Post-traumatic stress disorder

Reliving the event through upsetting thoughts, nightmares or flashbacks, or having very strong mental and physical reactions if something reminds the person of the event.

Avoiding activities, thoughts, feelings or conversations that remind the person of the event; feeling numb to one’s surroundings; or being unable to remember details of the event.

Having a loss of interest in important activities, feeling all alone, being unable to have normal emotions or feeling that there is nothing to look forward to in the future may also be experienced.

Feeling that one can never relax and must be on guard all the time to protect oneself, trouble sleeping, feeling irritable, overreacting when startled, angry outbursts or trouble concentrating.

Traumatic events that may trigger post-traumatic stress disorder (PTSD) include violent personal assaults, natural or human-caused disasters, accidents, or military combat. Among those who may experience PTSD are troops who served in the Vietnam and Gulf Wars; rescue workers involved in the aftermath of disasters like the terrorist attacks on New York City and Washington, D.C.; survivors of the Oklahoma City bombing; survivors of accidents, rape, physical and sexual abuse, and other crimes; immigrants fleeing violence in their countries; survivors of the 1994 California earthquake, the 1997 North and South Dakota floods, and hurricanes Hugo and Andrew; and people who witness traumatic events.

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when symptoms last more than 1 month.

Physical symptoms such as headaches, gastrointestinal distress, immune system problems, dizziness, chest pain, or discomfort in other parts of the body are common in people with PTSD. Often, these symptoms may be treated without the recognition that they stem from an anxiety disorder.

Treatment may be through cognitive-behavioral therapy, group therapy, and/or exposure therapy, in which the person gradually and repeatedly re-lives the frightening experience under controlled conditions to help him or her work through the trauma. Several types of medication, particularly the selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, can also help relieve the symptoms of PTSD.

Giving people an opportunity to talk about their experiences very soon after a catastrophic event may reduce some of the symptoms of PTSD. A study of 12,000 school children who lived through a hurricane in Hawaii found that those who got counseling early on were doing much better 2 years later than those who did not.