Post-Traumatic Stress Disorder (PTSD)

An estimated 5.2 million American adults ages 18 to 54, or approximately 3.6 percent of people in this age group in a given year, have PTSD (Narrow et al., 1998). About 30 percent of Vietnam veterans developed PTSD at some point after the war (Robins & Regiew, 1991). The disorder also has been detected among veterans of the Persian Gulf War, with some estimates running as high as 8 percent (The NIMH Genetics Workgroup, 1998). More than twice as many women as men experience PTSD following exposure to trauma (Regier et al., 1998).

Depression, alcohol or other substance abuse, or other anxiety disorders frequently co-occur with PTSD. The likelihood of treatment success is increased when these other conditions are appropriately diagnosed and treated as well.

Complex PTSD
Complex PTSD (sometimes called "Disorder of Extreme Stress") is found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood, such as childhood sexual abuse. Developmental research is revealing that many brain and hormonal changes may occur as a result of early, prolonged trauma, and contribute to difficulties with memory, learning, and regulating impulses and emotions. Combined with a disruptive, abusive home environment that does not foster healthy interaction, these brain and hormonal changes may contribute to severe behavioral difficulties (such as impulsivity, aggression, sexual acting out, eating disorders, alcohol/drug abuse, and self-destructive actions), emotional regulation difficulties (such as intense rage, depression, or panic) and mental difficulties (such as extremely scattered thoughts, dissociation, and amnesia). As adults, these individuals often are diagnosed with depressive disorders, personality disorders or dissociative disorders. Treatment often takes much longer, may progress at a much slower rate, and requires a sensitive and structured treatment program delivered by a trauma specialist.

Symptoms

Symptoms associated with reliving the traumatic event:

• Having bad dreams or nightmares about the event or something similar
• Behaving or feeling as if the event were actually happening all over again (these are known as "flashbacks")
• Having a lot of emotional feelings when reminded of the event
• Having a lot of physical sensations when reminded of the event (e.g. heart races, pounds, or "misses a beat"; sweating, difficulty breathing, feeling faint, feeling a loss of control)

• Avoiding thoughts, conversations, or feelings about the event
• Avoiding people, places, or activities that associated with the event
• Having difficulty remembering some important part of the event

Changes frequently made after the event:

• Loss of interest in things that once were considered important
• Feeling "detached" from people and finds it difficult to trust people
• Feeling emotionally "numb" and finds it hard to have loving feelings even toward those who are emotionally close
• Difficulty falling or staying asleep
• Irritable and angry
• Difficulty concentrating
• Feeling that one is not going to live very long and there is no reason to plan for the future
• Feeling easily startled
• Always "on guard"

• Stomach problems
• Intestinal problems
• Gynecological problems
• Weight gain or loss
• Chronic pain (e.g. back, neck, in women-pelvic area)
• Problems getting to sleep
• Problems staying asleep
• Headaches
• Skin rashes and other problems
• Irritability, "short fuse", "quick temper", other anger problems
• Nightmares
• Depression
• Lack of energy, chronic fatigue
• Alcoholism and other substance use problems
• General anxiety
• Anxiety (panic) attacks