People can be considered to have PTSD when they have been exposed to an extreme trauma, the symptoms last at least a month in duration, and the symptoms cause excessive distress so that social functioning and job performance are impaired. One sign of PTSD is that the traumatic event is relived repeatedly in the person’s mind – and this appears in the form of “flashbacks,” recurrent images, thoughts or dreams about the event…and even nightmares. Reminders of the event can cause distress – so many people go out of their way to avoid places and events that remind them of the catastrophic occurrence. Many people experience anxiety, restlessness, concentration difficulties, decreased memory, irritability, sleeplessness, hypervigilance, or an exaggerated startle response. Some people even experience what is called “survivor’s guilt” – because they survived and others did not or because of certain things they may have had to do in order to survive.
There are three main clusters of PTSD symptoms, and all three of these groupings must be present for a diagnosis of PTSD.
Intrusive Symptoms: Intrusive and repetitive memories which stir up negative feelings experienced during the trauma can overwhelm a person. These memories can appear in the form of:
– flashbacks (a feeling of reliving the trauma)
– frequent, distressing memories of the trauma
– emotional and physical distress when traumatic memories are triggered.
Arousal Symptoms: PTSD sufferers experience physiological reactions, which indicate that they don’t feel safe and they are physically on the alert to deal with danger. These can include:
– being easily startled or feeling jumpy
– hypervigilance (feeling “on guard” even when the situation is safe)
– concentration difficulties
– outbursts of anger and irritability
– problems in falling asleep or staying asleep.
Avoidance Symptoms: People suffering from PTSD go out of their way to escape the overpowering memories and arousal symptoms. This pattern of behavior can include:
– avoiding places, people or situations that serve as reminders of the trauma
– avoiding thoughts or feelings associated with the trauma
– memory loss about some aspects of the traumatic event
– feeling emotionally numb
– feeling estranged or detached from other people
– feelings of hopelessness and helplessness about the future
– decreased interest in pleasurable activities.
There are other emotional and physical problems that may accompany PTSD. Unfortunately, some people seek relief from these symptoms without dealing with the root cause so that the symptoms persist. These problems may precede PTSD, in which case they become exacerbated, or they might develop after the onset of PTSD. The emotional problems include panic disorder, agoraphobia (fear of being out in public), social anxiety (speaking in public), depression, obsessive-compulsive disorder, sleep disorders, suicidal thoughts and substance abuse (drug or alcohol abuse). The physical problems can include skin problems, pain, gastrointestinal disorders, fatigue, respiratory problems, low back pain, muscle cramps, headaches, and cardiovascular problems.
It is important to remember that PTSD is a normal reaction to a very abnormal situation. There is no shame in experiencing these symptoms, nor is having these symptoms a sign of weakness. Help is available from trained professionals so that in most cases, with the appropriate effort and courage, the symptoms can disappear completely, or at least substantially decrease and become more manageable.
Baya Mebarek, Psy.D., LMFT
San Diego Couples and Family Therapy serves the surrounding areas of Sorrento Valley Road as La Jolla, UTC San Diego, Del Mar, Rancho Santa Fe, Rancho Bernardo, Rancho Penasquitos, Poway, University City and Escondido.