Understanding PTSD

PTSD offers treatment options despite distressing symptoms

/ Author:  / Reviewed by: Joseph V. Madia, MD

Though surely around for as long as man has encountered trauma, posttraumatic stress disorder (PTSD) was not recognized by the American Psychiatric Association until the third edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) was published in 1980.

Since then, the disorder has gained much publicity and much misunderstanding. Though PTSD sufferers can feel lost, there are resources, support and treatment options available to those experiencing PTSD symptoms.

When Does PTSD Occur?

PTSD is an anxiety disorder that can affect people who have experienced a traumatic event, usually involving a life-or-death situation. Some traumatic events that can lead to PTSD include war, sexual or physical abuse or assault, serious accidents or a term in prison. Various roles in a trauma can potentially trigger the disorder. For example, if a devastating fire occurs, PTSD may occur in some victims who were rescued, in the firefighters who responded, in people who lost loved ones, or in passerby’s who witnessed the event, while some involved will not develop the disorder. Why certain people are prone to PTSD is a topic still under investigation by researchers.

It is normal for victims of trauma to experience strong emotions, however when the symptoms are intensely distressing and linger for more than a month, PTSD might be in play.


The symptoms of PTSD can be extremely painful and make it difficult to function normally. In some cases the disorder develops soon after the traumatic event, and in others it does not show up for years. For some sufferers, the distress is constant, while for others it comes and goes in waves.

Despite these variances, there are several major qualifiers associated with PTSD in the latest Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV-TR, published by the American Psychiatric Association). These include the traumatic event origin, duration, and interference with normal functioning discussed previously, as well as the symptoms below.

  • Intrusive Recollection

PTSD sufferers often relive the traumatic event over and over in vivid and realistic ways. These recollections can occur as nightmares, or in waking experiences. The victim may feel like they are very much experiencing the event again. Such experiences can be set off by a trigger that brings back memories of the trauma. The U.S. Department of Veteran Affairs’ National Center for PTSD provides an example of a sexual assault victim hearing a news report about a recent sexual assault and subsequently reliving their personal trauma.  

  • Avoidance

Those with PTSD will strongly avoid talking or thinking about the trauma, or even experiencing places that offer reminders of the event. They can also display an inability to remember certain important details of the event. One aspect of this “avoidance” factor is emotional numbing. Sufferers often show detachment to people or previously enjoyed activities. They may have trouble expressing or even experiencing emotions fully, and display a bleak outlook for the future.

  • Hyper-Arousal

PTSD sufferers may feel constantly agitated and on-edge, leading to issues with concentration and falling and staying asleep.  These feelings often cause outward bursts of anger. Due to the traumatic event origin, those with PTSD can feel like they need to constantly watch their backs for danger.


All of these painful symptoms can lead to other interferences with day-to-day life, like trouble maintaining personal relationships, substance abuse issues, and problems at work. Though PTSD is by its very nature painful and intrusive, there are multiple treatment options available to lessen symptoms and recover.

According to the National Center for PTSD, Cognitive behavioral therapy (CBT) seems to be the most widely effective treatment. CBT, sometimes called talk therapy or mental health counseling, can involve exposure therapy, in which patients repeatedly relive the event in order to desensitize and fully express emotions. CBT can also consist of cognitive therapy, in which patients challenge and explore their belief systems relating to the origin event.

Eye movement desensitization and reprocessing (EMDR) is another common treatment. This therapy involves eye movements combined with exposure to triggers that lead to a reliving of the trauma.

In a 2007 review of 33 randomized studies by Drs. Johnathon Bisson and Andrew Martin entitled “Psychological treatment of post-traumatic stress disorder (PTSD),” evidence showed that these CBT and EMDR treatments proved most effective (as self-reported by patients) amongst various therapies reviewed. Stress management and relaxation also proved effective, though slightly less convincingly than CBT.

The drugs known as SSRIs, or selective serotonin reuptake inhibitors, have also been shown effective in treating PTSD. These medications are traditionally used to treat depression

Beyond these varied professional treatments, the National Center for PTSD also recommends various methods of self-help to cope with the disorder. Tactics like mindfulness practice, peer support groups, exercise, relaxation techniques like meditation and investment in personal relationships are all greatly encouraged and have helped many on their road to recovery. Regardless of an individual sufferer’s path, organizations like the Department of Veterans Affairs (and many others) provide a wealth of resources and support for those with PTSD, ensuring that at the very least, these patients need not feel alone.  

Review Date: 
March 29, 2012