NewYork-Presbyterian. The University Hospital of Columbia and Cornell.

Post Traumatic Stress Disorder (PTSD)

What is Posttraumatic Stress Disorder (PTSD)?

PTSD is the development of certain symptoms following a traumatic event. Events that trigger PTSD are witnessing, experiencing or being threatened with serious danger to your own or another person's life or physical integrity. The traumatic event that triggers PTSD causes intense fear, horror and helplessness.

What are the symptoms of PTSD?

The symptoms of PTSD must include at least one of the following:

• recurrent and intrusive memories of the event
• recurrent, distressing dreams of the event
• suddenly acting or feeling as if the traumatic event were recurring
• intense emotional or physical distress during events that remind you of some aspect of the traumatic event

The person also avoids things or places associated with the trauma or experiences a general numbing. At least three of the following symptoms are part of avoidance or numbing:

• trying to avoid thoughts or feelings about the trauma
• trying to avoid things or places that bring out memories of the trauma
• inability to remember an important part of the trauma
• loss of interest or participation in usual activities
• feeling detached or apart from others
• restricted range of feelings
• a sense of a shortened future

Finally, there must be persistent symptoms of increased arousal, such as trouble falling asleep or staying asleep; irritability or outbursts of anger; trouble concentrating; hypervigilance; or being easily startled.

What causes PTSD?

PTSD is a response to a traumatic event. Not all people who experience traumatic events develop PTSD, so it must be the case that some people have a physical or emotional vulnerability that allows PTSD to develop.

What happens to people who have PTSD?

PTSD symptoms usually begin immediately or soon after the trauma. The symptoms can continue for many years without treatment, or may return periodically.

What is the treatment for PTSD?

Treatment most often consists of individual and/or family therapy, group meetings with other PTSD sufferers, and sometimes medicines. Medicines used to treat the symptoms of PTSD include antidepressants, lithium, anti-anxiety medicines, beta-blockers, clonidine and others.

What can I do to help get my PTSD under control?

• Meet regularly with your therapist and/or support group.
• Learn stress management, assertiveness, relaxation and/or self-hypnosis.
• Avoid highly stimulating or violent TV, movies, music, videotapes, or situations that increase your anxiety or symptoms.
• Since sleep can be a problem with this disorder, learn ways to promote restful sleep.
• Eat a healthy diet.
• Exercise regularly.
• Discuss the social use of alcohol with your therapist or counselor.
• Avoid street drugs.
• Work at forming and maintaining friendships and a network of support.
• Work hard in therapy.
• Accept that there may be setbacks.
• Take medicines regularly if they have been prescribed for you.
• Ask for help when you need it.

What happens if the symptoms return after I get them under control?

Since PTSD is a problem that can return after it's in control, it's a good idea for the patient and therapist or counselor to make a plan for what to do if symptoms return. The plan should be in writing and should include what specific symptoms are warning signs as well as exactly what needs to be done if they appear. If your symptoms return, you should call your therapist or counselor immediately and follow the agreed upon plan.

Where can I get more information about PTSD?

There are several good books about PTSD:

Bass, Ellen and Davis, Laura
The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse. Harper, 1994.

Blume, E. Sue
Secret Survivors: Uncovering Incest and its Aftereffects in Women. Balantine, 1997.

Lew, Mike
Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse. Harper-Collins, 1990.

Matsakis, Aphrodite
I Can't Get Over It: A Handbook for Trauma Survivors. New Harbinger, 1996.

Jack Gorman. The Essential Guide to Psychiatric Drugs. 1998.

David Sheehan. The Anxiety Disease. Bantam, 1986.

The following organizations can provide help, information and support:

Holocaust Survivors and Second Generation Groups
These self-help groups are available in some communities. Check your local phone book, call your local Self-Help Clearinghouse, or check with the National Self-Help Clearinghouse at 1-212-817-1822.

Combat Veterans support groups
These self-help groups are available in some communities. Check your local phone book, call your local Self-Help Clearinghouse, or check with the National Self-Help Clearinghouse at 1-212-817-1822.

Domestic Violence support groups
These self-help groups are available in some communities. Check your local phone book, call your local Self-Help Clearinghouse, or check with the National Self-Help Clearinghouse at 1-212-817-1822.

Anxiety Disorders Association of America (ADAA)
6000 Executive Blvd.
Rockville, MD 20852
301-231-9350
www.adaa.org