Post-traumatic stress disorder (PTSD) is a mental health disorder that occurs after experiencing or witnessing something traumatic or even life-threatening. Let’s get one thing straight here: If you’re experiencing PTSD, it doesn’t make you weak. It just means that you’ve been through something terrible and you need some help getting through it.
Psychiatrist Charles Marmar, director of the Post-traumatic Stress Disorder Research Program at NYU Langone, spoke with Allure about PTSD, including causes, symptoms, and treatments.
What is PTSD, and what are its potential causes?
PTSD is a mental health disorder that occurs in those who have witnessed or experienced some sort of traumatic event. These types of events include, but are not limited to: natural disasters; war; horrific accidents; rape; physical, emotional, and sexual abuse; another form of personal assault; or prolonged trauma. According to Marmar, “Potential causes are exposure to events that either threaten your life directly, threaten the life of someone close to you, are sudden or overwhelmingly horrific, even if your own life was not in danger.” The American Psychiatric Association estimates that one in 11 people will experience PTSD in their lifetime.
What are the symptoms of PTSD?
PTSD symptoms vary from person to person, but some signs are more widespread than others. Marmar tells Allure, “The most common symptoms are nightmares, flashbacks, and startle reactions. Nightmares mean you have vivid disturbing dreams which are recurrent. They can be like a movie, or they can even be weird dreams in which the event you witnessed gets morphed in certain ways, but they’re still traceable to the event itself.”
True flashbacks are pretty rare, says Marmar, and people tend to mislabel what they experience. In a true flashback, you feel you are actually transported to the event itself, and for a moment you believe your life is in danger. Startle reactions refer to a person being jumpy and on high alert in everyday life, even when completely safe.
How long after a traumatic event does PTSD present itself?
This can vary, though Marmar says most people who develop PTSD show intense symptoms directly after the event, with only a small minority developing symptoms much later on. Those who develop symptoms much later are most often warfighters, police, and first responders, Marmar says, likely because of their training, which includes management of helplessness.
“For most civilians,” Marmar explains, “if they’re not having symptoms and feeling pretty comfortable at three to four weeks, they probably won’t develop PTSD.” It’s important to note that PTSD isn’t always diagnosed until symptoms have persisted for a month or longer; until that point, doctors may refer to symptoms as an “acute stress reaction.” Symptoms must interfere with work and relationship functioning and cause intense stress for a month to be diagnosed as PTSD.
Is PTSD often seen alongside other mental health issues?
Marmar says there are a few mental health conditions that often run concurrently with PTSD, the most common of which is depression. “About half of people with chronic PTSD develop depression secondary to PTSD for reasons that are complex, including biological reasons as well as psychological, changes in the brain, as well as PTSD disrupting your life,” Marmar explains. “PTSD also affects reward circuitry, so it can directly cause depression in the brain.” Rather than seeing behavioral specialists, some people who suffer from PTSD develop dependencies on alcohol, which nearly always worsens symptoms, according to Marmar.
“Panic attacks may also occur, though they may not be true spontaneous panic attacks. Rather, they’re panic-like reactions when experiencing vivid images and memories, or you might have a panic feeling [when waking from] a traumatic dream.” Other conditions may occur if the PTSD is persistent, such as chronic insomnia, which Marmar says can make a person more prone to infections. “If [the PTSD is] very chronic, you can be at risk for cardiovascular disease, and it can even affect the quality of your cognitive thinking over time if it’s persistent.”
What are good coping mechanisms for when PTSD symptoms spring up?
There are plenty of coping mechanisms for PTSD, and many of them involve staying present in the moment and reminding yourself that you’re safe. Marmar advises, “A good thing to do is to remind yourself that you’re in a safe situation, to speak with someone you trust about the experience, and to think in a realistic way about what happened.”
It’s also important to not blame yourself for what happened, no matter what aftereffects you’re dealing with. Remind yourself whenever possible that most situations are relatively safe, and continue with your life and goals however possible. Get extra rest and go easy on yourself, and use yoga and meditation if that works for you (though you shouldn’t force yourself into any activities that don’t feel right for your recovery). If you feel as though turning off the news or logging off social media will help, try to do sometimes. Marmar also stresses that, if possible, it’s important to avoid becoming phobic when it comes to things related to the event.
What does a long-term treatment plan for PTSD look like?
Long-term treatment for PTSD is pretty controversial, notes Marmar, but cognitive processing therapy is considered the gold standard. He tells Allure, “It fundamentally helps you to evaluate more realistically your appraisal of the event without dragging you through re-experiencing the event with a doctor, and that’s combined with education, support, the protective effect of having a relationship with a trusted behavioral specialist and also combined with learning not to avoid everyday reminders of the trauma in your real life.”
Some PTSD patients also receive medication for treatment, including antidepressants, sedatives, antipsychotics, medications that help with insomnia, and other medication that helps with alcohol abuse, according to the New England Journal of Medicine. Because symptoms and patient needs vary, so does treatment.
Read more stories about mental health:
Now, watch this: