Post-Traumatic Stress Disorder
 

Overview

Following a disaster or a tragic trauma, many people will ultimately do well and return to their previous level of functioning. However, many people will initially experience distressing thoughts, feelings, and physical symptoms and may engage in risky behaviors to help cope. 

Traumatic events are not easy for anyone to comprehend or accept. Understandably, many children feel frightened and confused. Fortunately, many children, even those exposed to trauma, are quite resilient. Parents, teachers and caring adults can help by listening and responding in an honest, consistent and supportive manner. 

The majority of individuals exposed to potentially traumatic events experience posttraumatic symptoms, shortly after the traumatic event. Over time, in particular within the first month or so, the symptoms tend to gradually improve. In some cases, however, the symptoms can increase over time, create more emotional and psychological distress and interfere with overall functioning. In the latter case, the symptoms might be reflective of diagnosis of posttraumatic stress disorder (PTSD). 

Causes

Most people with PTSD develop the condition after experiencing a traumatic event, like a serious accident, physical or sexual assault, war or torture, or a natural disaster such as a bushfire or a flood. 

People who have a past history of mental illness or trauma, as well as stressful life conditions and a lack of support are more likely to develop PTSD. 

It’s important to remember that everyone experiences trauma differently. An event which is traumatizing for one person may not be too distressing for another person. Everyone has a different capacity for trauma, which is informed by a combination of risk factors including neurobiology, past experiences and genetics. 

Not everyone with PTSD has been through a dangerous event. In some cases, learning that a relative or close friend experienced trauma can cause PTSD. 

Symptoms & Signs

Feeling strong reactions such as fear, anger or sadness are natural after a traumatic event. For most people, these feelings will pass with time and support from friends and family. For people who develop PTSD, these feelings are intensely distressing and if left untreated, can last for a long time. The symptoms of PTSD may interfere with the person’s ability to carry on their everyday life, work and relationships. 

PTSD is identified by four main groups of symptoms: 

  • Flashbacks of the traumatic event through intrusive memories or nightmares. As well as strong emotions, there may be physical symptoms such as sweating, heart palpitations or panic attacks.
  • Feeling emotionally numb. Some people experience ‘dissociation’ – a feeling of watching from a distance as events unfold.
  • Feeling anxious and ‘jumpy’ for no reason. Heightened vigilance can mean the affected person is constantly on the lookout for danger, possibly leading to irritability and a lack of concentration.
  • Avoiding reminders of the event. The person deliberately avoids activities, places, people, thoughts or feelings associated with the event because they bring back painful memories.


PTSD In Children And Teens

Young people can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include: 

  • Wetting the bed after having learned to use the toilet
  • Forgetting how to or being unable to talk
  • Acting out the scary event during playtime
  • Being unusually clingy with a parent or other adult

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also start ‘acting out’ and develop disruptive and destructive behaviors. It’s important for parents and carers to seek help early if they think a young person is developing PTSD. 

If a person has been through a traumatic event and has experienced a combination of the above symptoms for a month or more, then they may be experiencing PTSD. 

People with PTSD are at a higher risk of developing other anxiety disorders, substance abuse issues, and mood disorders such as depression. 

Treatments

It is important for anyone with PTSD symptoms to work with a psychiatrist who has experience treating PTSD. The main treatments are psychotherapy, medications, or both. An experienced psychiatrist can help people find the treatment plan that meets their symptoms and needs. 

Some people with PTSD may be living through an ongoing trauma, such as being in an abusive relationship. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms.

People who have PTSD or who are exposed to trauma also may experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an important part of recovery.

What's the difference between a normal reaction to a traumatic event and PTSD?

People react to experience of trauma in a variety of ways, such as sadness, irritability and confusion. In the immediate aftermath of a major traumatic event most people complain of stress, difficulty concentrating, sleeping or getting along with others. With PTSD, the troubling symptoms worsen, affect social and work functioning, and persist longer than a month. If you or a loved one are struggling to cope with the effects of a trauma it may be useful to seek professional help

Are there physical problems that are commonly associated with PTSD?

In addition to the thoughts and feelings identified above, people with PTSD may also experience physical symptoms, such as increased blood pressure and heart rate, fatigue, muscle tension, nausea, joint pain, headaches, back pain or other types of pain. The person in pain may not realize the connection between their pain and a traumatic event. For people with chronic pain, the pain may actually serve as a reminder of the traumatic event, which in turn may intensify PTSD symptoms. During the COVID-19 pandemic, the perception of the lethal threat of the virus has been associated with stress and trauma-related somatic symptoms