What is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. It may cause intrusive memories, flashbacks, mood shifts, sleep issues or avoidance.

It will not go away on its own and may worsen over time, affecting your daily functioning as well as your relationships and work.

Seeking help from your doctor or a qualified trauma therapist is strongly advised 

Types of PTSD and related Diagnoses:

There are several subtypes of PTSD that can be influenced by the cause of trauma, timing or specific symptoms:

• Acute Stress response (ASD): Is a short-term mental health condition that can occur within 3 days to 4 weeks after experiencing an intensely traumatic event. Individuals may experience, anxiety, panic attacks, physical and emotional stress responses, intense fear, avoidance or helplessness, flashbacks or nightmares and feeling numb or detached from one’s body. If untreated it may develop into PTSD.

• Adjustment Disorder: Short-term, stress-related condition characterized by an intense, disproportionate emotional or behavioural reaction to a life change or event. It occurs within three months of the stressor, causing significant disruption to daily life, and usually resolves within six months after the stressor ends.

• PTSD with delayed expression: Full symptoms of PTSD don’t appear until at least six (and sometimes years) after the traumatic event, even though mild symptoms may start earlier. This type of PTSD can occur when faced with a new, overwhelming stressor or when smaller, later stressors eventually cause a full stress response, it can also occur when the individual is no longer in the situation and feels safer or more stable.

• Complex PTSD (C-PTSD): This comes from long-term or repeated, chronically traumatic situations (especially early childhood and via interpersonal trauma). It includes PTSD symptoms, plus ongoing problems with emotions, self-image and relationships.

• Dissociative PTSD: This includes symptoms of dissociation, like feeling disconnected from your body or feeling like the world isn’t real. It can occur both single event traumas and in early, attachment and neglect trauma or C-PTSD

Causes of PTSD

Exposure to a traumatic event causes post-traumatic stress disorder. Trauma is a situation that feels life-threatening or deeply stressful including:

• Physical, emotional, sexual, financial and verbal abuse or assault

• Serious accidents and incidents, natural disasters, fires or floods

• Severe injury or sudden illness, diagnosis

• The sudden or traumatic loss or death

• War or military combat, disaster relief

Common Symptoms of PTSD

Symptoms of PTSD can come and go throughout treatment. Triggers can cause symptoms feel more intense and can bring symptoms back when you encounter them, even after a long period of feeling better.

Triggers are very connected to our senses, they can come from sights, sounds, smells, places or situations that remind you of the trauma and can include a wide variety of circumstances such as certain dates, seasons or times of year, particular mannerisms, appearances, words and phrases and any other experience that may be associated with the event. Identifying triggers and building a supportive structure to anticipate and manage your reaction is an important part of trauma therapy.

There are four main symptom clusters of PTSD

Intrusion symptoms:

• Unwanted negative memories

• Flashbacks & feeling like the trauma is happening again

• Nightmares about the event or about possible recurrence

Avoidance symptoms:

• Avoiding people, places, activities or situations that remind you of the event

• Withdrawing from relationships, work daily life

• Trying not to think about or remember what happened

• Avoiding talking about the event or your feelings about it

Changes in thinking and mood:

• Frequently feeling fear, anger, guilt, shame, self-blame or horror

• Negative thoughts about yourself or others and difficulty feeling positive emotions

• Withdrawn, detached or distant from others and no interest in activities you once enjoyed

• Difficulty remembering important parts of the event

Changes in arousal and reactivity:

• Startle easily and feel like you're on high alert or overly watchful of your surroundings

• Feel irritable or have angry outbursts

• Difficulty concentrating, following a routine or sleeping

• Using substances or engaging in reckless behaviour

Risk factors

Certain factors may raise the risk before, during or after an experience such as:

• Avoidance as a primary coping tool can actively maintain and worsens the disorder

• Having no social support before or after a negative event

• Living through adverse childhood experiences or a negative or severe past event

• Feeling intense fear, panic or numbness during the event

• Ongoing stress, like financial hardship or discrimination

• Existing anxiety, depression or a family history of mental health conditions

• Being a first responder or military service member, living in a war zone or forced to migrate because of conflict

Diagnosis and Testing

Post- Traumatic Stress Disorder PTSD is diagnosed by a mental health specialist (Doctor, Psychiatrist, Psychologist, Nurse Practitioner) using the Diagnostic and Statistical Manual of Mental Disorders criteria for PTSD.

This process may include questionnaires, interviews and conversations with you about your symptoms, your medical and mental health history, and any trauma you’ve experienced.

They may also check for related conditions like depression, anxiety or substance use, as these diagnoses may occur alongside PTSD.

Management and Treatment of PTSD

Treatment often includes both therapy and medication, using one or the other or a combination of both together can help you to manage symptoms while you navigate daily life. Your provider will work with you to choose what fits your symptoms, needs and comfort level.

PTSD therapy

Psychotherapy is usually the first choice for treating PTSD. There are several approaches that can be used, each with their own benefits.

Trauma specific therapies will include some form of psycho-education, coping skills and processing and may be in the form of individual, 1-1 therapy, group therapy and family therapy

• Cognitive & Behavioural Approaches: These focus on changing thought patterns and modifying the behaviours that keep a person stuck in a fear response, they tend to include homework and be highly structured and time limited.

  Therapies include: Cognitive Processing Therapy (CPT), Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Dialectical Behaviour (DBT), Prolonged Exposure (PE)

• Body & Brain-Based (Somatic) Approaches: Often referred to as "bottom-up" processing these approaches help individuals regulate and engage the nervous system in processing without necessarily needing to verbally recount the trauma first.

  Therapies include: Deep Brain Reorienting (DBR), Eye Movement Desensitization & Reprocessing (EMDR), Somatic Experiencing (SE), Brainspotting, Art therapy

• Psychodynamic Approaches: Often referred to as "top-down" processing, these therapies focus on helping the individual understand their experience including any unconscious patterns, internal conflicts, and unresolved grief. Therapies include: Psychodynamic Therapy, Attachment-Based Therapy, Relational Therapy, Gestalt Therapy, Schema Therapy

Some individuals may find peer support groups, complementary therapies and engaging in their own reading and learning about trauma to be supportive.

These might include:

• Trauma Informed Yoga

• Mediation

• Art & Music Making

• Massage and Accupuncture

• Journalling

• Books, Podcasts, Seminars

• Service Animals

Common PTSD medications include:

• SSRIs and SNRIs: These antidepressants help balance brain chemicals. The U.S. Food and Drug Administration (FDA) approves SSRIs, like sertraline and paroxetine, for PTSD. They may reduce anxiety, low mood and intrusive thoughts.

• Prazosin: This may reduce nightmares and sleep problems. It’s often used off-label, and results may vary from person to person.

  
  

• Second-generation antipsychotics: Providers may use these in some cases when symptoms are severe or don’t improve with other treatments. These are usually added to other medications rather than used alone.

  
  

PTSD treatment is typically a long term approach. Recovery is not linear but symptoms can be managed and reduced.

PTSD can't be prevented but certain steps after trauma may lower your risk:

• Stay connected with supportive friends or family

• Seek professional help early if symptoms don’t improve after a few weeks

• Return to daily routines, like work or school, when it’s safe to do so

• Use healthy coping skills