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Let's Talk Facts About Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD)-once called shell shock-affects hundreds of thousands of people who have survived earthquakes, airplane crashes, terrorist bombings, inner-city violence, domestic abuse, rape, war, genocide, and other disasters, both natural and human made.

The Facts

Posttraumatic stress disorder (PTSD) has been called shell shock or battle fatigue syndrome. It has often been misunderstood or misdiagnosed, even though the disorder has very specific symptoms.

Ten percent of the population has been affected at some point by clinically diagnosable PTSD. Still more show some symptoms of the disorder. Although it was once thought to be mostly a disorder of war veterans who had been involved in heavy combat, researchers now know that PTSD also affects both female and male civilians, and that it strikes more females than males.

In some cases the symptoms of PTSD disappear with time, whereas in others they persist for many years. PTSD often occurs with-or leads to-other psychiatric illnesses, such as depression.

Everyone who experiences trauma does not require treatment; some recover with the help of family, friends, or clergy. But many do need professional treatment to recover from the psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic event.


PTSD usually appears within 3 months of the trauma, but sometimes the disorder appears later. PTSD's symptoms fall into three categories:




In people with PTSD, memories of the trauma reoccur unexpectedly, and episodes called "flashbacks" intrude into their current lives. This happens in sudden, vivid memories that are accompanied by painful emotions that take over the victim's attention. This reexperience, or "flashback," of the trauma is a recollection. It may be so strong that individuals almost feel like they are actually experiencing the trauma again or seeing it unfold before their eyes and in nightmares.

Avoidance symptoms affect relationships with others: The person often avoids close emotional ties with family, colleagues, and friends. At first, the person feels numb, has diminished emotions, and can complete only routine, mechanical activities. Later, when reexperiencing the event, the individual may alternate between the flood of emotions caused by reexperiencing and the inability to feel or express emotions at all. The person with PTSD avoids situations or activities that are reminders of the original traumatic event because such exposure may cause symptoms to worsen.

The inability of people with PTSD to work out grief and anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it. Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others-particularly friends or family-did not.

PTSD can cause those who have it to act as if they are constantly threatened by the trauma that caused their illness. They can become suddenly irritable or explosive, even when they are not provoked. They may have trouble concentrating or remembering current information, and, because of their terrifying nightmares, they may develop insomnia. This constant feeling that danger is near causes exaggerated startle reactions.

Finally, many people with PTSD also attempt to rid themselves of their painful re-experiences, loneliness, and panic attacks by abusing alcohol or other drugs as a "selfmedication" that helps them to blunt their pain and forget the trauma temporarily. A person with PTSD may show poor control over his or her impulses and may be at risk for suicide.


Today, psychiatrists and other mental health professionals have good success in treating the very real and painful effects of PTSD. These professionals use a variety of treatment methods to help people with PTSD to work through their trauma and pain.

Behavior therapy focuses on correcting the painful and intrusive patterns of behavior and thought by teaching people with PTSD relaxation techniques and examining (and challenging) the mental processes that are causing the problem.

Psychodynamic psychotherapy focuses on helping the individual examine personal values and how behavior and experience during the traumatic event affected them.

Family therapy may also be recommended because the behavior of spouse and children may result from and affect the individual with PTSD.

Discussion groups or peer-counseling groups encourage survivors of similar traumatic events to share their experiences and reactions to them. Group members help one another realize that many people would have done the same thing and felt the same emotions.

Medication can help to control the symptoms of PTSD. The symptom relief that medication provides allows most patients to participate more effectively in psychotherapy when their condition may otherwise prohibit it. Antidepressant medications may be particularly helpful in treating the core symptoms of PTSD-especially intrusive symptoms.

Other Sources of Information

American Psychiatric Association
1400 K Street, N.W.
Washington, DC 20005

Anxiety Disorders Association of America, Inc.
11900 Parklawn Drive, Suite 100
Rockville, MD 20852-2624

International Society for Traumatic Stress Studies
60 Revere Drive, Suite 500
Northbrook, IL 60062

National Center for PTSD
VA Medical Center (116D)
White River Junction, VT 05009

National Institute of Mental Health Public Inquiries
6001 Executive Blvd., Room 8184 MSC 9663
Bethesda, MD 20892-9663
FACTS ON DEMAND: 301-443-5158

U.S. Veterans Administration
Mental Health and Behavioral Sciences Services
810 Vermont Avenue, N.W., Room 990
Washington, DC 20410

© Copyright 2000 American Psychiatric Association
Call APA fastFAX (APA's toll-free fax-on-demand service) for a menu of items available free by fax: 1-888-267-5400.

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American Psychiatric Association
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Washington, DC 20005

The American Psychiatric Association is a cosponsor of the National Public Education Campaign on Clinical Depression in cooperation with the National Mental Health Association, National Alliance for the Mentally Ill, National Depressive and Manic Depressive Association and the DEPRESSION/Awareness, Recognition, and Treatment (D/ART) Program, National Institute of Mental Health.

Produced by the APA Joint Commission on Public Affairs and the Division of Public Affairs. This pamphlet was developed for educational purposes and does not necessarily reflect opinion or policy of the American Psychiatric Association.

One in a series of pamphlets designed to reduce the stigma surrounding mental illnesses by promoting informed factual discussion of the disorders and their psychiatric treatments.

©Copyright 1999 American Psychiatric Association

ISBN 0-89042-363-6

This article is provided by Medem, Inc. All rights reserved.

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