What is it?

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a traumatic event, such as combat, a natural or human-made disaster, a car accident, sexual assault, domestic violence, abuse or neglect, etc.

It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after a traumatic event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

  • If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time. PTSD typically requires treatment to process and resolve the trauma.

Who Develops PTSD?

Anyone can develop PTSD at any age. A number of factors can increase the chance that someone will have PTSD, such as having a very intense or long-lasting traumatic event or getting injured during the event. Personal factors (i.e. prior traumatic experience, age, gender) can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can increase the likelihood of developing PTSD and social support can decrease it.

What Are the Symptoms of PTSD?

Symptoms may start soon after the traumatic event or may not appear until months or years later. They also may come and go. There are four types of PTSD symptoms but they vary by individual.

The symptoms may include:

  1. Reliving the event (also called re-experiencing symptoms). Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:
    • You may have nightmares.
    • You may feel like you are going through the event again. This is called a flashback.
    • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
  2. Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:
    • You may avoid crowds, because they feel dangerous.
    • You may avoid driving if you were in a car accident or if your military convoy was bombed.
    • If you were in an earthquake, you may avoid watching movies about earthquakes.
    • You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
  3. Negative changes in beliefs and feelings. The way you think about yourself and others changes because of the trauma. This symptom has many aspects, including the following:
    • You may not have positive or loving feelings toward other people and may stay away from relationships.
    • You may forget about parts of the traumatic event or not be able to talk about them.
    • You may think the world is completely dangerous, and no one can be trusted.
  4. Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. You might suddenly become angry or irritable. This is known as hyperarousal. For example:
    • You may have a hard time sleeping.
    • You may have trouble concentrating.
    • You may be startled by a loud noise or surprise.
    • You might want to have your back to a wall in a restaurant or waiting room.

What Are the Symptoms of PTSD in Children?

Children may have symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

  • Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
  • Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
  • Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.

For more information, see

Will People with PTSD Get Better?

After a traumatic event, it’s normal to think, act, and feel differently than usual—but most people start to feel better after a few weeks or months. Talk to a doctor or mental health care provider if your symptoms:

  • Last longer than a few months
  • Are very upsetting
  • Disrupt your daily life

“Getting better” means different things for different people. There are many different treatment options for PTSD. For many people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense. Your symptoms don’t have to interfere with your everyday activities, work, and relationships.

What Treatments Are Available?

There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist.

Trauma-focused psychotherapy, which focuses on the memory of the traumatic event or its meaning, is the most effective treatment for PTSD. There are different types of trauma-focused psychotherapy, such as:

Medications for PTSD

Medications can be effective too. Some specific SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are used for depression, also work for PTSD. These include sertraline, paroxetine, fluoxetine, and venlafaxine.

(This information was adapted from The National Center for PTSD)

Trauma Responses and COVID-19

We are in the midst of a disaster — and I don’t mean just in a political or an economic sense. COVID-19 and its fallout are a disaster with repercussions for our emotional health. In this worldwide disaster, large numbers of people are affected by the same traumatic experience. During and after a disaster there can be numerous losses: loss of loved ones, coworkers, neighbors, homes, workplaces, communities, and so on. People lose their routines for living and working, going to school, and being with others. Some lose their confidence in the future. Disasters that continue over a long period of time can create ongoing insecurity and fear of danger that makes it difficult for people to function. It is normal to have stress reactions, as well as to grieve and mourn the traumatic losses. Our safety, security, and predictability in the world is challenged, and uncertainty becomes a part of life.

Normal stress responses

Typical responses to a disaster can include:

• Emotional (feeling) reactions: shock, disbelief, anxiety, fear, grief, anger, resentment, guilt, shame, helplessness, hopelessness, betrayal, depression, and/or emotional numbness.
• Cognitive (thinking) reactions: confusion, disorientation, indecisiveness, worry, shortened attention span, difficulty concentrating, memory loss, unwanted memories, repeated imagery, self-blame.
• Physical (bodily) reactions: tension, fatigue, edginess, difficulty sleeping, nightmares, being startled easily, racing heartbeat, nausea, aches and pains, worsening health conditions, change in appetite, change in sex drive.
• Interpersonal reactions: neediness, dependency, distrust, irritability, conflict, withdrawal, isolation, feeling rejected or abandoned, being distant, judgmental, or over-controlling in friendships, marriages, family, or other relationships.
• Spiritual ( meaning) reactions: wondering why, why me, where was God; feeling as if life is not worth living.

Traumatic Stress and PTSD

People may be more vulnerable to traumatic stress or PTSD if they were directly impacted or witnessed others being impacted. Disaster stress may revive memories or experiences of earlier trauma, as well as possibly intensifying pre-existing social, economic, spiritual, psychological, or medical problems. The shared experience of disasters and people’s resiliency can provide support.

Some risk factors include:

• Loss of family, neighborhood, or community
• Life-threatening danger or physical harm (especially to children)
• Exposure to horrible death, bodily injury, or bodies
• Loss of communication with or support from important people in one’s life
• Intense emotional demands
• Extreme fatigue, hunger, or sleep deprivation
• Extended exposure to danger, loss, emotional/physical strain
• Exposure to the novel coronavirus

Individuals are more vulnerable to PTSD if they have a history of:

• Other traumatic experiences (such as severe accidents, abuse, assault, combat,
immigrant and refugee experiences, rescue work)
• Chronic medical illness or psychological problems
• Chronic poverty, homelessness, unemployment, or discrimination
• Recent or earlier major life stressors or emotional strain (such as divorce or job loss).

What can we do to reduce our vulnerability and recover?

Try the following steps help to reduce stress symptoms and promote readjustment:

• Protect: find a safe haven and take opportunities to sit quietly, relax, and sleep
• Direct: begin working on immediate personal and family priorities to help you and your loved ones preserve or regain a sense of hope, purpose, and self-esteem
• Connect: maintain or re-establish communication with family, peers and counselors to talk about the experiences. Survivors may want to find opportunities to “tell their stories” to others who express interest and concern and, when they are able, to listen to others as they tell theirs, in order to release the stress a little bit at time and try to create meaning.
• Select: identify key resources for unemployment, health, housing, and basic emergency assistance. Identify local cultural or community supports. Take it one day at a time.

To manage the effects of COVID-19 try to:

• Focus on what’s most important to you and your family today
• Learn and understand what you and your loved ones are experiencing, to help remember what’s important
• Understand personally what this experience means as a part of your life, to go on with your life and even grow personally
• Take good care of yourself physically by exercising regularly, eating well, and getting enough sleep, to reduce stress
• When feasible, work together with others in your community to improve conditions, reach out to persons who are marginalized or isolated, and otherwise promote recovery.

How do I know if I need professional help?

Some signs include:

• Intrusive re-experiencing of former trauma (terrifying memories, nightmares, or flashbacks)
• Unsafe attempts to avoid disturbing memories or reality (such as through substance use or alcohol)
• Complete emotional numbing (unable to feel emotion, as if empty)
• Extended hyperarousal (panic attacks, rage, extreme irritability, intense agitation, exaggerated startle response)
• Severe anxiety (paralyzing worry, extreme helplessness)
• Severe depression (loss of energy, interest, self-worth, or motivation)
• Loss of meaning and hope
• Sustained anger or rage
• Dissociation (feeling unreal or outside oneself, as in a dream; having “blank” periods of time one cannot remember)

If your normal stress responses to COVID-19 do not improve or if they worsen with time, it is helpful to find professional support.  Please call me at 484-213-3616.

(This information is adapted from the International Society of Traumatic Stress Studies). 

42 Henley Road
Wynnewood, PA 19096
(484) 213-3616

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