June is Post-traumatic Stress Disorder Awareness Month, and as a veteran with more than 30 years in the Army Reserves and more than 13 years of psychiatry experience, this topic means a lot to me. Part of spreading awareness is sharing information about the disorder, so I’ve answered some common questions about PTSD below.
What is PTSD?
PTSD is a group of symptoms which include hyper vigilance, which means being hyper-aware of your surroundings, or being angry or irritable all the time. Avoidant behaviors are also common — things like difficulty trusting people, being in public or engaging in relationships with others. Difficulty reliving experiences can also happen, including flashbacks, nightmares or difficulty with a fight or flight response in response to certain environmental triggers.
How common is PTSD?
It’s pretty common. For example, between 15 to 20% of combat veterans will have significant symptoms of post-traumatic stress after their traumatic exposures. Other trauma that commonly leads to post-traumatic stress can include sexual traumas, automobile accidents or plane crashes.
Along with combat veterans, those who are victims of sexual or physical assault can also experience PTSD.
What are some common symptoms of PTSD to look for?
Symptoms can include the following:
- Persistent re-experiencing of the event
- Intrusive thoughts related to traumatic events, nightmares, or distressing dreams
- Frequent involuntary memories, which include flashbacks and intense negative emotional or physiologic responses that are reminders of the traumatic event
- Avoidance behaviors of traumatic triggers like not being able to watch certain movies, be in certain areas or be in crowds
- Negative alterations of cognition and mood
- Inability to recall important aspects of the trauma
- Frequent negative beliefs and expectations about oneself, others in the world and appropriate blaming of oneself for the trauma
- Exaggerated or negative beliefs about the consequences of trauma, or persistent negative emotional states, such as sadness or guilt
- Loss of interest in participating in important activities like family gatherings or work duties and detachment from people
- Increased arousal reactivity, which includes irritability, difficulties with sleep and concentration, increased startle reactions, increased vigilance for potential danger, self-harming acts or recklessness
Based on these symptoms, the syndrome crosses three areas — hypervigilance, avoidant behaviors and reliving experiences. The severity of symptoms varies from individual to individual, so it doesn’t always look the same for each patient.
What are the treatment options for PTSD?
The most effective treatment options are primarily psychotherapeutic or non-pharmacologic. Examples of these therapies include prolonged exposure, cognitive behavioral therapy, cognitive processing therapy and eye movement desensitization and reprocessing therapy. However, if patients cannot have full symptom resolution with psychotherapies, then there are medication options, although medications may not be as effective for long-term treatment of symptoms. Medications like antidepressants or those that assist with sleep can be commonly prescribed as alternatives to psychotherapies.
On average, how long does it take for someone to recover after an event?
It’s variable and depends on how long the symptoms have been present, the severity of the initial trauma, and the availability and responsiveness of appropriate treatment. We do know that with appropriate treatment, the condition is treatable and does improve.
Could treatments potentially be lifelong?
Certainly, there are people that end up having lifelong symptoms, either due to a relapse of symptoms or having other comorbid mental health conditions, like depression, anxiety or substance use disorders. Retraumatization can also occur. For example, a person who experienced a severe motor vehicle accident can be re-triggered by being in a motor vehicle.
If you or a loved one has experienced a traumatic event, and if any symptoms of hypervigilance, avoidant behaviors, or reliving experiences are impacting yours or their lives, then you should seek the advice of a mental health professional, so that treatment options can be discussed.
The UF Health Brain Wellness Program – Jacksonville, which has a planned opening in fall 2021, is dedicated to helping veterans and their families. The program will focus on the diagnosis and treatment of traumatic brain injury and post-traumatic stress. The program has started assessments for participants interested in taking part in the program. For those who are interested or would like more information, please email Brittnay.Camps@jax.ufl.edu.