What is Posttraumatic Stress Disorder (PTSD?)

Posttraumatic stress disorder, or PTSD, is a response some people have to experiencing a dangerous and frightening event.¹ Most people will experience a traumatic event in their lifetimes. However, not everyone exposed to a traumatic event develops PTSD as a result. About 6% of adults in the U.S. have had PTSD in their lifetime, though that includes people who received treatment and are no longer experiencing symptoms.²

PTSD affects people of every age and walk of life, so knowing the facts about PTSD could help you, a loved one or a client you serve professionally. Keep reading to learn all about PTSD’s causes, symptoms and treatment options available to those afflicted with the disorder, as well as the work that healthcare professionals do to serve such a vulnerable population.

PTSD is caused by experiencing an extremely stressful event or witnessing one firsthand. People who have served in the military, especially those who saw combat, are at higher risk of developing PTSD than civilians.² PTSD can also be a result of sexual assault, different types of abuse, accidents, natural disasters or other seriously stressful events.¹ The current definition of posttraumatic stress disorder in psychology encompasses people who developed symptoms after witnessing traumatic events, even if they did not experience the event directly.³

PTSD can affect people from all nationalities, cultures and religions. Still, certain factors indicate a higher prevalence of PTSD in certain populations. For instance, the Department of Veterans Affairs has found that women are almost twice as likely to have PTSD as men.² Genetics play an as-of-yet undefined role as well, which researchers are still working to understand better.

For some people, symptoms of PTSD may manifest as early as a month after a traumatic event, but for others, it may be years later.⁴ People suffering from PTSD often experience intrusive memories or flashbacks of the traumatic event, as their minds force them to relive it over and over. They may also avoid people or places that remind them of the event. Victims of PTSD may also show signs of heightened reactivity, feeling easily startled or threatened in normally safe situations.⁵

It’s important to note that symptoms vary for patients with PTSD. For instance, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires a person to meet only one of the five different possible intrusion symptoms—where the person is vividly and distressingly reminded of the traumatic event—to qualify for a potential diagnosis.⁶ Likewise, “negative alterations in mood or cognition” require the subject to meet just two out of the seven diagnostic criteria. That’s because every example of PTSD looks different in different people.

Is posttraumatic stress disorder a mental illness? And if so, how is it diagnosed?

PTSD is indeed a form of mental illness, which a mental health professional may diagnose using the DSM-5. The DSM-5 specifies that a PTSD diagnosis may be warranted if the person has been exposed to a traumatic event that meets specific criteria, and:

• Has one or more symptoms showing the event is intruding on their mind
• Consistently avoids thinking about the event, associating with external reminders of the event or both
• Experiences two or more negative changes in thinking and mood
• Experiences at least one form of heightened reactivity following the event

Also, the symptoms must last for at least one month and cause clinically significant impairment or dysfunction. Finally, if substance use or any other medical condition is a possible alternative cause, a diagnosis of PTSD cannot be given.⁶

If you or someone you know is suffering from the apparent symptoms of PTSD, it’s important to seek help from a healthcare professional like a psychiatrist, psychologist or clinical social worker. These trained clinicians can assess the mental and physical symptoms using the DSM-5 criteria in order to make an appropriate diagnosis and start the steps toward finding a workable treatment plan.¹

There are several commonly-recognized therapies for PTSD that the American Psychological Association (APA) has found to have positive results.

Cognitive-behavioral therapy (CBT) focuses on the relationships that exist among thoughts, feelings and behaviors, with the goal of empowering the client to change their life for the better by understanding their mind. Cognitive therapy, a variant of CBT, focuses on helping patients address their trauma by working through their thoughts around it. Prolonged exposure therapy is also a specific form of CBT, which helps clients diminish the continuing effects of traumatic memories by carefully approaching and exploring them in a safe environment.⁷

The APA has noted three psychotherapies that can be helpful treatment options, though they warn the research supporting these therapies is not yet as conclusive as other recommended types of therapy:⁷

1. Eye movement desensitization and reprocessing therapy (EMDR) uses eye movements to stimulate brain activity and recovery while the patient focuses on the traumatic memories
2. Narrative exposure therapy encourages clients to form the story of their lives to better frame the trauma they experienced 
3. Brief eclectic psychotherapy focuses on managing the patient’s negative emotions relating to a traumatic event

A doctor may also prescribe a medication to help manage PTSD symptoms. Currently, sertraline, paroxetine, fluoxetine and venlafaxine are conditionally recommended by the APA.⁷

With the right management strategies, many people dealing with PTSD have continued to lead meaningful lives. In addition to psychotherapy, there are many coping strategies people can practice in day-to-day life.⁸

It can be helpful to read or hear others describe PTSD in their own experience. This can help people living with PTSD see what’s common for those in the same situation, and feel less alone. Avoidance of stimuli and feelings related to the traumatizing event is a common symptom of PTSD, but talking about memories with friends, family or a counselor can deprive the memory of its power.⁸

Practicing active relaxation while doing something enjoyable is also a helpful strategy for many people. Going for a walk in nature, executing breathing exercises or prayer and meditation are all good options, but relaxation is unique to the individual, so everyone with PTSD should work on figuring out what helps them relax.⁸

People with PTSD also need to remain aware of the support systems they can lean on. For most, this will include friends and family. A licensed mental health professional can also be included here. Likewise, community and national resources can help in the battle against PTSD, both for civilians and veterans alike.⁹

Solid strategies and well-tested therapies can help people with PTSD recover and live full and healthy lives. However, in a world full of potentially traumatizing events, it’s important for social workers to be aware of the possibility that their clients may qualify for a PTSD diagnosis, so they can understand the clients’ experiences and provide the best help possible.

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