Facts about Post-Traumatic Stress Disorder: NIMH
Article title: Facts about Post-Traumatic Stress Disorder: NIMH
Conditions: Post-Traumatic Stress Disorder
What Are the Symptoms of PTSD?
Many people with PTSD repeatedly
re-experience the ordeal in the form of flashback episodes, memories,
nightmares, or frightening thoughts, especially when they are exposed to
events or objects reminiscent of the trauma. Anniversaries of the event
can also trigger symptoms. People with PTSD also experience emotional
numbness and sleep disturbances, depression, anxiety, and irritability or
outbursts of anger. Feelings of intense guilt are also common. Most people
with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is
diagnosed when symptoms last more than 1 month.
How Common Is PTSD?
About 3.6 percent of U.S. adults ages 18 to 54
(5.2 million people) have PTSD during the course of a given year. About 30
percent of the men and women who have spent time in war zones experience
PTSD. One million war veterans developed PTSD after serving in Vietnam.
PTSD has also been detected among veterans of the Persian Gulf War, with
some estimates running as high as 8 percent.
When Does PTSD First Occur?
PTSD can develop at any age, including
in childhood. Symptoms typically begin within 3 months of a traumatic
event, although occasionally they do not begin until years later. Once
PTSD occurs, the severity and duration of the illness varies. Some people
recover within 6 months, while others suffer much longer.
What Treatments Are Available for PTSD?
Research has demonstrated
the effectiveness of cognitive-behavioral therapy, group therapy, and
exposure therapy, in which the patient gradually and repeatedly relives
the frightening experience under controlled conditions to help him or her
work through the trauma. Studies have also shown that medications help
ease associated symptoms of depression and anxiety and help promote sleep.
Scientists are attempting to determine which treatments work best for
which type of trauma.
Some studies show that giving people an opportunity to talk about their
experiences very soon after a catastrophic event may reduce some of the
symptoms of PTSD. A study of 12,000 schoolchildren who lived through a
hurricane in Hawaii found that those who got counseling early on were
doing much better 2 years later than those who did not.
Do Other Illnesses Tend to Accompany PTSD?
depression, alcohol or other substance abuse, or another anxiety disorder
are not uncommon. The likelihood of treatment success is increased when
these other conditions are appropriately identified and treated as well.
Headaches, gastrointestinal complaints, immune system problems,
dizziness, chest pain, or discomfort in other parts of the body are
common. Often, doctors treat the symptoms without being aware that they
stem from PTSD. NIMH encourages primary care providers to ask patients
about experiences with violence, recent losses, and traumatic events,
especially if symptoms keep recurring. When PTSD is diagnosed, referral to
a mental health professional who has had experience treating people with
the disorder is recommended.
Who Is Most Likely to Develop PTSD?
People who have suffered abuse
as children or who have had other previous traumatic experiences are more
likely to develop the disorder. Research is continuing to pinpoint other
factors that may lead to PTSD.
It used to be believed that people who tend to be emotionally numb
after a trauma were showing a healthy response, but now some researchers
suspect that people who experience this emotional distancing may be more
prone to PTSD.
What Are Scientists Learning From Research?
NIMH and the VA
sponsor a wide range of basic, clinical, and genetic studies of PTSD. In
addition, NIMH has a special funding mechanism, called RAPID Grants, that
allows researchers to immediately visit the scenes of disasters, such as
plane crashes or floods and hurricanes, to study the acute effects of the
event and the effectiveness of early intervention.
Studies in animals and humans have focused on pinpointing the specific
brain areas and circuits involved in anxiety and fear, which are important
for understanding anxiety disorders such as PTSD. Fear, an emotion that
evolved to deal with danger, causes an automatic, rapid protective
response in many systems of the body. It has been found that the body's
fear response is coordinated by a small structure deep inside the brain,
called the amygdala. The amygdala, although relatively small, is a very
complicated structure, and recent research suggests that different anxiety
disorders may be associated with abnormal activation of the amygdala.
The following are also recent research findings:
- In brain imaging studies, researchers have found that the
hippocampus—a part of the brain critical to memory and emotion—appears
to be different in cases of PTSD. Scientists are investigating whether
this is related to short-term memory problems. Changes in the
hippocampus are thought to be responsible for intrusive memories and
flashbacks that occur in people with this disorder.
- People with PTSD tend to have abnormal levels of key hormones
involved in response to stress. Some studies have shown that cortisol
levels are lower than normal and epinephrine and norepinephrine are
higher than normal.
- When people are in danger, they produce high levels of natural
opiates, which can temporarily mask pain. Scientists have found that
people with PTSD continue to produce those higher levels even after the
danger has passed; this may lead to the blunted emotions associated with
- Research to understand the neurotransmitter systems involved in
memories of emotionally charged events may lead to discovery of
medications or psychosocial interventions that, if given early, could
block the development of PTSD symptoms.
For more information about post-traumatic stress disorder and
other anxiety disorders, contact:
National Institute of Mental Health
Office of Communications
and Public Liaison
6001 Executive Blvd., Room 8184, MSC
Bethesda, MD 20892-9663
Toll-Free: 1-88-88-ANXIETY (1-888-826-9438)
Mental Health FAX4U:
NIMH Web site:
For additional information on PTSD, visit the Web site for the
National Center for Post-Traumatic Stress Disorder of the Department
of Veterans Affairs at http://www.ncptsd.org/
Publication No. OM-99 4157 (Revised)
Printed September 1999
Updated: October 05, 2001
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