Most people will experience a traumatic event at some point in their lives, whether they’ve lived it themselves, witnessed it, or heard about it happening to a friend or family member.
When this happens, it’s normal and expected for those affected to act differently afterward-nightmares, being hyper-alert, or avoiding the place where the trauma happened, for example.
But if those behavioural changes last longer than a month or two, it could signal something more lasting than that initial after-shock: post-traumatic stress disorder (PTSD).
“After a traumatic event, for a little while, anybody would experience some after-events like upsetting memories,” says psychologist Shannon Wiltsey Stirman. “But as time passes, a lot of people notice that they start to feel better, and they notice that those difficulties start to decrease. But for a smaller subset of people, even after a couple of months, these types of problems remain, and that’s when we would think about diagnosing PTSD.”
While PTSD doesn’t discriminate, women are more than twice as likely as men to develop the condition at some point in their lives. It can happen at any time to any woman of any age. Here’s what you need to know.
How does PTSD develop?
PTSD is a collection of symptoms that develop after an extremely traumatic experience that involves exposure to a stressor. In this case, there could have been a threat of potential death, serious injury, or sexual violence, says Dr Gloria Kardong.
That last stressor could be partially to blame for the huge disparity in PTSD between men and women. After all, 1 in every 5 Australian women will be the victim of sexual assault at some point during their lifetimes.
Although the psychological and physiological causes of PTSD are still being researched, people who have already been exposed to trauma or who are already experiencing depression or anxiety are at higher risk, says Wiltsey Stirman. The same is true for those who experience ongoing trauma or were injured during the event.
But one important factor can also determine whether a person’s post-traumatic-event behaviors develop into PTSD: the support they get afterward. “If people have supportive people that they can talk with about what happened and how they’re feeling, they’re less likely to experience PTSD,” says Wiltsey Stirman.
Especially since there are often feelings of shame and guilt associated with a traumatic event, victims might be less apt to talk about it, and if it’s not well-received when they do, that could ultimately lead to them experiencing PTSD, says Wiltsey Stirman.
What are the symptoms of PTSD?
In order to receive a PTSD diagnosis, you must have symptoms that fall under four categories.
You relive your trauma
This means you can experience upsetting memories and thoughts, flashbacks, or nightmares, all of which cause you emotional distress, says Wiltsey Stirman. If you have PTSD, you will continue to relive your trauma a month or more after it occurred.
You avoid things that remind you of what happened
You might completely shy away from reminders of the trauma or the emotions associated with it. “That might mean that people aren’t going to places that remind them of what happened, or they might avoid crowds because crowds now feel dangerous,” says Wiltsey Stirman. But it can also look like people staying busier than usual.
"You might see someone who seems to be functioning at a really high level, but part of what they’re doing is trying to stay so busy that they don’t even actually have much time to think about what happened,” says Wiltsey Stirman.
Your way of thinking changes
PTSD can seriously mess with your head. You may have a hard time feeling positive emotions or view the world as being dangerous as a whole. “They may develop a sense of blame or responsibility for the trauma or results of the trauma and develop an altered worldview,” says Kardong. Because of those changed perceptions, you might start to lose trust in other people, which can also affect their interpersonal relationships, says Wiltsey Stirman.
You’re constantly on alert
The final cluster of symptoms involves feeling on edge, easily startled, or irritable, which could cause you to have difficulty sleeping or concentrating. “People kind of stay in a state of what we call hyperarousal,” says Wiltsey Stirman. Because of that hyperarousal, you start feeling constantly unsafe, which results in more reactive behaviors, like not wanting to get in a car if the traumatic event you experienced was a car accident. The important thing to recognise is that all of these signs can impact each person in a unique way. “Just from the variety of different ways they can manifest, it can look pretty different in different people,” says Wiltsey Stirman. So if you find yourself experiencing some mix or variation of these symptoms a month or more after the event, it’s worth scheduling an appointment with your therapist or health care provider.
How is PTSD treated?
Living with PTSD can be extremely debilitating for those affected. “PTSD can adversely affect every area of the person's life and make daily living almost intolerable,” says Kardong. Because of the symptoms and effects, PTSD can kill your self-esteem and mood while boosting your anxiety, all of which can affect family, personal, and professional relationships.
But there are several treatment options available for PTSD that have been proven to work. “What we know is that certain forms of psychotherapy seem to work better than medications,” says Wiltsey Stirman.
The first line of therapy with PTSD is trauma-focused treatments like cognitive behavioral therapy, which aims to help you process the memories you’ve been avoiding. You also take a look at how you’ve been making sense of what happened. These treatments take about 8 to 16 sessions, says Wiltsey Stirman.
If the trauma-focused treatments don’t seem to work or aren’t available, there is also present-centered therapy, which focuses on how the trauma affects your day-to-day life and problem-solves for those effects.
Plus, unlike other mental health conditions like depression, once PTSD is treated, it’s unlikely for someone to experience a relapse. “This is not something people have to live with their whole lives,” says Wiltsey Stirman.
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