Post-Traumatic Stress Disorder (PTSD)


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What is Post Traumatic Stress Disorder?


Post-traumatic stress disorder is a mental health condition that is triggered by witnessing or experiencing a terrifying event. What has always struck me is how a mechanism that has been so protective in our evolutionary history has now gone awry. One can think of an impala on the African savannah; if it has been attacked by a lion, then certainly, its mind and body should adapt so that it tries to make sure that this never happens again, and if it does, then it is prepared. The problem for many patients who suffer from PTSD is that the trauma that they have experienced, such abuse or combat, is no longer a real threat in their lives, but their minds and bodies act as if they are.

Needless to say, we see PTSD from an extensive variety of traumatic experiences. The Greek writer Thucycides described what we now call PTSD thousands of years ago. There are videos of patients during WWI who had symptoms that we now recognize. Movies such as The Deer Hunter and American Sniper have stunning portrayals of the cost of this disease by some of our favorite actors. Indeed, some of the strongest memories of my professional life are of those who have suffered from the hands of the Nazis, in combat in Vietnam, or, sadly, by their loved ones.

The criteria for PTSD are quite long and thought out  In my training at Boston University, I had the pleasure of learning from many of the leading thinkers in the field, and have applied this training through work at numerous VA hospitals.


The DSM-V criteria for PTSD are:


  • Experiencing or witnessing the trauma either first hand or in a direct contact
  • Dreams, nightmares, flashback  with significant distress
  • Avoidance of reminders of the trauma
  • Negative thoughts or mood associated with the trauma, including sad mood, guilt, exaggerated blame, negative emotions, detachment, lack of interest, problems experiencing positive emotions
  • Being in a hyper-aroused state with irritability, recklessness, issues with sleep, being on the lookout, being easily startled, and engaging in reckless or risky behavior

    How to Treat Post Traumatic Stress Disorder


    Like many other disorders, a combination of medications and therapy are best. First line treatment includes antidepressant medications which help people to not be so bothered by their experiences; they often feel calmer, more focused, and more hopeful. There are other medications available to help patients with sleep issues, nightmares, and hyperarousal symptoms they may be experiencing. Interestingly, cannabis even has a role in the treatment of this disease and is legal in the state of Rhode Island for this use.

    Psychotherapy is designed to help patients first cope with dealing with negative feelings, then to help them process the trauma with exposure to the negative feelings that they have about it, thus allowing their bodies to relearn that there is nothing to be afraid of at this time. Though it can be difficult, healing is possible, with most patients able to put these terrible experiences behind them.

    Frequently Asked Questions


    How do you know if someone has PTSD?


    PTSD usually occurs after a life threatening event. Even long after the event has passed, a person may suffer from nightmares, flashbacks, and a heightened state of anxiety. They may also go out of their way to avoid reminders of their traumatic experience.


    What are common symptoms of PTSD?


    The most common symptoms of PTSD include vivid flashbacks, intrusive images or thoughts, nightmares, distress upon experiencing reminders of their trauma, and physical symptoms like pain, nausea, sweating, or trembling.


    What happens if PTSD is left untreated?


    PTSD will not resolve on its own. When left untreated, it can lead to depression, sleep disorders, and drug and alcohol abuse. Symptoms can make it difficult for people to work and interact with those around them.


    What is the best way to treat PTSD?


    Both medications and Cognitive Behavior Therapy (CBT) are regarded as the most effective short-term and long-term treatment for PTSD. The CBT is trauma-focused, which means that the traumatic events are at the center of treatment.


    What are PTSD triggers?


    PTSD triggers include sounds, sights, smells, and thoughts that remind you of your traumatic experience and bring back strong memories, even making you feel as if you’re living through the event all over again. Some triggers are obvious, like seeing a news report of an assault, while others may have a less clear link to the original trauma.


    Is PTSD considered a disability?


    When PTSD interferes with your ability to work and carry out typical day-to-day activities, it may be considered a disability. If your PTSD is properly medically documented, it’s possible to file for a social security disability claim.


    Does PTSD change your personality?


    Yes, untreated PTSD can cause lasting personality changes that have both social and individual consequences.


    Does PTSD get worse with age?


    In some people, PTSD gets worse with age. If, for example, you’re retired, you may find that having more time on your hands and fewer distractions causes your symptoms to worsen as you reflect more on your traumatic experience.


    Does PTSD affect memory?


    People with PTSD may have trouble concentrating and issues with their memory, including memory loss. These are two common symptoms of PTSD that many people experience.


    How hard is it to get disability for PTSD?


    While it is possible to get disability payments for PTSD when it interferes with your ability to function, it can be difficult to prove symptoms like flashbacks, nightmares, and reliving traumatic events. This is why medical documentation is important.