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Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

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Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.

Intrusive memories

Symptoms of intrusive memories may include:

  • Recurrent, unwanted distressing memories of the traumatic event
  • Reliving the traumatic event as if it were happening again (flashbacks)
  • Upsetting dreams or nightmares about the traumatic event
  • Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

  • Negative thoughts about yourself, other people or the world
  • Hopelessness about the future
  • Memory problems, including not remembering important aspects of the traumatic event
  • Difficulty maintaining close relationships
  • Feeling detached from family and friends
  • Lack of interest in activities you once enjoyed
  • Difficulty experiencing positive emotions
  • Feeling emotionally numb

Changes in physical and emotional reactions

Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

  • Being easily startled or frightened
  • Always being on guard for danger
  • Self-destructive behavior, such as drinking too much or driving too fast
  • Trouble sleeping
  • Trouble concentrating
  • Irritability, angry outbursts or aggressive behavior
  • Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:

  • Re-enacting the traumatic event or aspects of the traumatic event through play
  • Frightening dreams that may or may not include aspects of the traumatic event

Intensity of symptoms

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

When to see a doctor

If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts

If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:

  • Reach out to a close friend or loved one.
  • Contact a minister, a spiritual leader or someone in your faith community.
  • Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline , available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.
  • Make an appointment with your doctor or a mental health professional.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe . Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

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You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

  • Stressful experiences, including the amount and severity of trauma you've gone through in your life
  • Inherited mental health risks, such as a family history of anxiety and depression
  • Inherited features of your personality — often called your temperament
  • The way your brain regulates the chemicals and hormones your body releases in response to stress

Risk factors

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

  • Experiencing intense or long-lasting trauma
  • Having experienced other trauma earlier in life, such as childhood abuse
  • Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders
  • Having other mental health problems, such as anxiety or depression
  • Having problems with substance misuse, such as excess drinking or drug use
  • Lacking a good support system of family and friends
  • Having blood relatives with mental health problems, including anxiety or depression

Kinds of traumatic events

The most common events leading to the development of PTSD include:

  • Combat exposure
  • Childhood physical abuse
  • Sexual violence
  • Physical assault
  • Being threatened with a weapon
  • An accident

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Complications

Post-traumatic stress disorder can disrupt your whole life — your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD may also increase your risk of other mental health problems, such as:

  • Depression and anxiety
  • Issues with drugs or alcohol use
  • Eating disorders
  • Suicidal thoughts and actions

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt — all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

  • Posttraumatic stress disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Dec.13, 2016.
  • Clinician's guide to medications for PTSD. National Center for PTSD. http://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp. Accessed Dec. 13, 2016.
  • Understanding PTSD and PTSD treatment. National Center for PTSD. http://www.ptsd.va.gov/public/PTSD-overview/basics/index.asp. Accessed Dec. 13, 2016.
  • Treatment of PTSD. National Center for PTSD. http://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp. Accessed Dec. 13, 2016.
  • Coping with traumatic stress reactions. National Center for PTSD. http://www.ptsd.va.gov/public/treatment/cope/coping-traumatic-stress.asp. Accessed Dec. 13, 2016.
  • Helping a family member who has PTSD. National Center for PTSD. http://www.ptsd.va.gov/public/family/helping-family-member.asp. Accessed Dec. 13, 2016.
  • Post-traumatic stress disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml. Accessed Dec. 13, 2016.
  • Posttraumatic stress disorder. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Posttraumatic-Stress-Disorder/Support. Accessed Dec. 13, 2016.
  • Rothbaum BO. Psychotherapy for posttraumatic stress disorder in adults. http//www.uptodate.com/home. Accessed Dec. 13, 2016.
  • What is posttraumatic stress disorder? American Psychiatric Association. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd. Accessed Dec. 13, 2016.
  • Lifestyle changes recommended for PTSD patients. National Center for PTSD. http://www.ptsd.va.gov/public/treatment/cope/coping-ptsd-lifestyle-changes.asp. Accessed Dec. 13, 2016.
  • Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 10, 2017.
  • Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 13, 2017.
  • Raskind MA, et al. Trial of prazosin for post-traumatic stress disorder in military veterans. The New England Journal of Medicine. 2018;378:507.
  • Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. June 27, 2018.
  • Post-traumatic stress: How can you help your loved one?

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Mayo Clinic Q and A: How to diagnose and support someone with post-traumatic stress disorder

Abby Ashbacher

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DEAR MAYO CLINIC: I'm reaching out because I'm in a tough spot. A close friend rode out Hurricane Ian in Florida last year and it seems to me that he's struggling now. He's angry and jumpy, while being numb to what's happening around him. He told me that he's not sleeping well, especially when another hurricane is in the news. Is it possible that he has PTSD from the hurricane? I'm not sure how to offer support without making him feel uncomfortable.

ANSWER: Post-traumatic stress disorder , also called PTSD, doesn't just happen to characters on the screen. It's a normal, natural response to trauma and happens when the nervous system, which is designed to protect you from danger, gets stuck in the fight-or-flight response.

People may develop PTSD when they experience, see or learn about a shocking experience or event involving harm, threatened death or serious injury. Natural disasters, like experiencing the power and devastation of Hurricane Ian, can trigger PTSD.

In addition to natural disasters, other common events that cause PTSD symptoms include accidents, being threatened with a weapon, combat exposure, abuse or receiving a life-threatening medical diagnosis.

PTSD symptoms

Some people experience distressing symptoms for a short period after a traumatic event but get better with time and self-care. For others, the symptoms worsen over time and begin to interfere with daily activities and relationships.

Overall, PTSD symptoms usually are grouped into four categories:

  • Intrusive thoughts Recurrent and unwanted memories of the traumatic event can cause significant emotional distress or physical reactions. The person may experience nightmares or flashbacks, which is reliving the traumatic event again.
  • Avoidance People with PTSD may avoid talking about the event or steer clear of places, activities or people that remind them of the event.
  • Mood and thought disturbances This category of PTSD symptoms can mirror depression , with people experiencing hopelessness, negative thoughts about themselves or others, detachment from loved ones, lack of interest in activities, emotional numbness and relationship difficulties.
  • Reactivity These symptoms may include being easily startled, always on guard for danger and overwhelming feelings of guilt or shame. The person may be irritable or have angry outbursts. They could have trouble sleeping or concentrating and engage in self-destructive behaviors such as drinking too much or taking illicit drugs.

It's important to note that some people may have a few PTSD symptoms but not enough for an official diagnosis of the condition. In these cases, treatment still can be helpful and can guide people toward self-care strategies and coping mechanisms.

PTSD treatment

The good news for you and your friend is that PTSD is treatable, and many people manage it well or recover from their symptoms. Some protective factors are especially helpful during recovery, including having positive social support from friends like you.

PTSD treatment involves addressing both the physical and mental aspects of the condition. Treatment plans developed by a healthcare professional are tailored to meet the needs of each person.

Certain treatments calm the nervous system and help people regain control over their physical responses to triggers. These tactics help the person have an automatic physical response to tell their body that a perceived threat isn't accurate. Examples include grounding techniques, breath awareness and body-focused interventions. For example, short and shallow breaths can be signs of the nervous system reacting to a trigger. Through treatment, people can identify this reaction and learn to take slow breaths, which can calm the physical reactions.

Cognitive processing therapy can help your friend identify and challenge negative thoughts and beliefs related to the hurricane. Other treatments, such as exposure therapy and eye movement desensitization and reprocessing can help as well. Finally, medications may be helpful when used in combination with other treatment options.

Positive support

I encourage you to discuss your concerns with your friend. Focus on your observations of his behaviors before and after the hurricane. Listen without judgment and don't minimize his feelings. Suggest that he seek professional help to undergo a thorough exam and have his symptoms evaluated.

Finally, I recommend that you learn more about PTSD to get a grasp of what he is going through and why he may react the way he does. Remember that each person's reaction to a traumatic event is valid, and his trauma shouldn't be compared to another's as "better" or "worse."

PTSD isn't a sign of weakness. It's a normal response to traumatic events, like a hurricane in your community. With a combination of interventions and professional help, your friend can learn to manage his symptoms and regain control. — Jackie Richter , Psychiatry & Psychology, Mayo Clinic Health System,  La Crosse, Wisconsin

________________________

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Posttraumatic Stress Disorder (PTSD)

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post traumatic trip symptoms

Posttraumatic stress disorder (PTSD) involves intense, unpleasant, and dysfunctional reactions after an overwhelming traumatic event.

Events that threaten death or serious injury can cause intense, long-lasting distress.

Affected people may relive the event, have nightmares, and avoid anything that reminds them of the event.

Treatment may include psychotherapy (supportive and exposure therapy) and antidepressants.

(See also Overview of Trauma- and Stressor-Related Disorders Overview of Trauma- and Stressor-Related Disorders Trauma- and stressor-related disorders result from exposure to a traumatic or stressful event. Specific disorders include posttraumatic stress disorder (PTSD), acute stress disorder, and adjustment... read more .)

When terrible things happen, many people are lastingly affected. In some, the effects are so persistent and severe that they are debilitating and constitute a disorder. Generally, events likely to cause PTSD are those that invoke feelings of fear, helplessness, or horror. Combat, sexual assault, and natural or man-made disasters are common causes of PTSD. However, it can result from any experience that feels overwhelming and life threatening, such as physical violence or an automobile crash.

These events may be experienced directly (such as having a serious injury or being threatened with death) or indirectly (witnessing others being seriously injured, killed, or threatened with death; learning of traumatic events that occurred to close family members or friends; or participating in the aftermath of someone else's trauma, as is the case with first responders). People may have experienced a single trauma or, as is common, multiple traumas.

post traumatic trip symptoms

It is not known why the same traumatic event may cause no symptoms in one person and lifelong PTSD in another. Nor is it known why some people witness or experience the same trauma many times over years without developing PTSD, but then develop it following an apparently similar episode.

PTSD affects almost 9% of people sometime during their life, including childhood (see Posttraumatic Stress Disorder in Children and Adolescents Acute and Posttraumatic Stress Disorders in Children and Adolescents Acute and posttraumatic stress disorders are reactions to overwhelming traumatic events that involve recurring, intrusive memories of the event as well as emotional numbness and increased tension... read more ). About 4% have it yearly.

PTSD lasts for more than 1 month. It may be a continuation of acute stress disorder Acute Stress Disorder Acute stress disorder is an intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting less than a month. If symptoms persist longer... read more or develop separately up to 6 months after the event.

Chronic PTSD may not disappear but often becomes less intense over time even without treatment. Nevertheless, some people remain severely handicapped by the disorder in social settings, at work, and in their personal relationships.

Symptoms of PTSD

When people with PTSD have symptoms, they typically fall into the following 4 categories:

Intrusion symptoms (the event repeatedly and uncontrollably invades their thoughts)

Avoidance of anything that reminds them of the event

Negative effects on thinking and mood

Changes in alertness and reactions, intrusion symptoms.

The traumatic event may repeatedly reappear in the form of involuntary, unwanted memories or recurrent nightmares. Some people have flashbacks, in which they relive events as if they were actually happening rather than simply being remembered.

People may also experience intense reactions to reminders of the event. A combat veteran's symptoms might be triggered by fireworks, for example, whereas those of a robbery victim may be triggered by seeing a gun in a movie.

Avoidance symptoms

People persistently avoid things—activities, situations, or people—that are reminders of the trauma. For example, they may avoid entering a park or an office building where they were assaulted or avoid speaking to people of the same race as their assailant. They may even attempt to avoid thoughts, feelings, or conversations about the traumatic event.

People may be unable to remember significant parts of the traumatic event (called dissociative amnesia Dissociative Amnesia Dissociative amnesia is amnesia (memory loss) caused by trauma or stress, resulting in an inability to recall important personal information. People have gaps in their memory, which may span... read more ).

People may feel emotionally numb or disconnected from other people. Depression Depression Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to interfere with functioning. It may follow a recent... read more is common, and people show less interest in previously enjoyed activities.

How people think about the event may become distorted, leading them to blame themselves or others for what happened. Feelings of guilt are also common. For example, they may feel guilty that they survived when other people did not. They may feel only negative emotions, such as fear, horror, anger, or shame, and may be unable to feel happy or satisfied or to love.

People may have difficulty falling asleep or concentrating.

They may become excessively vigilant for warning signs of risk. They may be easily startled.

People may become less able to control their reactions, resulting in reckless behavior or angry outbursts.

Other symptoms

Some people develop ritual activities to help reduce their anxiety. For example, people who were sexually assaulted may bathe repeatedly to try to remove the sense of being unclean.

Many people with PTSD try to relieve their symptoms with alcohol or illicit drugs and develop a substance use disorder Substance Use Disorders Substance use disorders generally involve behavior patterns in which people continue to use a substance (for example, a recreational drug) despite having problems caused by its use. The substances... read more .

A dissociative subtype of PTSD Dissociative Subtype of Posttraumatic Stress Disorder A person with the dissociative subtype of posttraumatic stress disorder (PTSD) experiences all the symptoms of PTSD as well as depersonalization (detachment from the self) and derealization... read more has now been recognized. A person with this disorder has all the symptoms mentioned above, plus depersonalization (feeling detached from one's self or body) and/or derealization (experiencing the world as unreal or dreamlike).

Diagnosis of PTSD

A doctor's evaluation, based on standard psychiatric diagnostic criteria

Doctors diagnose posttraumatic stress disorder (PTSD) when

People have been exposed directly or indirectly to a traumatic event.

Symptoms have been present for 1 month or longer.

Symptoms cause significant distress or significantly impair functioning.

People have some symptoms from each of the categories of symptoms associated with PTSD (intrusion symptoms, avoidance symptoms, negative effects on thinking and mood, and changes in alertness and reactions).

Doctors also check to see whether symptoms could result from use of a drug or another disorder.

Doctors diagnose the dissociative subtype of PTSD Dissociative Subtype of Posttraumatic Stress Disorder A person with the dissociative subtype of posttraumatic stress disorder (PTSD) experiences all the symptoms of PTSD as well as depersonalization (detachment from the self) and derealization... read more when, in addition to all of the symptoms mentioned above, the person has evidence of depersonalization (feeling detached from one's self or body) and/or derealization (experiencing the world as unreal or dreamlike).

PTSD often is not diagnosed because it causes such varied and complex symptoms. Sometimes the trauma may not be obvious to the doctor, and people are not always willing to discuss their trauma. Also, the presence of a substance use disorder Substance Use Disorders Substance use disorders generally involve behavior patterns in which people continue to use a substance (for example, a recreational drug) despite having problems caused by its use. The substances... read more or other mental health disorders (for example, depression, anxiety) can distract attention from the PTSD. When diagnosis and treatment are delayed, PTSD can become chronically debilitating.

Treatment of PTSD

Psychotherapy.

Sometimes medications

Treatment of other disorders, such as substance use or major depression

Self-care is crucial during and after a crisis or trauma. Self-care can be divided into 3 components:

Personal safety

Physical health

Mindfulness

Personal safety is fundamental. After a single traumatic episode, people are better able to process the experience when they know that they and their loved ones are safe. It can be difficult, however, to gain complete safety during ongoing crises such as domestic abuse, war, or an infectious pandemic. During such ongoing difficulties, people should seek the guidance of experts on how they and their loved ones can be as safe as possible.

Physical health can be put at risk during and after traumatic experiences. Everyone should try to maintain a healthy schedule of eating, sleeping, and exercise. Drugs that sedate and intoxicate (for example, alcohol) should be used sparingly, if at all.

A mindful approach to self-care aims to reduce the feelings of stress, boredom, anger, sadness, and isolation that traumatized people normally experience. If circumstances allow, at-risk individuals should make and follow a normal daily schedule, for example, get up, shower, get dressed, go outside and take a walk, and prepare and eat regular meals.

It is useful to practice familiar hobbies as well as activities that sound fun and distracting: draw a picture, watch a movie, or cook.

Community involvement can be crucial, even if it is difficult to maintain human connection during a crisis.

Stretching and exercise are beneficial, but it can be equally helpful to sit still and count one's own breaths or listen carefully for surrounding sounds. People can become preoccupied with the trauma or crisis, so it is useful to choose to think of other things: read a novel or get engaged with a puzzle. Unpleasant emotions may typically feel "frozen" during and after a trauma, and it can be a relief to find activities that shift the feeling state: laugh, watch a fun movie, do something silly, or draw with crayons. Under stress, people can become short-tempered, even with people they care about.

Spontaneous kindness can be a win/win solution for everyone: sending a nice note, making someone cookies, and offering up a smile may not only be a nice surprise for the recipient, but they can reduce the hopelessness and passivity that tends to be part of the sender's experience of trauma.

Psychotherapy is central to the treatment of PTSD.

Education about PTSD can be an important early step in therapy. The symptoms of PTSD can feel overwhelmingly confusing, and it is often very useful for people and loved ones to understand how PTSD can include seemingly unrelated symptoms.

Trauma-focused cognitive-behavioral therapy is the most effective treatment for PTSD. This form of therapy, which is also effective for acute stress disorder, includes education about the nature of stress and the body/mind's response to it, modifying one's thinking about the traumatic event and responses to it (or putting things into perspective), and undergoing carefully guided therapeutic exposure to memories of the traumatic experience.

It is important to find a mental health professional who expresses warmth, reassurance, and empathy to help people with PTSD who often suffer from shame, avoidance, hypervigilance, and detachment.

Stress management techniques , such as breathing and relaxation, are important. Exercises that reduce and control anxiety (for example, yoga, meditation) can relieve symptoms and also prepare people for treatment that involves stress-inducing exposure to memories of the trauma.

The strongest current evidence favors structured, focused psychotherapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more , usually a type of cognitive-behavioral therapy Behavioral therapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more called exposure therapy that helps to extinguish the fear left over from the traumatic event.

In exposure therapy , the therapist has people imagine being in situations associated with prior trauma. For example, they may be asked to imagine visiting a park where they were assaulted. The therapist may help people reimagine the traumatic event itself. Because of the often intense anxiety associated with traumatic memories, it is important for people in therapy to feel supported and for the exposure to proceed at the right pace. People who have been traumatized may be especially sensitive and vulnerable to the threat of being traumatized again, so treatment can get stalled if it goes too quickly. Often, treatment may shift from exposure to a more supportive, open-ended treatment, to help people be more comfortable with exposure therapy.

Broader and more exploratory psychotherapy may also ease return to a happier life, such as by focusing on relationships that may have been fractured by PTSD. Other types of supportive and psychodynamic psychotherapy can also be useful as long as they do not shift the focus of treatment away from exposure therapy.

Eye movement desensitization and reprocessing (EMDR) is treatment in which people are asked to follow the therapist's moving finger while they imagine being exposed to the trauma. Some experts think that the eye movements themselves help with desensitization, but EMDR probably works mainly because of the exposure, not the eye movements.

Medications

Medications are most commonly used when a co-occurring condition is identified along with the PTSD. For example, an antidepressant medication is often prescribed when the patient also appears to have a major depression. Similarly, antipsychotic medications (such as haloperidol or aripiprazole ) are used when psychotic symptoms are found along with the PTSD.

Antidepressants may also be an effective treatment for PTSD, even in people who do not also have major depression Depression Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to interfere with functioning. It may follow a recent... read more . Selective serotonin reuptake inhibitors are most often recommended. Other medications that may also be used include mood stabilizers (eg, valproic acid ) and atypical antipsychotics (eg, aripiprazole ).

A variety of other medications are used in people with PTSD. Often, they are used to target specific moods, thoughts, and behaviors that are part of an episode of PTSD or are part of a co-occurring disorder.

For example, to treat insomnia, doctors sometimes give sedating medications such as olanzapine and quetiapine (also used as antipsychotic drugs Antipsychotic drugs Schizophrenia is a mental disorder characterized by loss of contact with reality (psychosis), hallucinations (usually, hearing voices), firmly held false beliefs (delusions), abnormal thinking... read more ); these same medications are sometimes used for mood instability and impulsivity, as are mood stabilizers, such as valproic acid . For nightmares, an often-effective medication is prazosin , a drug more often used for high blood pressure).

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

National Institute of Mental Health, Post-traumatic Stress Disorder : General information on many aspects of posttraumatic stress disorder. including treatment, therapies, and educational programs

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Older adults, patient handouts, what is post-traumatic stress disorder (ptsd).

Post-traumatic stress disorder (PTSD) is a mental health disorder that some people develop after they experience or see a traumatic event. The traumatic event may be life-threatening, such as combat, a natural disaster , a car accident, or sexual assault . But sometimes the event is not necessarily a dangerous one. For example, the sudden, unexpected death of a loved one can also cause PTSD.

It's normal to feel afraid during and after a traumatic situation. The fear triggers a "fight-or-flight" response. This is your body's way of helping to protect itself from possible harm. It causes changes in your body such as the release of certain hormones and increases in alertness, blood pressure, heart rate, and breathing.

In time, most people recover from this naturally. But people with PTSD don't feel better. They feel stressed and frightened long after the trauma is over. In some cases, the PTSD symptoms may start later on. They might also come and go over time.

What causes post-traumatic stress disorder (PTSD)?

Researchers don't know why some people get PTSD and others don't. Genetics, neurobiology, risk factors, and personal factors may affect whether you get PTSD after a traumatic event.

Who is more likely to develop post-traumatic stress disorder (PTSD)?

You can develop PTSD at any age. Many risk factors play a part in whether you will develop PTSD. They include:

  • Your sex; women are more likely to develop PTSD
  • Having had trauma in childhood
  • Feeling horror, helplessness, or extreme fear
  • Going through a traumatic event that lasts a long time
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
  • Having a history of mental illness or substance use

What are the symptoms of post-traumatic stress disorder (PTSD)?

There are four types of PTSD symptoms, but they may not be the same for everyone. Each person experiences symptoms in their own way. The types are:

  • Flashbacks, which cause you to feel like you are going through the event again
  • Frightening thoughts
  • Stay away from places, events, or objects that are reminders of the traumatic experience. For example, if you were in a car accident, you might stop driving.
  • Avoiding thoughts or feelings related to the traumatic event. For example, you might try to stay very busy to try to avoid thinking about what happened.
  • Being easily startled
  • Feeling tense or "on edge"
  • Having difficulty sleeping
  • Having angry outbursts
  • Trouble remembering important things about the traumatic event
  • Negative thoughts about yourself or the world
  • Feeling blame and guilt
  • No longer being interested in things you enjoyed
  • Trouble concentrating

The symptoms usually start soon after the traumatic event. But sometimes they may not appear until months or years later. They also may come and go over many years.

If your symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

How is post-traumatic stress disorder (PTSD) diagnosed?

A health care provider who has experience helping people with mental illnesses can diagnose PTSD. The provider will do a mental health screening and may also do a physical exam. To get a diagnosis of PTSD, you must have all of these symptoms for at least one month:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms

What are the treatments for post-traumatic stress disorder (PTSD)?

The main treatments for PTSD are talk therapy, medicines, or both. PTSD affects people differently, so a treatment that works for one person may not work for another. If you have PTSD, you need to work with a mental health professional to find the best treatment for your symptoms.:

  • Talk therapy , or psychotherapy, can teach you about your symptoms. You will learn how to identify what triggers them and how to manage them. There are different types of talk therapy for PTSD.
  • Medicines can help with the symptoms of PTSD. Antidepressants may help control symptoms such as sadness, worry, anger, and feeling numb inside. Other medicines can help with sleep problems and nightmares.

Can post-traumatic stress disorder (PTSD) be prevented?

There are certain factors that can help reduce the risk of developing PTSD. These are known as resilience factors, and they include:

  • Seeking out support from other people, such as friends, family, or a support group
  • Learning to feel good about your actions in the face of danger
  • Having a coping strategy or a way of getting through the bad event and learning from it
  • Being able to act and respond effectively despite feeling fear

NIH: National Institute of Mental Health

From the National Institutes of Health

  • Post-Traumatic Stress Disorder (PTSD) (American Academy of Family Physicians) Also in Spanish
  • Posttraumatic Stress Disorder (Defense Health Agency)
  • PTSD Basics (National Center for PTSD) Also in Spanish
  • How Is PTSD Assessed? (National Center for PTSD)
  • PTSD Treatment Basics (National Center for PTSD) Also in Spanish
  • Coping Tips for Traumatic Events and Disasters (Substance Abuse and Mental Health Services Administration)
  • Coping with Traumatic Stress Reactions (National Center for PTSD) Also in Spanish
  • Abuse, Maltreatment and PTSD and Their Relationship to Migraine (American Migraine Foundation)
  • Chronic Pain and PTSD: A Guide for Patients (National Center for PTSD)
  • Common Reactions After Trauma (National Center for PTSD) Also in Spanish
  • Effects of PTSD on Family (National Center for PTSD) Also in Spanish
  • PTSD and Problems with Alcohol Use (National Center for PTSD)
  • Related Problems (National Center for PTSD)
  • Sleep Problems and PTSD (Department of Veterans Affairs)
  • How Common Is PTSD? (National Center for PTSD)

Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)

  • Article: The effect of nurse-initiated diary intervention on posttraumatic stress disorder and...
  • Article: BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of...
  • Article: The working mechanisms of imagery rescripting and eye movement desensitization and...
  • Post-Traumatic Stress Disorder -- see more articles
  • FindTreatment.gov (Substance Abuse and Mental Health Services Administration)
  • National Center for PTSD
  • Complex Trauma (National Child Traumatic Stress Network)
  • Helping Your Child Heal after a Trauma (Nemours Foundation) Also in Spanish
  • Posttraumatic Stress Disorder (Nemours Foundation) Also in Spanish
  • PTSD in Children and Teens (National Center for PTSD) Also in Spanish
  • Traumatic Grief (National Child Traumatic Stress Network)
  • Post-Traumatic Stress Disorder (Department of Health and Human Services, Office on Women's Health)
  • Postpartum Post-Traumatic Stress Disorder (Postpartum Support International)
  • Aging Veterans and Posttraumatic Stress Symptoms (National Center for PTSD) Also in Spanish
  • Post-traumatic stress disorder (Medical Encyclopedia) Also in Spanish
  • Traumatic events and children (Medical Encyclopedia) Also in Spanish

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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Posttraumatic Stress Disorder (PTSD)

, MD, New York-Presbyterian Hospital

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post traumatic trip symptoms

Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance of reminders of the trauma; negative cognitions and mood; hypervigilance and sleep disturbance. Diagnosis is based on clinical criteria. Treatment includes psychotherapy and sometimes adjunctive pharmacologic therapy.

(See also Overview of Trauma- and Stressor-Related Disorders Overview of Trauma- and Stressor-Related Disorders Most psychiatric diagnoses are clustered by core symptomatology. Trauma- and stressor-related disorders are unusual because they are grouped by apparent etiology: all of these disorders develop... read more .)

Lifetime prevalence of PTSD approaches 9%, with a 12-month prevalence of approximately 4% ( 1 General reference Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ).

Combat, sexual assault, and natural or man-made disasters are common causes of PTSD. PTSD can lead to serious social, occupational, and interpersonal dysfunction.

While acute stress disorder (ASD) Acute Stress Disorder (ASD) Acute stress disorder is a brief period of intrusive recollections occurring within 4 weeks of witnessing or experiencing an overwhelming traumatic event. Diagnosis is based on clinical criteria... read more can only be diagnosed within the first month after a trauma, PTSD can only be diagnosed at least 1 month after the trauma. ASD can develop directly into PTSD, or PTSD can develop months or even years after the trauma without preceding problems being obvious.

General reference

1. Goldstein RB, Smith SM, Chou SP, et al : The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol 51(8):1137-1148, 2016. doi: 10.1007/s00127-016-1208-5

Symptoms and Signs of PTSD

Symptoms of PTSD can be subdivided into 4 categories:

Negative alterations in cognition and mood

Alterations in arousal and reactivity

post traumatic trip symptoms

Intrusions : Intrusions are unwanted memories or nightmares that replay the triggering event. Intrusions can take the form of "flashbacks," which can be triggered by sights, sounds, smells, or other stimuli. For example, a loud noise might trigger the memory of an assault, leading the person to throw himself to the ground in a panic.

Avoidance : People with PTSD might avoid reminders of the trauma, such as particular parts of town or previously favorite activities.

Negative alterations in cognition and mood : Cognitive and mood changes include disinterest and detachment, distorted cognitions, anhedonia, inappropriate self-blame, and depression.

Alterations in arousal and reactivity : People with PTSD can demonstrate excessive arousal, irritability, and reactivity, or they may seem numb and distant.

A dissociative subtype of PTSD Dissociative Subtype of Posttraumatic Stress Disorder The diagnosis of dissociative subtype of posttraumatic stress disorder (PTSD) is made in patients who meet all the diagnostic criteria for PTSD and also experience persistent or recurrent dissociative... read more has been recognized. This includes all of the symptoms mentioned above, plus depersonalization (feeling detached from one's self or body) and/or derealization (experiencing the world as unreal or dreamlike).

Diagnosis of PTSD

Diagnostic and Statistical Manual of Mental Disorders , 5th Edition, Text Revision (DSM-5-TR) criteria

To meet DSM-5-TR criteria for diagnosis of PTSD, patients must have been exposed directly or indirectly to a traumatic event and have symptoms from each of the following categories for a period ≥ 1 month ( 1 Diagnosis reference Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ).

Intrusion symptoms ( ≥ 1 of the following):

Having recurrent, involuntary, intrusive, disturbing memories

Having recurrent disturbing dreams (eg, nightmares) of the event

Acting or feeling as if the event were happening again, ranging from having flashbacks to completely losing awareness of the present surroundings

Feeling intense psychological or physiologic distress when reminded of the event (eg, by its anniversary, by sounds similar to those heard during the event)

Avoidance symptoms ( ≥ 1 of the following):

Avoiding thoughts, feelings, or memories associated with the event

Avoiding activities, places, conversations, or people that trigger memories of the event

Negative effects on cognition and mood ( ≥ 2 of the following):

Memory loss for significant parts of the event (dissociative amnesia)

Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world

Persistent distorted thoughts about the cause or consequences of the trauma that lead to blaming self or others

Persistent negative emotional state (eg, fear, horror, anger, guilt, shame)

Markedly diminished interest or participation in significant activities

A feeling of detachment or estrangement from others

Persistent inability to experience positive emotions (eg, happiness, satisfaction, loving feelings)

Altered arousal and reactivity ( ≥ 2 of the following):

Difficulty sleeping

Irritability or angry outbursts

Reckless or self-destructive behavior

Problems with concentration

Increased startle response

Hypervigilance

In addition, manifestations must cause significant distress or significantly impair social or occupational functioning and not be attributable to the physiologic effects of a substance use or another medical disorder.

The dissociative subtype of PTSD is diagnosed when, in addition to all of the symptoms mentioned above, there is evidence of depersonalization (feeling detached from one's self or body) and/or derealization (experiencing the world as unreal or dreamlike).

PTSD is often overlooked. The trauma may not be obvious to the clinician, and the patient may not be motivated to discuss a difficult topic. The trauma can lead to a complex swirl of cognitive, affective, behavioral, and somatic symptoms. Diagnosis is often further complicated by the existence of a co-occurring depressive disorder Depressive Disorders Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more , anxiety disorder Overview of Anxiety Disorders Anxiety disorders are characterized by persistent and excessive fear and anxiety and the dysfunctional behavioral changes a patient may use to mitigate these feelings. Anxiety disorders are... read more , and/or substance use disorder Substance Use Disorders Substance use disorders involve a pathologic pattern of behaviors in which patients continue to use a substance despite experiencing significant problems related to its use. Diagnosis of substance... read more .

Diagnosis reference

1. Diagnostic and Statistical Manual of Mental Disorders , 5th edition, Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC, pp 301-313.

Treatment of PTSD

Self-care Self-care Acute stress disorder is a brief period of intrusive recollections occurring within 4 weeks of witnessing or experiencing an overwhelming traumatic event. Diagnosis is based on clinical criteria... read more

Psychotherapy

Pharmacotherapy.

Self-care is crucial during and after a crisis or trauma. Self-care includes:

Personal safety

Physical health

Mindfulness

Personal safety is fundamental. After a trauma, people are better able to process the experience when they know that they and their loved ones are safe. It can be difficult, however, to gain complete safety during ongoing crises such as domestic abuse, war, or an infectious pandemic. During such ongoing difficulties, people should seek the guidance of experts on how they and their loved ones can be as safe as possible.

Physical health can be put at risk during and after traumatic experiences. As much as possible, the at-risk person should try to maintain a healthy schedule of eating, sleeping, and exercise. Substances and medications that sedate (eg, benzodiazepines) and intoxicate (eg, alcohol) should be used sparingly, if at all.

A mindful approach to self-care aims to reduce the stress, boredom, anger, sadness, and isolation that traumatized people typically experience. If circumstances allow, at-risk individuals should make and follow a normal daily schedule, remain involved with their family and community, and practice familiar hobbies (or develop new ones).

It is useful to limit the amount of time spent on news and instead shift to other activities (eg, read a novel, do a puzzle, paint a picture, make cookies for a housebound neighbor).

Trauma-focused cognitive-behavioral therapy (CBT) has the most robust evidence for efficacy for most people with PTSD ( 1 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). As for acute stress disorder (ASD), this form of psychotherapy includes patient education, cognitive restructuring, and therapeutic exposure to recollections of the traumatic experience. Cognitive processing therapy is a type of CBT that involves talking through the implications of traumatic experiences and putting negative thoughts about oneself and the traumatic experiences into perspective, seeing them as different from the actual trauma.

Prolonged exposure is another effective psychotherapy that involves addressing a series of traumatic memories while managing the psychophysiologic response to them with techniques such as controlled breathing, thereby gradually desensitizing the impact of the memories.

Eye movement desensitization and reprocessing (EMDR) is a form of exposure therapy that may also be used ( 2 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). For this therapy, patients are asked to follow the therapist's moving finger while they imagine being exposed to the trauma. While some experts think that the eye movements themselves help with desensitization, others attribute its efficacy mainly to the exposure rather than the eye movements.

Therapeutic style is important in the treatment of PTSD ( 3 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). Warmth, reassurance, and empathy are some of the nonspecific factors that may be unusually important when working with people suffering from such core PTSD symptoms as shame, avoidance, hypervigilance, and detachment.

Evidence for pharmacotherapy in PTSD is less robust than that for trauma-focused psychotherapy ( 4 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). Most often, medications are used to treat co-existing psychiatric disorders, or especially prominent PTSD symptoms, such as depression or anxiety.

Selective serotonin reuptake inhibitors (SSRIs) Selective Serotonin Reuptake Inhibitors (SSRIs) Several drug classes and drugs can be used to treat depression: Selective serotonin reuptake inhibitors (SSRIs) Serotonin modulators (5-HT2 blockers) Serotonin-norepinephrine reuptake inhibitors... read more may reduce anxiety and/or depression ( 5 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). Prazosin appears helpful in reducing nightmares ( 6 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ). A brief course of sedating medications can help with insomnia. Various other medications are being used with increasing evidence of efficacy; these include mood stabilizers (eg, valproic acid ), atypical antipsychotics (eg, aripiprazole ), and psychedelics (such as MDMA, ketamine , and psilocybin) ( 7 Treatment references Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance... read more ).

Treatment references

1. Bisson J, Andrew M : Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev  (3):CD003388, 2007. doi: 10.1002/14651858.CD003388.pub3

2. Wilson G, Farrell D, Barron I, et al : The use of eye-movement desensitization reprocessing (EMDR) therapy in treating post-traumatic stress disorder—A systematic narrative review. Front Psychol ;9:923, 2018. doi: 10.3389/fpsyg.2018.00923

3. Howard R, Berry K, Haddock G : Therapeutic alliance in psychological therapy for posttraumatic stress disorder: A systematic review and meta-analysis. Clin Psychol Psychother 29(2):373-399, 2022. doi: 10.1002/cpp.2642

4. Wright LA, Sijbrandij M, Sinnerton R, et al : Pharmacological prevention and early treatment of post-traumatic stress disorder and acute stress disorder: A systematic review and meta-analysis. Transl Psychiatry 9(1):334, 2019. doi: 10.1038/s41398-019-0673-5

5. Stein DJ, Ipser JC, Seedat S : Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 22006(1):CD002795, 2006. doi: 10.1002/14651858.CD002795.pub2

6. Khachatryan D, Groll D, Booij L : Prazosin for treating sleep disturbances in adults with posttraumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials. Gen Hosp Psychiatry 39:46-52, 2016. doi: 10.1016/j.genhosppsych.2015.10.007

7. Krediet E, Bostoen T, Breeksema J, et al : Reviewing the potential of psychedelics for the treatment of PTSD. Int J Neuropsychopharmacol . 23(6):385-400, 2020. doi: 10.1093/ijnp/pyaa018

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What Is Post-Traumatic Stress Disorder (PTSD)?

What is ptsd, complications.

  • Next in PTSD Guide Understanding the History of PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition where people struggle to recover long after they experience or witness a deeply terrifying event.

In the past, the symptoms that comprise PTSD have been called "shell shock," "battle fatigue," and other names. It is now understood that any trauma–not war trauma alone–can cause the syndrome that is now called PTSD. Events that can lead to PTSD include a natural disaster, accident, combat, or sexual violence.

In this article, learn more about PTSD, including symptoms to look out for, what causes it, how to receive a diagnosis, treatment options, means of coping, and more.

Post-traumatic stress disorder is a psychiatric disorder that may develop after a person has experienced, seen, or been threatened by a traumatic event.

If you're living with PTSD, you may have flashbacks and nightmares, avoid situations that bring back unwanted memories, and struggle with anxiety, sadness, or anger.

You might feel like it's harder to connect with others or keep up with school or work like you used to.

PTSD is not a sign of weakness but a mental health condition that can be diagnosed and treated. With the help of a mental health professional, you or your loved one can begin to heal.

Theresa Chiechi / Verywell

Types of PTSD

Clinicians have described several distinct types of PTSD:

Acute Stress Disorder (ASD) : While PTSD is typically diagnosable four weeks following a trauma, acute stress disorder is diagnosable immediately following a trauma and up to four weeks after. People with ASD have a higher chance of developing PTSD, but if given appropriate treatment, those with ASD might be able to prevent PTSD.

Uncomplicated PTSD : Uncomplicated PTSD occurs when there are no other co-occurring mental health disorders, such as depression or anxiety.

Complex PTSD (C-PTSD) : C-PTSD usually results from a prolonged traumatic period, such as child abuse or neglect, and often stems from interpersonal trauma. Treatment for C-PTSD may involve the same things as for other types of PTSD but might take a longer time to recover from.

Dissociative PTSD : In dissociative PTSD, individuals might experience dissociation , which includes depersonalization and/or derealization. They may feel as though they are re-experiencing the trauma. It is more likely in those who experience trauma early in life.

PTSD Symptoms

It’s common to experience distressing memories and feelings immediately after a traumatic event and occasionally as life progresses.

However, for people living with PTSD, these intrusions last longer and disrupt your ability to function in day-to-day life. 

Symptoms of PTSD fall into four categories and include:

Intrusive symptoms:

  • Repeated, unwanted memories of the traumatic event 
  • Recurrent nightmares
  • Flashbacks as if you’re re-living the traumatic experience  
  • Severe distress when you’re reminded of the event 
  • Physical reactions to reminders of the event, such as increased heart rate or sweating
  • Avoiding thoughts or feelings of the traumatic event 
  • Staying away from reminders of trauma, such as people, places, objects, or situations 
  • Resisting conversations about what happened or how you feel about it 

Increased arousal:

  • Being easily startled or fearful 
  • Struggling with irritability or angry outbursts 
  • Having trouble concentrating 
  • Having difficulty falling or staying asleep 
  • Behaving recklessly or self-destructively 
  • Being overly aware of your surroundings and potential threats to safety

Changes in thoughts and feelings:

  • Struggling to remember important parts of the traumatic event
  • Ongoing, distorted beliefs about yourself or others (such as “I’m a bad person” or “No one can be trusted”) 
  • Recurrent feelings of fear, horror, anger, guilt, shame, or hopelessness 
  • Loss of interest in once enjoyable activities 
  • Feeling detached from others or struggling to maintain close relationships 
  • Having difficulty experiencing positive feelings like joy or satisfaction

Often, people with PTSD also have other physical and mental health problems, including depression and substance abuse. Symptoms of PTSD can waver in intensity or become worse over time.

PTSD in Different Populations

About half of American adults experience at least one traumatic event. While many people have a difficult time coping in the wake of trauma, only a small portion go on to develop PTSD.

In the United States, an estimated 7-8% of people live with PTSD at some point in their lives, and people who are Latinx, Black, or American Indian are disproportionately affected by this condition. Women are two to three times more likely to develop PTSD than men.

Women often have different PTSD symptoms, including a tendency to respond by seeking social support. Men tend to take a problem-solving approach to their PTSD symptoms.

The DSM-5 has, for the first time, set diagnostic criteria for young children experiencing PTSD. Younger children are more likely to exhibit signs of PTSD through play.

If you or someone you love is struggling with PTSD, reach out for help immediately. You can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 to find support and treatment facilities in your area. For more mental health resources, see our National Helpline Database . 

When PTSD symptoms listed above last for more than a month and cause significant distress or impairment, you may be diagnosed with PTSD.  Usually, mental healthcare providers will diagnose PTSD, including psychiatrists, psychiatric nurse practitioners, psychologists, social workers, and counselors. Family medicine doctors, also known as primary care physicians, can also diagnose the condition.

Remember that there's no need to check off every box for a diagnosis of PTSD. You only need to experience a certain number of symptoms from each category for an official diagnosis from a qualified mental health professional.

They'll review your symptoms and history with you to determine your diagnosis and what you need to cope and recover.

People may develop PTSD after experiencing or being exposed to an exceptionally stressful event that involves someone’s death or the threat of it, serious injury, or sexual violation. 

It’s unclear exactly why some people develop PTSD and others don’t. As is true for many mental health conditions, there is likely a slew of potential causes at the root of this condition, including:

  • Stressful life experiences, including how much trauma you’ve experienced and how severe it was
  • A family history of mental health conditions such as anxiety or depression
  • Your temperament or inherited personality traits
  • The way your brain regulates chemicals and hormones when you experience stress

Certain risk factors could also increase your chances of developing PTSD, such as:

  • Having experienced intense or prolonged trauma
  • Previous experiences of trauma, such as childhood abuse
  • Having a job that increases your risk of exposure to trauma (such as military personnel or first responders)
  • Having other mental health conditions, such as anxiety or depression 
  • Having problems with substance abuse  
  • Not having a solid support system

Fortunately, many research-backed treatments can help people living with PTSD cope with symptoms and begin to recover. Effective treatments for PTSD include:

Cognitive Behavioral Therapy  

Cognitive behavioral therapy (CBT) helps you learn how to recognize thought patterns that fuel negative beliefs about yourself, deal with reminders and emotions associated with the trauma, and help reduce maladaptive behaviors associated with PTSD.

Exposure Therapy 

Exposure therapy repeatedly exposes you to memories and reminders of trauma to learn how to cope effectively with distressing symptoms of PTSD like anxiety and avoidance.

Eye Movement Desensitization and Reprocessing 

Eye movement desensitization and reprocessing (EMDR) allows you to process traumatic memories in a new way with the help of guided eye movements.  

Medication 

Medication can help ease symptoms of PTSD and may improve your ability to participate in psychotherapy.

You may be prescribed antidepressants such as selective serotonin reuptake inhibitors (SSRI) like Zoloft (sertraline) or Paxil (paroxetine), anti-anxiety medications (though generally only for a short period due to the potential for dependence or abuse), or other medications to help reduce sleep disturbances like nightmares.  

Psychedelic Therapy

Certain psychedelic agents, such as ketamine, psylocibin, and MDMA, show promise in the treatment of PTSD. These medications change the way the brain processes fear, and can also help treat co-existing mental health disorders such as depression.

Complementary Therapies 

Additionally, there are several promising alternative therapies to consider adding to your treatment regimen, such as animal-assisted therapy and trauma-sensitive yoga.

Learning to cope with symptoms of PTSD can be challenging, which is why seeking treatment and developing healthy ways of managing your symptoms is essential. 

Here are a few coping strategies to add to your skillset:

  • Learn how to deal with distressing thoughts and memories of trauma. 
  • Find ways to cope with reminders of trauma and flashbacks .
  • Address sleep problems related to PTSD. 
  • Learn how to cope with related mental health conditions, such as anxiety , depression , and substance abuse . 
  • For more help and community, consider joining a support group.

People with PTSD are more likely than others to experience other mental health problems, including depression, anxiety, substance use disorder, and suicidal thoughts. Some evidence even shows it can reduce overall lifespan, although more research needs to be done to determine the mechanism of these findings.

After experiencing trauma, people are at increased risk of developing PTSD. Symptom types include intrusive symptoms (nightmares and flashbacks), avoidance (staying away from reminders of the trauma), increased arousal (being startled easily, trouble concentrating, or difficulty sleeping), and changes in thoughts or feelings (believing you are "bad" or loss of interest in activities you used to enjoy).

A healthcare professional can make a diagnosis by reviewing your history and symptoms, and by using questionnaires. Treatment can include talk therapy, medications, and other interventions such as eye movement desensitization and reprocessing (EMDR) and exposure therapy. Speak to a healthcare provider if you or a loved one is experiencing troubling symptoms.

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Landin-Romero R, Moreno-Alcazar A, Pagani M, Amann BL. How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action . Front Psychol . 2018;9:1395. doi:10.3389/fpsyg.2018.01395

Elsouri KN, Kalhori S, Colunge D, et al. Psychoactive drugs in the management of post traumatic stress disorder: a promising new horizo n. Cureus . 14(5):e25235. doi:10.7759/cureus.25235

Song K, Xiong F, Ding N, Huang A, Zhang H. Complementary and alternative therapies for post-traumatic stress disorder . Medicine (Baltimore) . 2020;99(28):e21142. doi:10.1097/MD.0000000000021142

Nilaweera D, Phyo AZZ, Teshale AB, et al. Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis . BMC Psychiatry . 2023;23:229. doi:10.1186/s12888-023-04716-w

Beetz A, Schofmann I, Girgensohn R, Braas R, Ernst C. Positive effects of a short-term dog-assisted intervention for soldiers with post-traumatic stress disorder—A pilot study . Front Vet Sci. 2019 Jun 7. do:10.3389/fvets.2019.00170

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What to Know About Traumatic Shock

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Types of Traumatic Shock

Diagnosing traumatic shock.

Trauma shock is any sudden, terrible experience that disrupts your well-being and overwhelms you. A traumatic experience can shock your system, causing you to go into a state of dissociation , where your body and mind feel disconnected and nothing feels real.

Your brain resorts to this adaptive defense mechanism when trying to cope with stressful or overwhelming events that it cannot prevent or escape. Shock helps reduce your awareness of your physical or emotional pain by dulling your senses, making you numb , and reducing your conscious cognizance of the event.

At a Glance

After a trauma, it's common for people to experience overwhelming physical and emotional reactions. This helps blunt your awareness of the pain but can also come with distressing symptoms like chills, shakiness, changes in blood pressure, rapid breathing, fear, and panic. In this article, we'll explore some symptoms people often experience and what can cause them. We'll also cover some coping strategies to help you regain your equilibrium.

Symptoms of Traumatic Shock

Trauma can cause a wide range of physical and emotional symptoms. However, every individual reacts to it differently.

Physical Symptoms

These are some of the physical symptoms that may accompany traumatic shock:

  • Lightheadedness
  • Unconsciousness 
  • Stomach pain
  • Rapid heartbeat
  • Muscle tension
  • Elevated blood pressure
  • Rapid, shallow breathing

Emotional Symptoms

These are some of the emotional symptoms that may accompany traumatic shock:

  • Irritability
  • Helplessness
  • Disorientation 
  • Numbness  
  • Withdrawal 
  • Emotional outbursts
  • Inability to concentrate
  • Difficulty making decisions
  • Decreased awareness of surroundings
  • A feeling of being unsafe

The dissociative state typically lasts for a short time, such as a few minutes or hours; however, in some cases of repeated or prolonged trauma, it can persist for a much longer period of time.

Afterward, it’s not uncommon for the person to be preoccupied with the event, forget it entirely, or have flashbacks or nightmares of it.

What Causes Traumatic Shock?

While anything that significantly disrupts your emotional equilibrium can be considered a traumatic event, these are some examples of events that can cause traumatic shock:

  • Abandonment
  • Domestic abuse
  • Financial crisis
  • Imprisonment
  • Injury 
  • Life-threatening event 
  • Natural disaster
  • Sexual abuse or assault
  • Witnessing a traumatic incident that happens to someone else

Traumatic shock can be categorized into different types, depending on how it affects the brain and body.

Dissociative Shock

Traumatic events can sometimes cause a person to go into shock and disconnect from either themselves or the people around them. People who experience dissociative shock may feel disconnected from reality, suffer memory loss, or develop dissociative disorders.

Medical Trauma

Certain physical injuries or illnesses can be traumatic for the body and cause the person to go into a state of shock. These are the different types of shock, medically speaking:

  • Hypovolemic shock is marked by severe blood and fluid loss, which can make it difficult for the heart to pump blood and in turn, cause vital organs to stop functioning.
  • Distributive shock is characterized by abnormalities in the blood vessels that distribute blood around the body, which can lead to low blood pressure.
  • Cardiogenic shock , often caused by a heart attack, occurs when the heart isn't able to pump blood to the rest of the body. It is also known as cardiac shock.
  • Neurogenic shock is caused by spinal cord injuries that can damage the nervous system and interfere with blood flow.

While these types of shock are medical conditions, they can also affect us emotionally and vice versa because the body and mind are interlinked . 

For instance, someone who has been shot at or been in a car accident may have severe blood loss and go into hypovolemic shock; however, they may also sustain severe emotional trauma. Similarly, someone who receives devastating news or experiences a trauma may have a heart attack and go into cardiac shock.

These conditions are medical emergencies that can be life-threatening and need to be treated right away. If someone has sustained a medical injury, call 911 immediately.

If you or a loved one have experienced an emotional trauma and are struggling to cope with it, it’s important to seek help from a healthcare professional, ideally someone who specializes in treating trauma .

The healthcare professional will assess your condition and symptoms, perform any tests or exams required, diagnose your condition and its severity, refer you to a specialist if needed, and chart out a treatment plan for you.

Depending on your symptoms and the amount of time it has been since the traumatic event, you may be diagnosed with:

  • Acute stress disorder (ASD): ASD is a mental health condition that can occur in the first month after a traumatic event.
  • Post-traumatic stress disorder PTSD): PTSD is a mental health condition where the symptoms of trauma persist for months after the traumatic event.
  • Dissociative disorders: These are a group of disorders characterized by a feeling of dissociated from reality.

How Is Emotional Trauma Treated?

The emotional effects of trauma are best treated by healthcare providers who specialize in trauma-informed care , which takes a different approach from other types of mental healthcare. Trauma-informed care recognizes the need for healthcare providers to understand the person’s life experiences to deliver effective care.

Treatment for emotional trauma may involve:

  • Medication to alleviate symptoms
  • Trauma-focused therapy to help you process the painful events and develop coping strategies

Depending on the circumstances, treatment may be administered on an inpatient, outpatient, or partial hospitalization basis.

Press Play for Advice on Healing From Trauma

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Coping With Traumatic Shock

These are some coping strategies that can help you if you are dealing with a traumatic event that has shocked you:

  • Seek social support : Reach out to loved ones you feel safe and comfortable with. While you might be tempted to withdraw, having the support of loved ones is essential as you recover.
  • Practice self-care : Prioritize your physical and emotional needs. Do things that provide comfort. Get regular sleep, watch a favorite show, take baths, read a book, or anything else that helps you feel cared for.
  • Give yourself time : Understand that healing from trauma takes time. Don’t set unrealistic expectations for yourself or compare yourself to others.
  • Seek help and treatment if you need it : Remember that there are trained professionals who can help you and that recovery is possible.

Keep in Mind

A traumatic event can send you into a state of shock, particularly if it takes you by surprise and you are unable to process it. Traumatic shock is a defense mechanism that helps protect your brain and body. 

Traumatic shock can be accompanied by a range of physical and emotional symptoms, such as numbness, confusion, disassociation, dizziness, and rapid heartbeat. It is usually short-lived, but can feel a lot longer.

If you are struggling to deal with the trauma , you can seek help from a licensed healthcare professional, who can help you process it and equip you with the skills you need to cope.

Kleber RJ. Trauma and public mental health: A focused review .  Front Psychiatry . 2019;10:451. doi:10.3389/fpsyt.2019.00451

Krause-Utz A, Frost R, Winter D, Elzinga BM. Dissociation and alterations in brain function and structure . Curr Psychiatry Rep . 2017;19(1):6. doi:10.1007/s11920-017-0757-y

MIT Medical. Common reactions to traumatic events .

Lanius RA. Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience research .  Eur J Psychotraumatol . 2015;6:27905. doi:10.3402/ejpt.v6.27905

El-Solh AA. Management of nightmares in patients with posttraumatic stress disorder: Current perspectives .  Nat Sci Sleep . 2018;10:409-420. doi:10.2147/NSS.S166089

American Psychological Association. Trauma and shock .

Cénat JM. Complex racial trauma: Evidence, theory, assessment, and treatment .  Perspect Psychol Sci . 2023;18(3):675-687. doi:10.1177/17456916221120428

Boyer SM, Caplan JE, Edwards LK. Trauma-related dissociation and the dissociative disorders: Neglected symptoms with severe public health consequences .  Dela J Public Health . 2022;8(2):78-84.doi:10.32481/djph.2022.05.010

Standl T, Annecke T, Cascorbi I, Heller AR, Sabashnikov A, Teske W. The nomenclature, definition and distinction of types of shock .  Dtsch Arztebl Int . 2018;115(45):757-768. doi:10.3238/arztebl.2018.0757

National Heart, Lung, and Blood Institute. Cardiogenic shock .

U.S. Department of Veterans Affairs. Acute stress disorder .

National Institute of Mental Health. Post-traumatic stress disorder .

Substance Abuse and Mental Health Services Administration. Key ingredients for successful

trauma-informed care implementation .

Lake Behavioral Hospital. Recognizing the signs and symptoms of emotional psychological trauma .

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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Intensive trauma treatment relieves PTSD symptoms within eight days, finds researcher

by Radboud University

stress

Relieved from post-traumatic stress disorder symptoms in eight days? It is possible with a highly intensive treatment method that combines trauma-focused therapies and lots of exercise. "About 80% of people no longer have a PTSD diagnosis at the end of the treatment," says Eline Voorendonk, who will receive her Ph.D. on 15 March for her research on this method.

About 80% of people have a traumatic experience at some point in their life. Of these, about 7% develop a post-traumatic stress disorder (PTSD), as a result of, for example, sexual abuse , physical violence , war, or a serious accident. PTSD symptoms, which include reliving the trauma, avoidance behavior, and being overly alert, have a significant impact on daily functioning.

This means that there are thousands of Dutch people with PTSD in need of treatment. Although recognized treatments such as exposure and EMDR therapy are effective, approximately one-quarter of participants stop prematurely, and almost half do not respond well to treatment.

Together with her colleagues, Eline Voorendonk, Ph.D. candidate at Radboud University's Behavioral Science lnstitute and research coordinator at PSYTREC Psychotrauma Expertise Center, sought ways to optimize the treatment of PTSD. She did so by investigating whether it helps to intensify treatment, and by exploring the addition of exercise to the treatment of patients with PTSD.

Intensive program

The resulting intensive trauma-focused treatment combined exposure therapy, EMDR therapy, psychoeducation and physical activity, and was offered within a very short time frame of eight days. "We also wanted to explore the addition of physical activity," says Voorendonk.

"The idea that exercise contributes to mental recovery has become increasingly popular in recent years, also for PTSD. But do people with PTSD benefit from the exercise or from the social support and extra personal attention that comes with it? We therefore compared a group that was offered a lot of moderate-intensity exercise in addition to intensive trauma-focused treatments with a group that was also engaged, but creatively, and therefore stayed at a low heart rate."

Several studies show that the treatment method is highly effective: approximately 80% of people no longer had a PTSD diagnosis after the eight-day treatment. Only 2% to 6% of people dropped out. Surprisingly, this was true both for the group that exercised intensively and the group that engaged in creative activities. "It seems that, within the context of these intensive treatments, the positive effect of exercise on PTSD symptoms is overestimated," says Voorendonk.

This is not to say that exercise is not important, she says. PTSD is often associated with physical health problems, and exercise contributes to physical health. "We may need to zoom in further on the influence of exercise on PTSD. Think about the optimal intensity, duration and sequence of exercise: how does it work and what works for whom?" For example, a study by Voorendonk and her colleagues showed that exercise after an exposure session caused a stronger decrease in symptoms compared to exercise prior to an exposure session.

The positive outcome of the intensive treatment also appears to persist in the longer term—at least six months—with only limited relapse. Moreover, the treatment appears to be suitable for people with Complex PTSD (CPTSD), a severe form of PTSD in which the patient suffers from additional symptoms.

"It is thought that these symptoms get in the way of the trauma-focused treatment, so another treatment is often recommended that first focuses on stabilization. The study we conducted with more than 200 people with CPTSD shows that they respond equally well to intensive trauma-focused treatment. Starting straight away can avoid unnecessary delays," says Voorendonk.

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Jonathan Fadok Ph.D.

Post-Traumatic Stress Disorder

Taming the amygdala in ptsd, cutting-edge techniques can improve ptsd symptoms..

Posted March 19, 2024 | Reviewed by Ray Parker

  • What Is PTSD?
  • Find a therapist to heal from trauma
  • The amygdala detects threats and helps us deal with danger.
  • Patterns of brain activity called theta rhythms are important for fear memories.
  • Theta rhythms in PTSD patients are linked to symptom severity.
  • Changing amygdala theta rhythms significantly reduces PTSD symptoms.

Fear is an adaptive emotion that helps us cope with threatening situations. Deep within the temporal lobe of the brain is the amygdala, the most studied brain area involved in fear. The amygdala uses all kinds of information from outside and inside the body to help us interpret and react to danger.

The Amygdala and Fear

Upon detecting a threat, the amygdala causes reactions that prepare us to deal with danger. For example, if you hear a sudden noise behind you when walking alone at night, you might experience a racing heart, changes in breathing, and tension in your muscles. These amygdala-dependent reactions enhance the body's readiness to respond to the threat.

The amygdala is also important for making fearful memories. When an individual encounters a threatening situation, the amygdala forms a memory of that event, tying together all the parts of the environment , such as sounds, smells, and visual features. These fearful memories help us adapt and make faster decisions in the future. However, in some people who have experienced trauma, the amygdala is hyperactive , which is believed to cause maladaptive behavior that is distressing. An example of this is the symptoms associated with post- traumatic stress disorder ( PTSD ).

Amygdala Activity Rhythms Associated With Threats

Distinct types of brain rhythms are associated with various cognitive functions, including fear memory. In the amygdala, a type of rhythm called theta is thought to help the amygdala process information and form memories. Most of what we understand about amygdala theta rhythms comes from animal studies because measuring it requires placing electrodes into the brain. Theta has been recorded in the amygdala of patients with epilepsy undergoing neurosurgery ; however, whether theta might be different in PTSD patients is poorly understood. Finding out how theta functions in people suffering from PTSD could be critical for developing new treatments.

Recording Theta in the Human Amygdala

In a remarkable study, Gill et al. recorded amygdala rhythmic activity as part of voluntary clinical trials for PTSD. Patients were implanted with electrodes into the amygdala, and brain activity was recorded for more than one year. Activity in the amygdala was recorded while patients looked at unpleasant images and listened to audio recordings of their own trauma-related memories. Patients also self-reported their symptoms using a questionnaire, and the researchers were able to link amygdala theta activity changes to times when PSTD symptoms were at their worst.

Neuromodulation of Amygdala Theta for Treatment of PTSD

The authors then applied an innovative technique known as closed-loop stimulation to change amygdala function in the hope of reducing PTSD symptoms. In closed-loop stimulation, the surgical device was used to stimulate electrically the amygdala when theta was detected. Remarkably, using this treatment strategy for one year led to significantly reduced severity of PTSD symptoms as well as reduced amygdala theta activity during aversive stimuli.

Future Directions

Admittedly, this is an invasive approach that requires neurosurgery and careful monitoring of patient health. Other clinical trials in PTSD patients are underway that are using non-invasive neurofeedback with functional MRI to downregulate amygdala function during trauma recollection . While this neurofeedback technique is showing promise for giving patients control over amygdala activity, it has yet to reduce symptoms significantly when compared to control subjects. Nonetheless, further work using these types of approaches is called for and necessary to help the millions of individuals suffering from PTSD.

Gill, J.L., Schneiders, J.A., Stangl, M. et al. A pilot study of closed-loop neuromodulation for treatment-resistant post-traumatic stress disorder. Nat Commun 14, 2997 (2023). https://doi.org/10.1038/s41467-023-38712-1

Zhao, Z., Duek, O., Seidemann, R. et al. Amygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial. Transl Psychiatry 13, 177 (2023). https://doi.org/10.1038/s41398-023-02467-6

Jonathan Fadok Ph.D.

Jonathan Fadok, Ph.D., is an Assistant Professor of Psychology at Tulane University where he holds the Burk-Kleinpeter Professorship in Science and Engineering.

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Monday, March 18, 2024

NIH studies find severe symptoms of “Havana Syndrome,” but no evidence of MRI-detectable brain injury or biological abnormalities

Compared to healthy volunteers, affected U.S. government personnel did not exhibit differences that would explain symptoms.

Using advanced imaging techniques and in-depth clinical assessments, a research team at the National Institutes of Health (NIH) found no significant evidence of MRI-detectable brain injury, nor differences in most clinical measures compared to controls, among a group of federal employees who experienced anomalous health incidents (AHIs). These incidents, including hearing noise and experiencing head pressure followed by headache, dizziness, cognitive dysfunction and other symptoms, have been described in the news media as “Havana Syndrome” since U.S. government personnel stationed in Havana first reported the incidents. Scientists at the NIH Clinical Center conducted the research over the course of nearly five years and published their findings in two papers in JAMA today.

“Our goal was to conduct thorough, objective and reproducible evaluations to see if we could identify structural brain or biological differences in people who reported AHIs,” said Leighton Chan, M.D., chief, rehabilitation medicine and acting chief scientific officer, NIH Clinical Center, and lead author on one of the papers. “While we did not identify significant differences in participants with AHIs, it’s important to acknowledge that these symptoms are very real, cause significant disruption in the lives of those affected and can be quite prolonged, disabling and difficult to treat.”

Researchers designed multiple methods to evaluate more than 80 U.S. government employees and their adult family members, mostly stationed abroad, who had reported an AHI and compared them to matched healthy controls. The control groups included healthy volunteers who had similar work assignments but did not report AHIs. In this study, participants underwent a battery of clinical, auditory, balance, visual, neuropsychological and blood biomarkers testing. In addition, they received different types of MRI scans aimed at investigating volume, structure and function of the brain.

In this study, researchers obtained multiple measurements and used several methods and models to analyze the data. This was done to ensure the findings were highly reproducible, meaning similar results were found regardless of how many times participants were evaluated or their data statistically analyzed. Scientists also used deep phenotyping, which is an analysis of observable traits or biochemical characteristics of an individual, to assess any correlations between clinically reported symptoms and neuroimaging findings.

For the imaging portion of the study, participants underwent MRI scans an average of 80 days following symptom onset, although some participants had an MRI as soon as 14 days after reporting an AHI. Using thorough and robust methodology, which resulted in highly reproducible MRI metrics, the researchers were unable to identify a consistent set of imaging abnormalities that might differentiate participants with AHIs from controls.

“A lack of evidence for an MRI-detectable difference between individuals with AHIs and controls does not exclude that an adverse event impacting the brain occurred at the time of the AHI,” said Carlo Pierpaoli, M.D., Ph.D., senior investigator and chief of the Laboratory on Quantitative Medical Imaging at the National Institute of Biomedical Imaging and Bioengineering, part of NIH, and lead author on the neuroimaging paper. “It is possible that individuals with an AHI may be experiencing the results of an event that led to their symptoms, but the injury did not produce the long-term neuroimaging changes that are typically observed after severe trauma or stroke. We hope these results will alleviate concerns about AHI being associated with severe neurodegenerative changes in the brain.”

Similarly, there were no significant differences between individuals reporting AHIs and matched controls with respect to most clinical, research and biomarker measures, except for certain self-reported measures. Compared to controls, participants with AHIs self-reported significantly increased symptoms of fatigue, post-traumatic stress and depression. Forty-one percent of participants in the AHI group, from nearly every geographic area, met the criteria for functional neurological disorders (FNDs), a group of common neurological movement disorders caused by an abnormality in how the brain functions, or had significant somatic symptoms. FNDs can be associated with depression and anxiety, and high stress. Most of the AHI group with FND met specific criteria to enable the diagnosis of persistent postural-perceptual dizziness, also known as PPPD. Symptoms of PPPD include dizziness, non-spinning vertigo and fluctuating unsteadiness provoked by environmental or social stimuli that cannot be explained by some other neurologic disorder.

“The post-traumatic stress and mood symptoms reported are not surprising given the ongoing concerns of many of the participants,” said Louis French, Psy.D., neuropsychologist and deputy director of the National Intrepid Center of Excellence at Walter Reed National Military Medical Center and a co-investigator on the study. “Often these individuals have had significant disruption to their lives and continue to have concerns about their health and their future. This level of stress can have significant negative impacts on the recovery process.”

The researchers note that if the symptoms were caused by some external phenomenon, they are without persistent or detectable patho-physiologic changes. Additionally, it is possible that the physiologic markers of an external phenomenon are no longer detectable or cannot be identified with the current methodologies and sample size.

About the NIH Clinical Center: The NIH Clinical Center is the clinical research hospital for the National Institutes of Health. Through clinical research, clinician-investigators translate laboratory discoveries into better treatments, therapies and interventions to improve the nation's health. More information: https://clinicalcenter.nih.gov .

About the National Institute of Biomedical Imaging and Bioengineering (NIBIB): NIBIB’s mission is to improve health by leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the physical and engineering sciences with the life sciences to advance basic research and medical care. NIBIB supports emerging technology research and development within its internal laboratories and through grants, collaborations, and training. More information is available at the NIBIB website: https://www.nibib.nih.gov .

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

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Pierpaoli C, Nayak A, Hafiz R, et al. Neuroimaging Findings in United States Government Personnel and their Family Members Involved in Anomalous Health Incidents. JAMA. Published online March 18, 2024. doi: 10.1001/jama.2024.2424

Chan L, Hallett M, Zalewski C, et al. Clinical, Biomarker, and Research Tests Among United States Government Personnel and their Family Members Involved in Anomalous Health Incidents. JAMA. Published online March 10, 2024. doi: 10.1001/jama.2024.2413

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The Effects of Repetitive Head Impact Exposure on Mental Health Symptoms Following Traumatic Brain Injury

Affiliation.

  • 1 Author Affiliations: Departments of Rehabilitation and Human Performance (Drs de Souza, Kumar, and Dams-O'Connor) and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York, New York; Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio (Drs Bogner and Corrigan); Department of Physical Medicine and Rehabilitation, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Rabinowitz); and Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia (Dr Walker).
  • PMID: 38483265
  • DOI: 10.1097/HTR.0000000000000936

Objective: This study aimed to characterize the types and timing of repetitive head impact (RHI) exposures in individuals with moderate to severe traumatic brain injury (TBI) and to examine the effects of RHI exposures on mental health outcomes.

Setting: TBI Model Systems National Database.

Participants: 447 patients with moderate to severe TBI who reported RHI exposure between 2015 and 2022.

Design: Secondary data analysis.

Main measures: RHI exposures reported on the Ohio State University TBI Identification Method (OSU TBI-ID) were characterized by exposure category, duration, and timing relative to the index TBI. Mental health outcomes were evaluated at the 5-year follow-up assessment using the Patient Health Questionnaire-9 (PHQ-9) for depression symptoms and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms.

Results: The majority of RHI exposures were sports-related (61.1%), followed by other causes (20.8%; including falls), repetitive violence/assault (18.8%), and military exposures (6.7%). Males predominantly reported sports and military exposures, while a larger proportion of females reported violence and falls. Sports exposures were most common before the index TBI, while exposures from falls and violence/abuse were most common after TBI. RHI exposures occurring after the index TBI were associated with higher levels of depression (β = 5.05; 95% CI, 1.59-8.50) and anxiety (β = 4.53; 95% CI, 1.02-8.05) symptoms than exposures before the index TBI.

Conclusion: The findings emphasize the need to consider RHI exposures and their interaction with TBI when assessing mental health outcomes. Understanding the prevalence and challenges associated with RHI post-TBI can inform targeted interventions and improve the well-being of individuals with TBI. Preventive measures and ongoing care should be implemented to address the risks posed by RHI, particularly in individuals with prior TBI, especially surrounding fall and violence/abuse prevention.

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Study examines mental health impact of campus gun-related incidents

Dth-university-post-shooting-mental-health

This article is part of the Mental Health Collaborative, a project completed by nine North Carolina college newsrooms to cover mental health issues in their communities. To read more stories about mental health, explore the interactive project developed specifically for this collaborative .

UNC junior Mary McKenzie said she rarely sits on the first floor of the Student Union.  That’s where she was during the Sept. 13 lockdown after a person threatened an Alpine Bagel Cafe employee with a gun.

“When I see something out of the ordinary, my first thought always goes to, ‘Something's going on again,’” she said . “And then I'm waiting for an alarm or an alert.”

Joe Friedman , a clinical psychology graduate student, is researching the long-term effects on campus mental health from the two incidents of gun violence early in the fall semester. 

The ongoing  research  study will track the survey responses of students, faculty and staff throughout the academic year, following the  shooting on Aug. 28 and the Sept. 13 lockdown.

Of the five scheduled surveys, the first was sent out six weeks after Aug. 28 and received 287 responses, Friedman said. Although the number of responses dropped in the following surveys, he said  survey respondents were largely sourced through email listservs. The last survey will be sent out in March .

“The purpose of the study is for us to learn why certain people are having a more challenging time coping with stressful or traumatic events such as this, and also how we can better help people who have been most affected during this,” Friedman said . 

Friedman said the first survey found that one in five respondents reported clinically significant symptoms of post-traumatic stress. That number jumped to one in four among students. 

“We're seeing that students are reporting more severe symptoms than faculty and staff,” Friedman said . “And we're also seeing that individuals who identify as a racial or ethnic minority are reporting more severe post-traumatic stress symptoms on average.” 

He also said the surveys showed a significantly higher level of post-traumatic stress symptoms among individuals who were close to Alpine and the Union during the second lockdown but did not show a significant difference based on proximity to Caudill Labs on Aug. 28. 

Friedman said there is potential for bias in the sample because people who felt more mental health repercussions from the events may have been more likely to elect to complete the survey. 

Jonathan Abramowitz , Friedman’s research mentor and director of clinical training in the psychology and neuroscience department, said when a group of people experiences a traumatic event, the majority tend to recover on their own, but there are always some individuals who continue to have difficulties. 

Abramowitz said anxiety presents in three ways: physically in the form of muscle tension and headaches, mentally through symptoms such as racing thoughts and difficulty concentrating and behaviorally through avoidance and taking extra precautions. He said post-traumatic stress is a subset of anxiety and can include additional symptoms such as an exaggerated startle response and loss of interest in activities. 

One undergraduate student who wished to remain anonymous said she struggled with increased anxiety after being in the Union during the second lockdown. She also said she had a difficult time prioritizing her mental health while completing classwork after the incidents. 

“As soon as we were back, we still had the same amount of material to cover but you had less time to cover it,” she said . “That has always been the question — were those mental health days really worth it?”

Friedman said two-thirds of the sample reported not seeking any kind of support or psychological services in response to what happened.

“From Aug. 29-Sept. 1, 2023, CAPS provided walk-in services to 192 students,” UNC Media Relations said in an email statement. “During that same time frame in 2022, CAPS provided walk-in services to 87 students.”

Media Relations said they were unable to attribute a reason to the visits.

Although memories of the incidents last fall no longer impact her every day, McKenzie said there are still one or two times a week when something out of place, like someone yelling or running, makes her feel tense. 

Friedman said the research is a reminder that it is very common to still be affected by a traumatic event, even months later. He  said he encourages people to seek support from friends and family, as well as trained mental health professionals. 

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“If you are struggling with this, just realize that you're not alone,” Friedman said . “Even though the lockdown happened in the past, your current emotions about it are real and valid and not something you should feel ashamed about.”

@dailytarheel  |  [email protected]

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CDC updates Covid isolation guidelines for people who test positive

A passenger wears a mask while riding a train in Washington, D.C.

People who test positive for Covid no longer need to isolate for five days , the Centers for Disease Control and Prevention said Friday.

The CDC’s new guidance now matches public health advice for flu and other respiratory illnesses: Stay home when you’re sick, but return to school or work once you’re feeling better and you’ve been without a fever for 24 hours.

The shift reflects sustained decreases in the most severe outcomes of Covid since the beginning of the pandemic, as well as a recognition that many people aren’t testing themselves for Covid anyway.

“Folks often don’t know what virus they have when they first get sick, so this will help them know what to do, regardless,” CDC director Dr. Mandy Cohen said during a media briefing Friday.

Over the past couple of years, weekly hospital admissions for Covid have fallen by more than 75%, and deaths have decreased by more than 90%, Cohen said.

“To put that differently, in 2021, Covid was the third leading cause of death in the United States. Last year, it was the 10th,” Dr. Brendan Jackson, head of respiratory virus response within the CDC’s National Center for Immunization and Respiratory Diseases, said during the briefing.

Many doctors have been urging the CDC to lift isolation guidance for months, saying it did little to stop the spread of Covid.

The experiences of California and Oregon , which previously lifted their Covid isolation guidelines, proved that to be true.

“Recent data indicate that California and Oregon, where isolation guidance looks more like CDC’s updated recommendations, are not experiencing higher Covid-19 emergency department visits or hospitalizations,” Jackson said.

Changing the Covid isolation to mirror what’s recommended for flu and other respiratory illnesses makes sense to Dr. David Margolius, the public health director for the city of Cleveland.

“We’ve gotten to the point where we are suffering from flu at a higher rate than Covid,” he said. “What this guidance will do is help to reinforce that— regardless of what contagious respiratory viral infection you have — stay home when you’re sick, come back when you’re better.”

Dr. Kristin Englund, an infectious diseases expert at the Cleveland Clinic, said the new guidance would be beneficial in curbing the spread of all respiratory viruses.

“I think this is going to help us in the coming years to make sure that our numbers of influenza and RSV cases can also be cut down, not just Covid,” she said.

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Still, the decision was likely to draw criticism from some clinicians who point to the fact that the U.S. logged 17,310 new Covid hospitalizations in the past week alone.

“It’s something that is likely to draw a wide array of opinions and perhaps even conflicting opinions,” said Dr. Faisal Khan, Seattle’s director of public health. “But [the CDC’s] rationale is sound in that the pandemic is now in a very different phase from where it was in 2021 or 2022 or 2023.”

Though the isolation guidelines have been wiped away, the CDC still encourages people to play it safe for five days after they are feeling better. That includes masking around vulnerable people and opening windows to improve the flow of fresh air indoors.

The majority of viral spread happens when people are the sickest. “As the days go on, less virus spreads,” Cohen said.

People at higher risk for severe Covid complications, such as the elderly, people with weak immune systems and pregnant women, may need to take additional precautions.

Dr. Katie Passaretti, chief epidemiologist at Atrium Health in Charlotte, said it was a “move in the positive direction.”

“We are continuing to edge into what the world looks like after Covid, with Covid being one of many respiratory viruses that are certain that circulate,” she said.

The new guidance is for the general public only, and does not include isolation guidelines in hospital settings, which is generally 10 days.

On Wednesday, the agency said that adults 65 and older should get a booster shot of the Covid vaccine this spring. It’s anticipated that the nation will experience an uptick in the illness later this summer.

Winter and summer waves of Covid have emerged over the past four years, with cases peaking in January and August, respectively, according to the  CDC .

Another, reformulated, shot is expected to be available and recommended this fall.

CDC’s main tips for reducing Covid spread:

  • Get the Covid vaccine whenever it is available. Cohen said that 95% of people who were hospitalized with Covid this past winter had not received the latest vaccine.
  • Cover coughs and sneezes, and wash hands frequently.
  • Increase ventilation by opening windows, using air purifiers and gathering outside when possible.

post traumatic trip symptoms

Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

IMAGES

  1. PTSD symptoms

    post traumatic trip symptoms

  2. Post-traumatic Stress

    post traumatic trip symptoms

  3. Post–Traumatic Stress Disorder: Signs and Symptoms

    post traumatic trip symptoms

  4. Post Traumatic Stress Disorder (PTSD)

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  5. Common Post-Trauma Responses

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  6. Trauma Therapy

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VIDEO

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  2. Post-Traumatic Stress Disorder

  3. Understanding Complex Post Traumatic Stress Disorder

  4. Post-Traumatic Parasitism (From "ULTRAViolence")

  5. Handling Post Traumatic Experiences

  6. post-traumatic growth

COMMENTS

  1. Post-traumatic stress disorder (PTSD)

    Overview. Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Most people who go through traumatic events may have temporary ...

  2. PTSD (Post-Traumatic Stress Disorder): Symptoms & Treatment

    People with PTSD have intense and intrusive thoughts and feelings related to the experience that last long after the event. PTSD involves stress responses like: Anxiety, depressed mood, or feelings of guilt or shame. Having flashbacks or nightmares. Avoiding situations, places and activities related to the traumatic event.

  3. Post-Traumatic Stress Disorder

    Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body's "fight-or-flight" response, which helps us avoid or respond to potential danger.

  4. Posttraumatic Stress Disorder (PTSD)

    Key points. PTSD is a mental health condition in which a person has experienced a traumatic event that causes long-term stress. The traumatic event can be experienced directly, witnessed, or due to repeated exposure to shocking events. A person can also have PTSD when trauma occurs to a close friend or family member.

  5. Mayo Clinic Q and A: How to diagnose and support someone with post

    In addition to natural disasters, other common events that cause PTSD symptoms include accidents, being threatened with a weapon, combat exposure, abuse or receiving a life-threatening medical diagnosis. PTSD symptoms. Some people experience distressing symptoms for a short period after a traumatic event but get better with time and self-care.

  6. Psychiatry.org

    Medical leadership for mind, brain and body. Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.

  7. PDF Post-Traumatic Stress Disorder

    What is post-traumatic stress disorder, or PTSD? It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body's "fight-or-flight" response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most will recover from their symptoms over time.

  8. Posttraumatic Stress Disorder (PTSD)

    More Information. Posttraumatic stress disorder (PTSD) involves intense, unpleasant, and dysfunctional reactions after an overwhelming traumatic event. Events that threaten death or serious injury can cause intense, long-lasting distress. Affected people may relive the event, have nightmares, and avoid anything that reminds them of the event.

  9. PTSD Symptoms: How To Spot the Signs of Post Traumatic Stress Disorder

    PTSD doesn't always come with clues like nightmares and flashbacks. Sometimes it seems like a mood change unrelated to the traumatic event. You'll know it by its negativity. You may feel hopeless ...

  10. What is PTSD? Post-Traumatic Stress Disorder Symptoms and Causes

    Symptoms of PTSD are often grouped into types. These types include: avoidance, intrusive memories, changes in emotional reactions, and negative changes in thinking and mood. The most common symptoms of post-traumatic stress disorder include flashbacks, jumpiness (literally "jumping out of one's skin"), emotional detachment.

  11. Post-Traumatic Stress Disorder

    Feeling horror, helplessness, or extreme fear. Going through a traumatic event that lasts a long time. Having little or no social support after the event. Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home. Having a history of mental illness or substance use.

  12. Posttraumatic Stress Disorder (PTSD)

    Treatment. Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks; avoidance of reminders of the trauma; negative cognitions and mood; hypervigilance and sleep disturbance. Diagnosis is based on clinical criteria.

  13. Post-traumatic stress disorder (PTSD): Symptoms, treatment, and more

    Post-traumatic stress disorder (PTSD) is a mental health condition that can happen after a person experiences a traumatic event, causing them to feel fearful, shocked, or helpless. It can have ...

  14. What Is Post-Traumatic Stress Disorder (PTSD)?

    Causes. Post-traumatic stress disorder (PTSD) is a mental health condition where people struggle to recover long after they experience or witness a deeply terrifying event. In the past, the symptoms that comprise PTSD have been called "shell shock," "battle fatigue," and other names. It is now understood that any trauma-not war trauma alone ...

  15. Post-Traumatic Stress Disorder

    Ongoing negative emotions, such as fear, anger, guilt, or shame. Loss of interest in previous activities. Feelings of social isolation. Difficulty feeling positive emotions, such as happiness or satisfaction. Cognition and mood symptoms can begin or worsen after the traumatic event.

  16. The Causes, Symptoms, and Diagnosis of, plus the Treatments for, Post

    Post-Traumatic Stress Disorder (PTSD): Everything You Need to Know Get the doctor-approved details on causes, symptoms, treatments, and other facts and tips that can make life with PTSD easier ...

  17. PTSD: Signs and symptoms to be aware of

    Post-traumatic stress disorder (PTSD) may affect each person differently. However, there are some common symptoms many people experience, such as intrusive thoughts, nightmares, memory loss, and more.

  18. All the Symptoms of PTSD

    one or more intrusion symptoms linked to the traumatic event. constant avoidance of anything related to the traumatic event. significant changes in mood or cognition associated with the traumatic ...

  19. Traumatic Shock: Definition, Symptoms, Causes, and Treatment

    Traumatic shock is a defense mechanism that helps protect your brain and body. Traumatic shock can be accompanied by a range of physical and emotional symptoms, such as numbness, confusion, disassociation, dizziness, and rapid heartbeat. It is usually short-lived, but can feel a lot longer. If you are struggling to deal with the trauma, you can ...

  20. Intensive trauma treatment relieves PTSD symptoms within eight days

    Relieved from post-traumatic stress disorder symptoms in eight days? It is possible with a highly intensive treatment method that combines trauma-focused therapies and lots of exercise. "About 80% ...

  21. Taming the Amygdala in PTSD

    An example of this is the symptoms associated with post-traumatic stress disorder . Amygdala Activity Rhythms Associated With Threats Distinct types of brain rhythms are associated with various ...

  22. Post-Traumatic Arthritis: Causes, Symptoms & Treatment

    Post-Traumatic Arthritis. Post-traumatic arthritis causes stiffness and pain in your affected joints after an injury. You probably won't need surgery, but it might take a few months to feel better. Any injury to your joints (like a car accident or sports injury) can cause post-traumatic arthritis. Contents Overview Symptoms and Causes ...

  23. NIH studies find severe symptoms of "Havana Syndrome," but no evidence

    "The post-traumatic stress and mood symptoms reported are not surprising given the ongoing concerns of many of the participants," said Louis French, Psy.D., neuropsychologist and deputy director of the National Intrepid Center of Excellence at Walter Reed National Military Medical Center and a co-investigator on the study. "Often these ...

  24. PDF Post-Traumatic Stress Disorder

    Some people develop post-traumatic stress disorder (PTSD) after experiencing a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body's normal "fight-or-flight" response, which helps us avoid or respond to potential danger. People may experience a range of ...

  25. The Effects of Repetitive Head Impact Exposure on Mental ...

    Objective: This study aimed to characterize the types and timing of repetitive head impact (RHI) exposures in individuals with moderate to severe traumatic brain injury (TBI) and to examine the effects of RHI exposures on mental health outcomes. Setting: TBI Model Systems National Database. Participants: 447 patients with moderate to severe TBI who reported RHI exposure between 2015 and 2022.

  26. Study examines mental health impact of campus gun-related incidents

    Friedman said the first survey found that one in five respondents reported clinically significant symptoms of post-traumatic stress. That number jumped to one in four among students.

  27. CDC lifts Covid isolation guidelines for those who test positive as

    The CDC's new guidance for Covid now more closely matches public health advice for flu and other respiratory illnesses and no longer suggests isolating for five days.