Post Traumatic Stress Disorder

Reacting to a Traumatic Event

A common belief among the general population of the United Kingdom is that only war veterans experience Post Traumatic Stress Disorder (PTSD). The truth is, while with PTSD there is a higher incident rate amongst people exposed to war and terror, the condition can arise from experiencing anything traumatic and anxiety provoking.

PTSD is a serious potentially disabling condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events.

It’s not unusual for people who have experienced traumatic events like this to have flashbacks, nightmares, or intrusive memories when something terrible happens — like the explosions in Northern Ireland during the conflicts.

Relationships, Trauma, and PTSD

Trauma survivors who have PTSD may have trouble with their close family relationships or friendships. Their symptoms can cause problems with trust, closeness, communication, and problem solving, which may affect the way the survivor acts with others. In turn, the way a loved one responds to him or her can affect the trauma survivor. A circular pattern may develop that could harm relationships.

PTSD Facts

  • Millions of people age 18 and older have PTSD.
  • 67 percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.
  • People who have experienced previous traumatic events run a higher risk of developing PTSD.
  • PTSD can also affect children and members of the military



  • PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However, symptoms may not appear until several months or even years later. The disorder is characterised by three main types of symptoms:
  • Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
  • Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
  • Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.


Diagnosis criteria

  • The diagnosis criteria that applies to adults, adolescents, and children older than six include those listed below:
  • Exposure to actual or threatened death, serious injury, or sexual violation:
  • Directly experiencing the traumatic events
  • Witnessing, in person, the traumatic events
  • Learning that the traumatic events occurred to a close family member or close friend
  • Experiencing repeated or extreme exposure to aversive details of the traumatic events (Examples are first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless exposure is work-related.


The presence of one or more of the following:

  • Spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events (Note: In children repetitive play may occur in which themes or aspects of the traumatic events are expressed.)
  • Recurrent distressing dreams in which the content or affect (i.e. feeling) of the dream is related to the events (Note: In children there may be frightening dreams without recognizable content.)
  • Flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring (Note: In children trauma-specific reenactment may occur in play.)
  • Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
  • Physiological reactions to reminders of the traumatic events
  • Persistent avoidance of distressing memories, thoughts, or feelings about or closely associated with the traumatic events or of external reminders (i.e., people, places, conversations, activities, objects, situations)


Two or more of the following:

  • Inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
  • Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”).
  • Persistent, distorted blame of self or others about the cause or consequences of the traumatic events
  • Persistent fear, horror, anger, guilt, or shame
  • Markedly diminished interest or participation in significant activities
  • Feelings of detachment or estrangement from others
  • Persistent inability to experience positive emotions
  • Two or more of the following marked changes in arousal and reactivity:
  • Irritable or aggressive behavior
  • Wreckless or self-destructive behavior
  • Hypervigilance
  • Exaggerated startle response
  • Problems with concentration
  • Difficulty falling or staying asleep or restless sleep


Also, clinically significant distress or impairment in social, occupational, or other important areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition, such as traumatic brain injury.


The main treatments for people with PTSD are psychotherapy (such as cognitive-behavioral therapy (CBT)), medications, or both. Everyone is different, so a treatment that works for one person may not work for another.

It is important for anyone with PTSD to be treated by a mental health care professional who is experienced with PTSD. This is an anxiety disorder that demands a sensitive approach. Some people will need to try different treatments to find what works for their symptoms.

Exposure therapy

This therapy helps people face and control their fear by exposing them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings. This is a really effective method of therapy, but the practitioner must be experienced in order to do so.

Cognitive restructuring

This therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.

Stress inoculation training

This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way.

Virtual reality treatment

This consists of custom virtual environments that have been carefully designed to support exposure therapy of anxiety disorders. The treatment involves exposing the person with PTSD to a virtual environment that contains the feared situation, instead of taking the patient into the actual environment or having the patient imagine the traumatic situation.

The therapist controls the virtual environment through a computer keyboard, ensuring full control of the exposure and the ability manipulate situations to best suit the person within the confines of a therapist’s office.


Dr. Robert Leahy – Anxiety Free: Unravel Your Fears Before They Unravel You,  Second Edition

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