Post-traumatic stress disorder is a mental health condition triggered when an individual witnesses or goes through events that are psychologically traumatic. Such events could include natural disasters, war, or any other situation where an individual experiences a feeling of intense fear and helplessness. While many individuals that go through the events adjust after the ordeal, some people find that their symptoms usually get worse. The worsening symptoms are usually caused as a result of post-traumatic stress disorder (PTSD). Following a trauma, it is usually normal to experience the range of symptoms associated with PTSD. However, when the symptoms usually extend for more than three months, they are usually considered as part of the PTSD syndrome. A proper understanding of PTSD can be made by analyzing the effects and treatments of PTSD.
Most survivors of trauma usually return to normal after some time. However, there are some individuals that could have advanced stress reactions which do not go away and could get worse with time. Symptoms of trauma that usually last for several months or get worse over time usually develop into PTSD. PTSD thus develops after a traumatic event, approximately 60% of men and 50% of women usually experience a type of traumatic event at some point in their lifetime (). Individuals that get exposed to a traumatic event experience symptom of PTSD days and weeks after the event. For some people, the traumatic event could be numbing and the symptoms could be long-lasting. The reasons for long-lasting symptoms are usually developed by social, psychological, and biological factors that usually lead to the development of PTSD.
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Effects of PTSD
Early Effects
The effects of post-traumatic stress disorder can be both far-reaching and debilitating. The trauma usually causes short-term and long-term effects on the victim. The short-term impact occurs due to the body’s immediate response after the traumatic event. The symptoms could include panic, amnesia, agitation, and dissociation. Some individuals that experience the short-term effects could have the symptoms going for up to four weeks. Throughout this time, a large number of those individuals will develop various symptoms such as anxiety disorder which is marked by a feeling of avoidance, reliving the event, and feelings of hyper-arousal. One can also develop unhealthy behavior that could be used to cope for the short-term. These high-risk behaviors often include drug abuse, alcohol, smoking, and obesity.
The early effects of PTSD can be divided into three separate symptoms. A person that gets diagnosed with PTSD usually has three symptoms which include re-experiencing symptoms, avoidance and numbing symptoms, and arousal symptoms (Friedman, 207). Re-experiencing symptoms are usually symptoms which involve reliving a traumatic event. People can relieve the trauma by having upsetting memories of a traumatic event. The memories can usually come back to an individual unexpectedly. The memories usually result in physical and emotional reactions. At certain times, the emotions can feel real and can make someone feel as if the events are taking place again. Relieving the symptoms this way is usually referred to as a flashback. It is usually associated with similar emotional turmoil like the traumatic event with feelings of horror, helplessness, and fear.
Avoidance and numbing symptoms and effects usually occur in individuals that try to avoid the traumatizing event. Many individuals that have PTSD will tend to re-experience some of the aspects of the traumatic events when they are exposed to objects and events that cause reminiscence of the trauma. There are situations such as anniversaries of an event and similarities in the person, circumstance, or place that could trigger the symptoms. These individuals usually try to avoid situations that could trigger the adverse memories of the event. The effects are that individuals could avoid going to the places where the trauma occurred or viewing news reports and TV programs about the event. One could avoid other sensational items such as sound, smell, sight, and even people that remind one of the traumatic events. Some can try to distract themselves as a way to avoid the traumatic event.
Numbing effects are usually another way where the symptoms of the traumatic event occur. Individuals that have PTSD could find it difficult to get in touch with their feelings or to express the emotions of their trauma. An individual that feels emotionally numb may try to isolate themselves from others. The numbing effects could cause one to disengage themselves from the activities which they initially enjoyed. The numbing effect can be far-reaching where an individual forgets and becomes unable to talk about the most important part of the traumatic event.
Individuals that have PTSD could experience arousal effects where they feel constantly alert after the trauma. The increased emotional arousal can be associated with diverse symptoms such as outbursts of anger, difficulty in sleeping, difficulty in concentrating, and irritability. The individuals could be aroused and constantly on the lookout for any signs of danger. They could get startled easily when any of the signs of the traumatic event appear. The arousal effects usually appear differently for people that have experienced PTSD. It could occur in the form of an accelerated heart rate, rapid breath, hypervigilance, cold sweating, and jumpiness. These symptoms usually occur for a long time after the trauma has passed.
Lasting Effects of PTSD
If not properly treated, PTSD can lead to a significant impairment of individuals that are struggling with the disorder. It can lead to an individual developing a number of medical illnesses and several types of mental health disorders. Long-term health problems that could develop or get worse as a result of an untreated post-traumatic stress disorder could include depression, anxiety, social isolation and withdrawal, separation or divorce, suicidal behaviors and thoughts, eating disorders, and self-harm ("Post-Traumatic Stress Disorder", 2018). All these are long-term effects of PTSD and an individual may also experience sleep disturbances, anxiety, emotional numbness, guilt, sadness, and outbursts of anger. One could avoid all situations, people, or circumstances which remind them of the ordeal.
The experience of PTSD can also be associated with increased use of alcohol. Simpson et al. (2014) studied the relationship between the symptoms of PTSD and alcohol use. The results revealed that PTSD symptoms can be associated with greater alcohol use. The use of alcohol can occur on the same day of the event and even in later years. The study further revealed how drinking was a coping and enhancement mechanism for PTSD. The study revealed that more than half of the men with PTSD also have problems with alcohol. It also showed that a 1-unit increase in the PTSD severity symptoms was also associated with a 37% increase in the amount of alcohol that had been consumed on the same day. The results of the study revealed that the long-term effects of PTSD can be associated with alcohol abuse and an increase in the PTSD symptoms result in an increase in alcohol use.
PTSD has also been closely associated with mental health problems such as depression, anxiety, and suicidal thoughts. A study by Ramsawh et al. (2014) analyzed the association of PTSD with suicidal behaviors and depression in the US army. The study revealed that suicide rates have increased significantly in the United States Army over the past year. The suicidal rate was highest where the incidence of the posttraumatic stress disorder (PTSD) and depression was experienced. The study showed a correlation between PTSD, depression, and suicidal thoughts. This means that U.S. Army veterans should seek help when facing early symptoms of PTSD and prevent it from developing to depression and suicidal thoughts. The symptoms of depression among patients of PTSD was also found to be more pronounced among women that experienced PTSD (Roley, 2015). Women experienced the severity of depressive symptoms such as social anxiety, and fears, and problems with alcohol.
Individuals with PTSD also experience problems with normal functioning and undertaking in daily activities. People that have PTSD are usually associated with problems in their lives such as unemployment, divorce, separation, domestic violence, and the increased chance of being fired compared to other individuals without PTSD. For instance, Vietnam veterans that had PTSD were found to have an increased problem with their family and interpersonal relationships. They also experienced an increased rate of unemployment and violence in their homes.
The far-reaching consequences have been found to be associated with an alteration of the structure of the brain. Medical studies have shown that PTSD is associated with a dysfunction in several regions of the brain such as the amygdala with hyperactivation and the prefrontal gyrus with hypo-activation (Zandieh et al., 2016). PTSD is also associated with increased physiological and neurobiological changes. The effects are associated with alteration of the brainwave activity, abnormal action of the amygdala, and a decreased volume of the hippocampus. The hippocampus and the amygdala are sections of the brain which are involved with the integration and processing of memory. The alteration of these sections of the brain results in adverse effects that alter the normal functioning of an individual.
Studies of the brain through MRI scans show how PTSD can lead to structural changes in the brain among different patients. Findings by Zandieh et al. (2016) showed how PTSD can have effects on specific brain structures. The effect on these structures of the brain usually plays a big role in the chronic and psychiatric symptoms of PTSD that could last even after decades of being exposed to the trauma. Human right workers and healthcare professionals should consider the mental impacts of PTSD when treating their patients. The results from the study showed that it is possible for an individual to have structural and metabolic changes in the brain after trauma. When trying to find the appropriate treatment, it may be important for medical professionals to perform an MRI scanning of the brain to understand the disease and the best possible treatment.
Treatment Options
Psychotherapy
Treatment for PTSD usually starts with a detailed evaluation and development of a treatment plan that would meet the unique needs of the survivor. There are two treatment options for PTSD which include psychotherapy and medications. Therapy in the treatment of PTSD involves talking with a mental health professional to work through the experiences and the impact of the traumatic events on an individual. The aim of psychotherapy is to help the individual integrate the traumatic event in their lives so that it functions just like a memory in the background and not interfere with one’s life. Therapy would provide a safe place where trauma survivors can tell their stories, feel less isolated, and be tolerated even when they show adverse symptoms. Group treatment and family therapy can also be used as medications to accelerate the treatment as a group or family.
Therapy for PTSD usually starts with a process that focuses on comfort and coping, restoring the feeling of safety, calming of one’s nervous system, and education an individual about their experience and why. Cognitive behavioral therapy (CBT) is a therapeutic treatment option. It includes exposure therapy, cognitive restructuring, and stress inoculation training (Khan et al., 2018). All these CBT techniques have been developed and advanced over the years and can help patients that are experiencing PTSD symptoms find relief.
Exposure therapy uses mental imager or writing to recall the events that happened and help the patients cope up with their feelings. It could involve exposing patients to the memory and experience of the trauma in a safe environment. Doing this makes the patient feel a sense of empowerment. They can go through the traumatizing experience with a feeling of power, strength, and be ready to overcome it. The tools used to recall the event are imagery, visits, and writing about the events that happened. However, the therapy technique may be used selectively because it can cause to adverse effects of the trauma in case the patient is uncomfortable and is stilling feeling helpless.
Cognitive restructuring helps people to make sense of their experience and memories and to view the events differently than how it happened. Cognitive restricting is used to create an accurate memory and imagery of the traumatic event. People that experience trauma usually recall the experience differently compared to how it actually happened. One could have feelings of guilt and shame about what may not be their fault. The therapist can try to work with the patient and help them look at the traumatic event in a way that is more realistic.
Stress inoculation training helps an individual reduce anxiety when confronted with anxiety-provoking situations. An individual can be taught about different strategies that can be used to reduce anxiety symptoms. Various strategies that can be used include deep breathing with the diaphragm, muscle relaxation training, role-playing, and learning to silently talk to oneself. All these strategies can help one to change the negative thoughts that are usually associated with the trauma and PTSD. Just like other cognitive behavioral therapy techniques, stress inoculation training treatment helps an individual to view their experiences and trauma in a healthier way.
There have also been new types of therapy treatments that have been developed such as eye movement desensitization and reprocessing (EMDR). This is a treatment that makes use of elements of cognitive behavioral therapy and exposure therapy with the use of other techniques such as eye movements, hand taps, and sounds. A study by Khan (2018) revealed that EMDR is better than CBT in reducing and treating post-traumatic symptoms and anxiety. However, it is equally effective in reducing depression when compared to CBT. The use of EMDR treatment is more effective in overall and is recommended for patients with PTSD.
Other forms of therapy that can be included for treatment are group treatment and family therapy. Group treatment is an ideal form of treatment because it seeks to provide help and support for patients while sharing the traumatic event in an environment that is safe. Family therapy will involve the involvement of the entirety of the patient’s family support. This will enable one’s family members to understand why an individual goes through lots of stress and why one may get angry from time to time (Perlick et al., 2017). The family will be best prepared to help an individual and this will lead to the building of better relationships.
Medication
Treatment by medication involves the administration of drugs. There are two medications for PTSD that have been approved by the U.S. Food and Drug Administration (FDA) which include paroxetine (Paxil) and sertraline (Zoloft). These medications are antidepressants which have selective serotonin reuptake inhibitors (SSRIs) primarily used to treat depression. The drugs are used to control some of the symptoms of PTSD such as worry, anger, sadness, and feelings of numbness and helplessness ("Signs, Symptoms & Effects of PTSD”, 2018). Medications can be used with therapy to make it possible for a wholesome and effective treatment. Antidepressants can take several days and weeks before one realizes a significant improvement. It is thus important that one allows for enough time for the treatment to take effect and for the medications to work. In case the medications do not work, one can work with their doctor to adjust the dosage or switch to another treatment option.
There are other types of medications that doctors could prescribe for a patient such as benzodiazepines, antipsychotics, and other antidepressants. Benzodiazepines are usually administered to PTSD patients that have difficulty in sleeping. The medication helps patients relax and to sleep easily. However, care should be taken to prevent the possible development of dependence. Antipsychotics can be prescribed to PTSD patients that experience severe forms of paranoia, suspiciousness, and agitation. There are other forms of antidepressants such as citalopram and fluoxetine that could help patients feel happier and less tense. Antidepressants could help patients that are experiencing PTSD and other anxiety disorders such as depression and suicidal thoughts. There are potential side effects to these medications that one should be informed about.
In conclusion, the effects of PTSD can be short-term or long-term and treatment options should be considered so that one can resume to healthy living. Short-term effects occur after encountering a traumatic event and could last up to one month. Long-term effects can lead to severe mental disorders and treatment option should be highly considered. PTSD has been associated with alteration of the structure of the brain. It is usually associated with depression and suicidal thoughts. Treatment can be administered through the use of psychotherapy or medication. Successful treatment of PTSD should allow the feelings and memories to become integrated so that the symptoms eventually go away.
References
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Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive Behavioral Therapy versus Eye Movement Desensitization and Reprocessing in Patients with Post-Traumatic Stress Disorder: Systematic Review and Meta-analysis of Randomized Clinical Trials. Cureus , 10 (9), e3250. doi:10.7759/cureus.3250
Perlick, D. A., Sautter, F. J., Becker-Cretu, J. J., Schultz, D., Grier, S. C., Libin, A. V., Schladen, M. M., … Glynn, S. M. (2017). The incorporation of emotion-regulation skills into couple- and family-based treatments for post-traumatic stress disorder. Military Medical Research , 4 , 21. doi:10.1186/s40779-017-0130-9
Post-Traumatic Stress Disorder | Psychology Today. (2018). Retrieved from https://www.psychologytoday.com/us/conditions/post-traumatic-stress-disorder
Ramsawh, H. J., Fullerton, C. S., Mash, H. B. H., Ng, T. H. H., Kessler, R. C., Stein, M. B., & Ursano, R. J. (2014). Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the US Army. Journal of Affective Disorders , 161 , 116-122.
Roley, M. E., Claycomb, M. A., Contractor, A. A., Dranger, P., Armour, C., & Elhai, J. D. (2015). The relationship between rumination, PTSD, and depression symptoms. Journal of Affective Disorders , 180 , 116-121.
Signs, Symptoms & Effects of PTSD | Pacific Grove Hospital. (2018). Retrieved from https://www.pacificgrovehospital.com/ptsd/symptoms-signs-effects/
Simpson, T. L., Stappenbeck, C. A., Luterek, J. A., Lehavot, K., & Kaysen, D. L. (2014). Drinking motives moderate daily relationships between PTSD symptoms and alcohol use. Journal of abnormal psychology , 123 (1), 237-47.
Zandieh S, Bernt R, Knoll P, et al. Analysis of the Metabolic and Structural Brain Changes in Patients with Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using ¹ ⁸ F-FDG PET and MRI. Medicine (Baltimore) . 2016;95(15): e3387.
