About 1 in 3 people who experience severe trauma will develop PTSD. It is not entirely understood why some people develop it and others don’t. However, you may be more likely to develop PTSD after a traumatic event if you’ve had anxiety or depression or don’t get much support from friends or family.

Several possibilities have been suggested such as:

PTSD may result from an intuitive mechanism meant to help you survive more traumatic experiences. For example:

1. Many people experience flashbacks, which may force them to think about the event in detail so they’re better prepared if it occurs again.
2. The feeling of being “on edge” (hyperarousal) may develop to provide a quick reaction in another crisis.

Although these responses may be meant to help with survival, they are not helpful because they prevent the individual from processing and moving on from the trauma.

Some studies have indicated that people with PTSD have abnormal levels of stress hormones. Often known as the “fight-or-flight” response, it helps to deaden senses and dull pain. Individuals with PTSD have been found to continue to produce high levels of fight-or-flight hormones even when there isn’t any danger.

In brain scans, the parts of the brain involved with emotional processing appear different in people with PTSD. One part of the brain responsible for emotions and memory is called the hippocampus and in people with PTSD, the hippocampus appears smaller in size. It’s believed that changes in this part of the brain might be related to:

1. Fear and anxiety
2. Problems with memory
3. Flashbacks

The dysfunction of the hippocampus may prevent flashbacks and nightmares from being properly processed, so the anxiety they cause doesn’t reduce over time. Treatment of PTSD helps with the proper processing of memories, so the flashbacks and nightmares disappear gradually.

This is the most typical symptom. It is when the person involuntarily and vividly relives the traumatic experience in the form of:

1. Nightmares
2. Flashbacks
3. Upsetting and repetitive images or sensations
4. Physical sensations such as pain, sweating, feeling sick, or shaking

Some people have continual negative thoughts about the event, constantly asking themselves questions that keep them from coming to terms with the event. They may ask why it happened to them and if they could have stopped it. This just leads to feelings of guilt or shame.

Another key symptom is avoiding any reminder of the event. Typically, this means avoiding certain places or people that remind them of the trauma or avoiding talking about it. People with PTSD often try to push memories of the event out of their minds by distracting themselves with work or hobbies. Then some people try to deal with their feelings by trying not to feel anything at all. This is called emotional numbing. Some people will turn to substances and become isolated and withdrawn.

1. Always on guard for danger
2. Angry outbursts
3. Irritability
4. Sleeping problems
5. Problems concentrating
6. Being easily startled

Adverse changes in thinking and mood include:

1. Negative thoughts about other people, the world, or themself
2. Hopelessness about the future
3. Problems maintaining close relationships
4. Feeling removed from friends and family
5. Memory problems (this includes not remembering important parts of the traumatic event)

Often, people with PTSD have other problems including:

1. 1. Other mental health problems such as types of anxiety, depression, and other mood disorders.
   2. Destructive or self-harming behaviors such as drug or alcohol abuse.
   3. Physical symptoms such as headaches, dizziness, chest pains, and stomach aches

Some of the evidence-based psychotherapies we use to treat PTSD include:

1. 1. 1. Prolonged exposure therapy: This therapy uses repeated, detailed imagining of the trauma or progressive exposures to “triggers” in a controlled, safe way. Eventually, the individual faces, gains control of their fear, and learns to cope.
      2. Cognitive-behavioral therapy (CBT): Cognitive processing therapy is a cognitive behavioral therapy designed to treat PTSD and co-occurring symptoms specifically. The goal is to change painful negative emotions (shame, guilt, etc.) and beliefs (I failed, the world is dangerous, etc) that have been caused by the trauma.
      3. Individual therapy: Individual psychotherapy is used to help individuals manage their emotions, behaviors, and thoughts. One-on-one sessions with a therapist will help you or a loved one learn more about your mental disorders and teach you coping strategies to better manage them.
      4. Group therapy: Group therapy for PTSD encourages survivors of similar traumatic events to share their experiences. Members help each other realize that many people would respond and feel the same way. Family therapy also might help because the distress and behavior of the person with PTSD often affect the whole family

Medication can help control PTSD symptoms. The relief that it provides enables many people to take part in psychotherapy more effectively.

1. 1. 1. Antidepressants and anti-anxiety medications: SSRIs and SNRIs such as Zoloft and Paxil are antidepressants that are commonly used to treat core symptoms and anxiety. They can be used alone or in combination with psychotherapy.
      2. Insomnia medication: Zolpidem is a nonbenzodiazepine medication with a low potential for addiction that helps relieve sleep problems.