Trauma & Post-Traumatic Stress Disorder (PTSD)

“Oh, that’s the thing that happens when you go to war.” 

While that’s definitely a possibility, war isn’t the only way to develop PTSD, nor does every person who goes to war develop PTSD. PTSD is a possible complication of having experienced trauma, just like pneumonia can be a complication of an upper respiratory infection. It doesn’t always happen, but when it does, it can seriously impair your life.

Post-traumatic Stress Disorder (PTSD) can develop from being exposed to a wide variety of traumatic events such as motor vehicle crashes, home accidents, sexual assault, domestic violence, or being involved in a natural disaster.  As the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes it, PTSD happens after “being witness to or being exposed to situations involving threatened or actual serious physical harm or death.” But it’s important to keep in mind that experiencing a trauma doesn’t mean a person will absolutely develop PTSD. In fact, the vast majority of those exposed to a trauma will NOT develop the disorder.

Only 7 or 8 people out of 100 who are exposed to a trauma event will develop PTSD according to the National Center for PTSD.

Immediately after a significantly traumatic event, it is completely normal (and expected!) to experience symptoms such as difficulty sleeping, mood changes, feeling “on edge,” and having nightmares. This is the body’s natural response when bad things happening. But if a full month goes by and symptoms have not improved, therapists begin to consider a diagnosis of PTSD. 

PTSD symptoms can include feeling as though the traumatic event is recurring, unwanted thoughts and memories of the event popping into the mind, recurrent bad dreams about what happened, and feeling “on edge” and generally mistrustful of others. Anger outbursts are not uncommon. They may find themselves feeling fearful “for no reason” and in new or odd situations (e.g. the grocery store, a wide-open space, etc.). This can lead to an increased startle response and feeling “on edge.” 

Ironically, one of the main reasons why people develop PTSD is because they work so hard to “get over it” by putting the event out of their mind and “just move on.” But avoidance of thoughts, memories, and places and things that remind a person of the event are actually PTSD symptoms AND a major contributor to the development of the disorder. Avoidance unfortunately lead to problems in how the memory is stored in the brain. Similar to digestion, the brain will not let a traumatic memory go if it’s not first processed and it will continually “throw up” reminders to get it done.  Avoidance leads to more and more avoidance, and over time, an increase in overall PTSD symptoms and a great deal of misery for the person experiencing it.

Trauma vs PTSD

Because the DSM-V diagnosis of PTSD requires exposure to actual or threatened death, serious injury, or sexual violence, many deeply traumatic life experiences like divorce, infidelity, job loss, bankruptcy, death of a loved one from illness, and other major life disruptions actually don't qualify for a PTSD diagnosis, but that doesn't make them any less devastating. These are genuinely traumatic events that can leave a person feeling shattered, anxious, and unable to move forward. While these experiences don't meet the specific criteria for PTSD, they can still cause significant emotional distress, sleep problems, difficulty concentrating, and a sense that the world has been turned upside down. The therapeutic approaches that help with PTSD like processing the experience, challenging unhelpful thoughts, and gradually re-engaging with life can also be helpful in navigating these painful traumatic experiences. Suffering doesn't have to fit a specific diagnostic category to deserve professional support and evidence-based intervention.

Treatments

Prolonged Exposure (PE): One of the most effective treatment options for PTSD is referred to as Prolonged Exposure (PE). This therapy involves “revisiting” the traumatic and describing it in specific detail with the therapist. It is sort of the “anti-avoidance.” While this is likely the LAST thing a person with PTSD wants to do, it has been demonstrated to be highly effective in resolving symptoms. The good news is, the worst of the discomfort in telling the story improves very quickly, and overall symptom alleviation can be swift. Over time with repeated recalls of the event, the memory and symptoms lose their intensity and the emotional pain subsides. Although the person will never forget the painful memory, they may regain the ability to live life without symptoms getting in the way of their peace of mind, relationships, and overall happiness.

Cognitive Processing Therapy (CPT): CPT is another strongly recommended trauma-focused therapy that combines writing about the traumatic event with cognitive techniques to help identify and challenge unhelpful thought patterns related to the trauma. This approach helps people understand how trauma has affected their thinking and develop more balanced, realistic thoughts about themselves, others, and the world.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): This approach directly addresses memories of the traumatic event and thoughts and feelings related to it. It includes various cognitive, behavioral, and emotional processing techniques and has shown evidence for effectiveness in treating PTSD symptoms.

Both PE and CPT have been strongly recommended by major clinical guidelines based on extensive research evidence. These approaches typically involve 12-16 weekly sessions of 60 minutes each and have shown consistent reduction of PTSD symptoms when completed. Research indicates these treatments are equally effective, so the choice between them often comes down to preference and what feels like the best fit.

Healing Trauma and PTSD is Possible

PTSD is a treatable condition. The intrusive memories, constant alertness, and avoidance patterns that characterize PTSD aren't permanent. They're symptoms that respond well to proper intervention.

With evidence-based therapy, most people with PTSD see significant improvement in their symptoms and ability to function in daily life. Many people find they can return to activities they had been avoiding, sleep better, and feel more like themselves again.

The key is working with a therapist specifically trained in trauma-focused approaches. While PTSD symptoms can feel overwhelming and permanent, they represent your brain's attempt to protect you from perceived danger. With the right therapeutic approach, you can help your brain learn that the danger has passed, allowing those hypervigilant responses to diminish.

Recovery doesn't mean forgetting what happened or pretending it didn't matter. It means being able to remember the traumatic event without being overwhelmed by it, and living your life without constantly feeling under threat.

PSYCHē PLLC has therapists ready to help.