Post traumatic stress disorder (PTSD) can develop when one is exposed to life-threatening events. Unfortunately, living with PTSD is fraught with difficulty and distress, and highly disruptive to one’s quality of life. The following is a list of 13 things to be careful of if you suffer from PTSD (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000):
- Avoidant behaviors
- Psychic numbing
- Detachment from others
- Not able to feel emotions
- Exaggerated startle response
- Concentration problems
- Survivor guilt
- Auditory hallucinations and paranoid delusions
- Depression and substance abuse
Flashbacks can occur, as if the person were still in the past, and feels like they are really experiencing the same traumatic event. This can be dangerous, as people who experience flashbacks may act out and try to react to the flashback as if it were really occurring again. Also, flashbacks can occur suddenly during the day, and is as vivid as if one were watching a movie of the traumatic event.
People with PTSD will avoid situations or places which remind them of the traumatic event. The problem with avoidant behaviors is that it makes the anxiety worse. Although the avoidance reduces the anxiety in the short term, it is still maladaptive coping. To decrease the anxiety over the long term, exposure work related to the trauma needs to occur. Avoidance behaviors can ultimately lead to marital conflict or loss of job.
Psychic numbing is a reduced responsiveness to the environment…in other words, one would be a ‘zombie’. With such decrease in reactivity, one will have difficulty with activities requiring responsiveness, such as driving.
Detachment and estrangement from others is a big problem with PTSD, as much support is needed from friends, family, and therapists. Detaching from one’s natural support system can lead to more problems for anyone. But someone with PTSD especially needs the support of others in order to recover.
People with PTSD may not be able to feel emotions, like love, intimacy or sex. Their relationships may suffer as a result. Partners, spouses, and family members may be alienated by one’s inability to reciprocate emotions like caring and love. It’s important to make loved ones aware of this problem, as the inability to feel emotions is part of the illness.
Nightmares about the traumatic event can be highly disruptive to one`s sleep. These nightmares forces one to continually reexperience the trauma. Bed partners and other occupants of one`s household may notice the nightmares, as one may shout or may have highly disruptive movements causing lots of noise.
Outbursts of anger can occur in people with PTSD. These outbursts can be violent, especially if the target of the anger resembles the perpetrator or aggressor. For example, a Vietnam Veteran with the U.S. Army may become irritable with Asians.
As part of the anxiety and increased arousal after a traumatic event, one may scan their environment excessively, on guard for any sources of danger. One then becomes on edge, almost paranoid at times. This arousal (ie hypervigilance) can occur in the same person with PTSD who at other times engages in avoidance (ie psychic numbing). Generally, arousal occurs with reexperiencing a trauma (ie flashback, nightmare), whereas avoidance is associated with decreases in responsiveness to the environment (ie psychic numbing).
People with PTSD may have such increased arousal that they respond more intensely to loud noises or sudden touch. For example, a war veteran becomes `jumpy` whenever loud noises go off, reminding one of bombs going off.
Increased arousal may also lead to concentration problems. This makes it difficult to focus and complete tasks, forcing one to spend more time on tasks. As such, job or school performance may suffer.
People with PTSD may have guilt about surviving an accident where others have died. They may also have guilt about the methods they used to keep alive. It`s important to keep talking with a trusted person about this guilt, as this guilt can eventually lead to other problems, like depression, as discussed below.
In some severe and chronic cases, one can develop auditory hallucinations and paranoid delusions associated with the traumatic event. When one hears voices or becomes paranoid, one is not based in reality, and this is a sign of severe mental illness. One needs to see a psychiatrist when one has difficulty with differentiating reality from fantasy.
Depression and substance abuse can develop in someone with PTSD. The demoralization and guilt associated with trauma can lead to clinical depression, which can lead to suicide if left untreated. And substance abuse can occur, in one`s attempts to forget about the trauma and to help feel better. When depression or substance abuse develops with PTSD, one should see a psychiatrist for treatment.
In summary, PTSD is associated with multiple problems, such as reexperiencing the trauma (flashbacks, nightmares), avoidance (detachment), and arousal (hypervigilance). This list gives the main things to be careful of if you suffer from PTSD.