medications are also used to improve symptoms of PTSD, particularly hallucinations, delusions, and illusions. In addition, medication also helps to reduce dissociative symptoms and emotional numbness. Currently, risperidone is the most commonly used antipsychotic medication.

Anticonvulsants: Patients who are emotionally unstable or excessively angry when they see objects or situations that remind them of the traumatic event may be prescribed anticonvulsant medications such as carbamazepine and lithium.

Benzodiazepines: Benzodiazepines are used when patients experience nightmares leading to sleep disturbances and excessive agitation. This group of medications has the potential to cause addiction, so it is only used in low doses for a short period of time.

Other types of medication: In addition to the above medications, patients with PTSD may also be prescribed other medications such as beta blockers (propranolol) and atypical antidepressants.

Using medication can be very helpful in controlling the symptoms of post-traumatic stress disorder (PTSD). However, medication alone is not enough, and it must be combined with psychotherapy for the best results. After stabilizing the patient for an extended period, doctors will slowly decrease the dosage to avoid withdrawal symptoms.

  1. Psychotherapy

Psychotherapy is an essential method in treating PTSD. While medication can quickly improve the brain’s biochemical balance, it cannot heal psychological trauma. This is why patients must receive psychotherapy alongside medication.

Psychotherapy helps patients release their emotions and eliminate their traumas about past events. Through this therapy, experts help patients stabilize their mental state and reinforce their personalities, enabling them to face stress with courage and strength. Additionally, psychotherapy directs patients toward healthy living and helps them control accompanying psychological issues.

Post-traumatic stress disorder

Psychotherapy plays an important role in the treatment of post-traumatic stress disorder

Psychological therapies for patients with post-traumatic stress disorder include:

  • Cognitive-behavioral therapy
  • Exposure therapy
  • EMDR (Eye Movement Desensitization and Reprocessing)
  • Supportive therapy

Most patients with post-traumatic stress disorder have sensitive emotions, personality traits, anxiety, and depression. Therefore, after treatment, experts will also provide patients with relaxation techniques to relieve stress and negative emotions in daily life. In addition to individual therapy, group therapy may also be considered to find empathy and gain more experience in overcoming this condition.

Post-traumatic stress disorder

Patients with post-traumatic stress disorder should build a healthy lifestyle to support their physical and mental well-being

Here are some care measures for patients with post-traumatic stress disorder (PTSD):

  1. Maintain a healthy lifestyle: Eating a balanced diet, getting enough sleep, and exercising regularly can help improve overall health and reduce symptoms of PTSD.
  2. Practice relaxation techniques: Techniques such as deep breathing, meditation, and yoga can help reduce stress and anxiety.
  3. Avoid drugs and alcohol: Using drugs or alcohol to cope with PTSD symptoms can actually worsen them in the long run.
  4. Seek social support: Having a strong support network of family and friends can provide emotional support and help reduce feelings of isolation.
  5. Participate in therapy: Continuing therapy after treatment can help maintain progress and provide ongoing support.
  6. Manage triggers: Identifying and avoiding triggers that worsen symptoms can help prevent flashbacks, nightmares, and other PTSD symptoms.
  7. Take prescribed medication: If prescribed medication for PTSD, it’s important to take it as directed and not stop without consulting a healthcare provider.

Overall, taking care of one’s physical, emotional, and social well-being can aid in the recovery process for those with PTSD.

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