People joke about having post-traumatic stress disorder if their coffee order is wrong, says Elena Breese, a Boston Marathon bombing survivor from Phoenix, Arizona.
“But I wish people understood how difficult regular life can be for those like me, who live with PTSD,” she says. “It’s not an invisible illness. My family and close friends see what this disorder can do to me.”
Breese isn’t alone. Nearly 4% of the population has suffered from PTSD at some point in their lives, according to the World Health Organization (WHO). Although living with PTSD is difficult, there are treatments and support available to help you or a loved one live life to the fullest.
“Living with PTSD can be a challenge,” says Breese, who is also an advisory board member of Strength to Strength, an international organization that supports victims of terror and their families, and an executive board member of National Alliance on Mental Illness Valley of the Sun. “But it has also given me a lens to see life through that has made me more compassionate, empathetic and understanding of people who need help. For this, I am grateful for how having PTSD has shaped my life since the bombing.”
Read on to learn more about PTSD, common PTSD symptoms and how to treat PTSD.
[READ: What to Do During a Mental Health Crisis]
What Is PTSD?
PTSD is a mental condition that occurs after experiencing a life-threatening, violent or distressing event.
PTSD is diagnosed by a mental health professional, considering the following criteria:
— The individual has had an exposure to a traumatic event, either directly or indirectly.
— The traumatic event is continually reexperienced, which may be through flashbacks, nightmares or unwanted thoughts.
— These experiences interfere with daily life for more than one month.
There is also another type of PTSD called complex PTSD. C-PTSD is often caused by long-term, repeated trauma, rather than a single traumatic event.
PTSD was once called “shell shock,” “battle fatigue” or “Vietnam Veterans’ Disorder,” representing the many soldiers returning home from conflict who struggled with mental health issues as a result of their experiences overseas. Since then, the definition of PTSD has been refined and expanded to include more than only veterans with PTSD. Where once upon a time it was thought to only affect soldiers returning from combat, we now understand that it can affect virtually anyone who’s experienced or witnessed a trauma.
PTSD Causes and Symptoms
PTSD is typically triggered by a single, traumatic event — such as a terrible accident — or a series of ongoing traumas, like childhood sexual abuse, particularly in cases with C-PTSD.
When in danger, the body naturally experiences a fight-or-flight response, which is a beneficial instinct to help us avoid getting hurt. When this response gets too intense, and lasts even after the trauma has passed, it leads to intrusive thoughts that can negatively impact your life — that’s PTSD.
Symptoms of PTSD are grouped into four clusters of symptom types. The first group is reexperiencing the trauma that may occur through:
— Unwanted and distressing recollections or memories
— Nightmares or bad dreams about the event
— Flashbacks
— Intrusive thoughts
The second group of symptoms is centered around avoidance and may include:
— Feelings of emotional numbness
— Avoidance of places, activities or people associated with the trauma
— Trying to avoid talking or thinking about the event
The third group of symptoms is related to increased arousal and may include:
— Feeling anxious or on edge all the time
— A heightened startle-response (jumping at unexpected sounds, for example)
— Difficulty sleeping
— Angry outbursts or extreme irritability
— Feelings of guilt or shame
— Engaging in self-destructive behavior or self-medicating with drugs or alcohol
The fourth and final group relates to negative changes in mood and thinking that may include:
— Mood swings
— Angry outbursts
— Difficulty focusing or concentrating
— Negative feelings about oneself or others
— Depression and hopelessness
— Feeling detached from loved ones and unable to engage in formerly enjoyable activities
Not every patient who has PTSD will experience all these symptoms, but in order for the disorder to be diagnosed, the symptoms need to be present for at least a month. These symptoms may not surface for months or even years after a traumatic event, making it sometimes difficult to pinpoint the triggering event.
Risk Factors for PTSD
Anyone can develop PTSD at any point in their lives, though not everyone who experiences trauma will develop PTSD.
The following are risk factors for PTSD:
— Experiencing or witnessing a trauma, which can be anything from a near-death experience, an accident, a war, death of a loved one, ongoing abuse or even medical trauma
— Being female, as females are more at risk to develop PTSD than men, according to the WHO
— Having lower levels of education, thought to be because those with more education may have improved coping and resilience skills
— Lacking support by family members or friends after experiencing a traumatic event
— Having another mental health condition, such as substance use disorder, depression, schizophrenia or anxiety
— Having a family history of mental health conditions
Why some people are able to avoid PTSD while others develop it is not fully understood and is still being researched.
[Read: How Foods and Drinks Affect Our Mental Health]
Diagnosing PTSD
If you find yourself having one or more of the symptoms listed above, you should speak with your health care provider about what you’re experiencing.
There is no blood test that can diagnose PTSD, but your health care or mental health provider will diagnose you through a thorough medical history and by performing a physical examination to rule out any other medical conditions that could lead to some of these symptoms. As mentioned above, most people receive a diagnosis of PTSD when they’ve had a number of the previously listed symptoms for a month or more.
Your primary care physician may be able to make a diagnosis of post-traumatic stress disorder. You may also be referred to a specialist, such as a psychologist, psychiatrist or psychiatric mental health nurse practitioner for additional evaluation, support and treatment.
[READ: Types of Therapy: Choosing the Right One for You.]
Health Impacts of PTSD
PTSD has been shown through scientific research studies to be associated with various long-term physical and mental health problems in veterans, says Paul Greene, a psychologist and director of the Manhattan Center for Cognitive-Behavioral Therapy in New York. Greene says health conditions that often arise from PTSD may be:
— Cardiovascular disease, including heart failure, stroke and abnormal heart rhythms
— Chronic pain
— Respiratory conditions
— Disrupted sleep and insomnia
— Other mental health disorders, including depression or anxiety
— Anger
— Difficulty with interpersonal relationships
You should always bring up your history of PTSD at any medical appointment, even if the visit isn’t directly about mental health. This helps your provider understand how PTSD may be impacting your physical health.
Treatment for PTSD
No matter who you see for help, it’s best to seek help sooner rather than later. As research into PTSD has increasingly shown, early intervention after a traumatic event helps.
You may be treated with a combination of approaches, including:
— Medications, such as antidepressant medications like selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. This includes a variety of prescription medications, such as Prozac and Zoloft.
— Talk therapy, cognitive behavioral therapy (CBT) or prolonged exposure therapy, which can help with emotionally processing the trauma
— A type of therapy called eye movement desensitization and reprocessing. EMDR therapy must be performed by a mental health provider certified in this type of therapy that helps reprocess traumatic events. The patient is told to reimagine the traumatic event while moving his or her eyes rapidly, often by a tracking movement made by the therapist. It’s believed that pairing eye movements with an intense mental focus on the traumatic experience allows the brain to process the problematic material differently.
— Other treatment options are vast and include acupuncture, pet therapy, support groups, art or music therapy or yoga.
Don’t hesitate to talk to your medical or mental health provider about considering unique combination therapies.
“I feel like I’ve tried everything over the years,” Breese says. “I think approaching PTSD from every angle and throwing every resource I could find towards it has helped me find healing and greater management of my PTSD.”
You can also try utilizing support from apps or hotlines. These two options play a valuable support role in treating PTSD, says Brian Livesay, a clinical psychologist with experience in veteran mental health, trauma and developmental psychology. Livesay also serves as a clinician at the Cheyenne VA Medical Center in Wyoming.
“Hotlines provide immediate emotional assistance. Apps support ongoing self-management and reinforce therapeutic skills,” Livesay says. “It’s important to remember that neither replaces professional therapy, but they help empower individuals, reduce isolation and improve continuity of care.”
Seeking help and support
Regardless of the approach or combination of treatments used, it’s important to see a health professional for help if you have PTSD. Left untreated, PTSD can disrupt any aspect of your daily life, from work, school, relationships or even just taking care of yourself.
Despite this, there is still some stigma related to PTSD. You may feel you need to “pull yourself up by the bootstraps” or “get over it,” but PTSD is real and not something you need to handle on your own. A 2018 study in Frontiers in Behavioral Neuroscience states that trauma-informed PTSD counseling, such as CBT or prolonged exposure therapy, has a large evidence base showing its effectiveness.
Seeking help for PTSD is important and not a sign that you’re weak or that you’ve done anything wrong.
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A Patient’s Guide to Post-Traumatic Stress Disorder originally appeared on usnews.com
Update 06/30/25: This story was previously published at an earlier date and has been updated with new information.
