“I have heard of Posttraumatic Stress Disorder (PTSD), but never understood what it is. Could you provide some information about this disorder?”

PTSD is an anxiety disorder that is related to surviving a traumatic event, in which you feel your life or someone else’s life is threatened. These events can be catastrophic, such as natural disasters, terrorist attacks, and war zones. Often times the event may be more individualized, such as a serious car accidnet, physical or sexual abuse, or animal attack.

Most people respond to life threatening event with some fear after the event, but it goes away after a few months. Even if they develop PTSD after the initial trauma, 1 out of 3 people’s symptoms resolve shortly. For those who lives remain disrupted, cognitive behavioral therapy is an effective treatment. Interestinly, some people do not develop symptoms for months or years after the initial event.

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

Helpful websites include: http://www.aest.org.uk; http://www.ncptsd.va.gov

Total Life Counseling Center works with many clients suffering from PTSD with EMDR, CBT (Cognitive Behavioral Therapy), or EFT (Emotional Freedom Techniques). For a free 15 minute phone consultation, call (407)248-0030.

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Author: Evelyn Wenzel, MSW, LCSW, CAP