Post-traumatic stress disorder (PTSD) is a relatively common mental health condition resulting from traumatic experiences, with ongoing distressing symptoms and impaired function. It can affect adults and children of any age. It increases the risk of other mental health conditions, including depression, anxiety, substance misuse and suicide.
Various theories explain the condition, including that previous assumptions that the world is a good place are destroyed by the traumatic event and that there is an unconscious loss of trust in the world’s safety.
Traumatic Events
PTSD can result from any event that the individual finds traumatic.
Examples include witnessing or experiencing:
- Violence (e.g., sexual assault, domestic violence, abuse or physical attacks)
- Major car accidents
- Major health events (e.g., traumatic childbirth, serious illness or death of a loved one)
- Natural disasters
- Military, combat and war zone events
Presentation
The symptoms vary between patients based on their individual experiences and responses. The history will contain exposure to one or repeated traumatic events.
Key symptoms include:
- Intrusive thoughts relating to the event
- Re-experiencing (experiencing flashbacks, images, sensations and nightmares of the event)
- Hyperarousal (feeling on edge, irritable and easily startled)
- Avoidance of triggers that remind them of the event (e.g., people, places or talking about the event)
- Negative emotions (e.g., fear, anger, guilt or worthlessness)
- Negative beliefs (e.g., the world is dangerous)
- Difficulty with sleep
- Depersonalisation (feeling separated or detached)
- Derealisation (feeling the world around them is not real)
- Emotional numbing (unable to experience feelings)
Diagnosis
The Trauma Screening Questionnaire (TSQ) can be used as a screening tool, prompting a referral for further assessment.
Diagnosis is based on criteria from either:
- Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- International Classification of Diseases (ICD-11)
Management
Management is tailored to the individual. Options include:
- Psychological therapy (e.g., trauma-focused CBT)
- Eye movement desensitisation and reprocessing (EMDR)
- Medication (e.g., SSRIs, venlafaxine or antipsychotics)
Eye movement desensitisation and reprocessing (EMDR) involves processing traumatic memories while performing specific eye movements. The theory is that the improperly stored traumatic memories are reprocessed and stored again in a more normal way so that they no longer cause as much negative emotion and distress.
Last updated June 2024
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