A mental illness affecting some people who witness or experience a traumatic event, post-traumatic stress disorder can severely impact a person’s ability to socialize, remain employed and enjoy meaningful relationships. Examples of traumatic events commonly causing PTSD include being sexually or physically assaulted, involvement in military combat, suffering major losses due to natural disasters and vehicle accidents. Some individuals may also develop PTSD after a nonviolent event, such as the death of a child or parent. People may even develop PTSD from witnessing a terrible event.
What is interesting about PTSD is that symptoms may not emerge for several years. Psychiatrists hypothesize that at the moment a person must suddenly cope with a traumatic event, they may subconsciously try to suppress their fear and terror as a form of self-preservation. It’s only later that a traumatic memory is triggered by something (a noise, a visual, a nightmare) that forces suppressed memories into their consciousness.
The Biological Factor Behind PTSD
Research suggests that individuals with lower levels of cortisol, dopamine and serotonin may be predisposed to developing symptoms of PTSD. Dopamine and serotonin regulate feelings of anxiety, aggression, pleasure and apathy. Cortisol is a hormone essential for physically and psychologically coping with stress in a healthy manner. Insufficient levels of these neurotransmitters may interfere with a person’s ability to manage emotions evolving from witnessing or being the victim of a traumatic event.
Early Warning Signs of PTSD
No one remains unaffected by trauma. No matter what their prior mental health history, people confronted by traumatic events are at risk of developing PTSD. In some cases, a trauma victim may present early signs of PTSD by seeming to “overreact” to normal events. Soldiers returning home from battle may run frantically away from the sound of a car backfiring. Someone who experienced the loss of their home due to a tornado may become panic-stricken at the sight of storm clouds. A female child victimized by a male sexual abuser may be terrified by men who resemble the abuser. In some cases there may not be an obvious connection (to an onlooker) between the trauma and associated triggers; a sufferer may be triggered by the sight of blue skies, for example, if the originating trauma occurred on a sunny day.
People who inexplicably begin drinking alcohol or using drugs may be exhibiting another early warning sign of PTSD. When asked by concerned family members or friends why they “took up” drinking, a trauma victim may say, “Oh, I’m just trying to calm my nerves. I’ll be all right.” Drug abuse by trauma victims is often harder to detect. Well-meaning doctors may temporarily prescribe anti-anxiety medications to someone dealing with a recent trauma. Unfortunately, anxiolytics and opioid prescription drugs are addictive and could lead to trauma survivors turning to street drugs when their prescription runs out.
Spotting Signs of PTSD in Others
If you know someone who has suffered a traumatic event in their life, watch for development of one or more of the following PTSD signs:
- Avoidance behaviors and self-isolation (avoiding anything that reminds them of the trauma they experienced)
- Feelings of depersonalization, alienation, numbness and detachment from reality
- Being in a constant state of hyperarousal (jumping at the slightest noise or movement, misinterpreting reality as threatening when it’s not)
- Insomnia/sleep disturbances/recurring nightmares
- Having angry, sometimes irrational outbursts for no reason
- Development of high blood pressure, ulcers, weight gain or loss, migraines, eczema or other stress-related diseases
- Suffering random flashbacks of the trauma (thoughts and images that enter the mind and can’t be controlled)
- Inability to experience pleasant emotions accompanied by feelings of numbness and detachment
PTSD symptoms may also improve or worsen over time. Some trauma victims appear to be coping well simply because they are ignoring (suppressing) unpleasant emotions and thoughts about the trauma. However, the unpredictability of PTSD means that a loved one you are worried about could go from acting normal to being inexplicably aggressive, depressed or even suicidal.
Is It PTSD or Something Else?
Symptoms of PTSD could be mistaken for other mental disorders by primary care doctors who do not specialize in psychiatric conditions. Common misdiagnoses for PTSD include:
Acute stress disorder: Severe anxiety after a traumatic event that does not last longer than a few months.
Traumatic brain injury: A violent blow to the head can cause a TBI. There may or may not be visible signs of head trauma.
Adjustment disorder: Children and adults enduring a traumatic event (loss of parent or spouse, for example) may start acting impulsively, withdraw, feel hopeless and have suicidal thoughts.
Derealization/depersonalization disorder: People with this disorder describe feelings of being “outside” their bodies, feeling robotic and not completely in control of their movements or speech. While this disorder is usually seen in victims of childhood trauma, it should not be confused with clinical PTSD.
Different Types of PTSD and Their Signs
Complex PTSD
Originally described in the 1990s, C-PTSD is a subcategory of PTSD involving a person’s exposure to a series of traumatic incidents over time. In other words, each psychologically disruptive event would not be traumatic enough to cause PTSD. Instead, the cumulative damage of multiple upsetting events may induce C-PTSD symptoms.
An example of someone with complex post-traumatic stress disorder could be a young adult who was victimized as a child by parental abandonment or chronically neglectful caregivers. While this mistreatment didn’t involve physical abuse, the repetitive withholding of love, affection and attention to a child’s basic needs throughout their childhood and adolescence can be just as traumatic as witnessing a murder or a terrorist bombing.
Comorbid PTSD vs Uncomplicated PTSD
Uncomplicated PTSD is a straight diagnosis of post-traumatic stress disorder. In other words, a psychiatrist did not find the person experiencing other mental illnesses. A diagnosis of comorbid PTSD means the person has PTSD and one or more major psychiatric illnesses. Panic disorder, major depression, substance abuse disorder and dissociative identity disorder are sometimes comorbid with PTSD.
How Is PTSD Diagnosed?
Psychiatrists will diagnose someone with PTSD if that person presents the following criteria for one month or longer:
- Flashbacks, terrifying thoughts and nightmares (reexperiencing symptoms)
- Avoidance behavior
- Two or more reactivity and arousal symptoms (becoming severely frightened by certain sounds, for example)
- Two or more mood and cognition symptoms (having obsessive thoughts about death, major depression, paranoia)
Women often have different PTSD symptoms than men. Women tend to have difficulty feeling emotions and are more easily startled. Alternately, instead of reacting with their emotions to triggers, men may react physically by fighting with others or using weapons to threaten harm.
Is PTSD Self-Diagnosable?
Can trauma victims recognize and acknowledge their own symptoms of PTSD? In most cases, yes. But the overwhelming anxiety and fear they experience mentally and physically can prevent them from getting help on their own. A person with PTSD is just as frightened of remembering traumatic events as an addict is of going through detox.
