Post Traumatic Stress Disorder, or PTSD, is different than an immediate stress reaction or grief. Many of us have had a traumatic experience -- death of a loved one, house fire, robbery or assault, serious injury, divorce. At the time we understandably feel very upset or frightened, or sad. But usually the grief passes, the pain lessens overtime and life becomes more or less back to normal.
Sometimes people experience life-threatening or life-changing situations that are so distressing or cruel that the memory doesn't fade, not even slightly. For some people, the experience is so extreme that they find they cannot get past it to move on with life. Someone who feels this way may be suffering from Post Traumatic Stress Disorder (PTSD).

"I was 16 when I went on a date with the boy I had worshipped from afar. He was older and I thought very sophisticated and worldly. On our way home, he pulled the car over to the side of a remote road and raped me. At first I felt devastated, but after a while I believed it was behind me. That's what I wanted to do, and I thought I should be able to. But the truth is, I've never been the same since. I wake up at night thinking he's in my room. and I can barely move or even breathe. I can still smell his breath and hear his voice...."


Re-living the Event through recurring nightmares or other intrusive images that "pop" into one's head at any time. People who suffer from PTSD also have extreme emotional or physical reaction, such as uncontrollable shaking, chills, heart palpitations or panic when faced with reminders of the event.

Avoiding reminders of the event including places, people, thoughts or other activities associated with the trauma. PTSD sufferers feel emotionally empty, withdrawing from friends and family, and losing interest in everyday activities.

Being on guard or hyper-aroused including irritability or sudden anger, difficulty sleeping, lack of concentration, being overly alert and/or easily startled.

People with PTSD may have low self-esteem or relationship problems, or may seem disconnected from their loved ones. In addition, other problems may develop that can mask or intensify PTSD symptoms including;

* Psychological problems including depression, or another anxiety disorder such as panic disorder.

* Physical complaints such as chronic pain, fatigue, stomach pains, breathing problems, headaches, muscle cramps or aches, lower back pain or heart problems.

* Self-destructive behaviors including alcohol or drug abuse, self-injurious behavior like cutting, as well as suicidal tendencies.

"I had no memory at all about my father sexually abusing me when I was a child. I guess I just blocked it from my memory. On my wedding night which was supposed to be so special and wonderful, I just completely lost it. When my husband started to carress me, I became hysterical and almost scared him to death. Since then, I haven't really wanted to be sexual with my husband, but I do for his sake. Each time I just leave the situation; I leave my body. It's like I'm sitting up in the corner of the ceiling looking down at myself. Over the last 5 years, I just became more and more depressed. I felt like I was going through the motions. When my youngest was about 3 years old, it all just came flooding back and that's when I got help."

PTSD symptoms can appear within several weeks of the trauma, but some people don't experience symptoms until months, even years, later. It is important to understand that people respond differently to trauma. Some people will have only a few problems and those problems will go away with understanding and support from loved ones. Others will need some kind of treatment before they can move forward with their lives.

How is PTSD Treated?

The most important steps in treating PTSD are often the most difficult--recognizing the problem and getting help. There are reasons why this can be hard to do:

- A person who has experienced a traumatic event may hope, or even expect to "handle it" and "get over it" on their own.

- Sometimes a person will feel guilty about what happened and may mistakenly blame themselves, or they believe they deserve the hurt and pain. Sometimes, the experience may be too personal, painful or embarrassing to discuss.

- Some people avoid dealing with anything related to the trauma, especially as they try to get back to "normal". They are afraid of "opening a can of worms" and not being able to close it again.

- PTSD can make a person feel isolated or alone, or different, making it difficult to reach out.

- A person with PTSD doesn't always make the connection between the traumatic event and the emotional emptiness, anger, anxiety, and sometimes physical symptoms they unexpectedly feel months, even years, after the trauma.

- Sometimes people don't know that help is available, or don't know where to turn for help.

Psychotherapy, such as cognitive behavior therapy including exposure and anxiety management treatments, are effective in treating PTSD. Certain medications are also effective in the treatment of PTSD.

"I had been through that same car wash a hundred times. That day, I started through the wash and, as the big arm of the machine was going across the hood of my car and up the front windshield, it crashed through. I was pinned in the car in the middle of the car wash. I don't remember much after that. I was taken to the hospital and am pretty much recovered from my injuries, but now I can't get into the car to go anywhere. I am terrifed to have anything to do with cars, garages, and now I can't go to public places. My husband doesn't understand and I really don't either. I just know I can't get in a car. I haven't returned to work, and I'm afraid I never will. I'm just too scared."

How Can Family and Friends Help?

It can be very difficult to watch a loved one or good friend deal with the after effects of a trauma. The person may become distant or emotionally numb, or may be struggling with other symptoms. But try not to become discouraged. This person needs you now more than ever. Here are some things you can do:

1. Encourage the person to seek and continue treatment. This can be hard because treatment means confronting the trauma and all of the upsetting and frightening emotions and memories connected to it. But your encouragement and support during treatment will help a great deal.

2. Provide emotional support and listen. Encourage the person to share his or her feelings and be a good listener. However, do not try to take the lead and try to coax the person to talk or ask a lot of questions about what is happening with their therapy when they wish to maintain their privacy.

3. Be patient and have realistic expectations for recovery. The healing process can take some time. Depending on the severity of the situation, recovery could take many months. Understanding this and putting some of your own needs on hold will help you stay optimistic and supportive when it is needed most.

4. Take care of yourself. Being there for someone who is recovering from a traumatic experience can be stressful. Take time to take care of yourself. Learn how to be supportive without taking the role of a therapist.

5. Remember that someone who is suffering from PTSD cannot "get over it" or "just not think about it". Having PTSD is not a sign that the person is weak. And more often than not, stress from trauma will show itself months, if not years, after a trauma.

"I don't know what I would have done without my family. Everybody was in such pain after my sister was murdered. Four months after her death, I was arrested for stealing some furniture from my neighbor's house. I had absolutely no recollection of it! I knew the neighbor's house was for sale because I saw the agent showing it two or three days prior. The police just came to the door and arrested me...I had no idea why. They had received a call from my next-door-neighbor who had seen me putting the furniture in my shed. When I went to the shed with the police, there it was! I couldn't even explain it to my family, but they stood by me and made sure I got help."


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