An acute stress reaction sets in at the same time as the crisis situation and subsides after a few days. Those affected appear numb, disoriented and withdraw. They perceive what has happened as unreal. This can be seen, for example, in residents during a house fire.
In contrast, the first symptoms of PTSD set in a few days or even years later. After a traumatic experience, PTSD manifests itself in around ten percent of those affected.
The typical symptoms include
- avoidance and repression of the traumatic experience
- Irritable behavior, nervousness and anxiety
- the occurrence of memories of the trauma, which is experienced again
- a decline in previous interests and feelings
- jumpiness
- concentration problems
- trembling
- sleep disturbances
- numbness
The affected person experiences the psychological stress again and again in their memory. This becomes noticeable in the form of flashbacks. The patient feels as if they are reliving the traumatic situation.
Certain situations in their memories can lead to severe anxiety. Intense nightmares are also not uncommon. In some cases, those affected believe that they themselves are to blame for the experience.
Other patients tend to have somatic complaints. This means that they experience physical symptoms for which no organic causes can be found. In the worst cases, people with PTSD also attempt suicide (suicidal behavior).
Children with post-traumatic stress disorder often show behavioral abnormalities such as aggressive behavior. Some children also replay their experiences over and over again.
Post-traumatic stress disorder is listed in the ICD-10 (diagnostic catalog of the World Health Organization) in section F43 - Reactions to severe stress and adjustment disorders; the disorder itself is coded F43.1.
The diagnosis F43.1 is made if
- the symptoms last longer than one month and
- the person affected is therefore no longer able to cope with everyday life.
If the symptoms last longer than three months, medicine refers to chronic PTSD. Chronic means "long-lasting" and not that the illness is incurable.
Traumatic experiences are considered to be
- Natural disasters
- fires
- experience of violence
- experience of war
- hostage-taking
- Serious physical illness (cancer, stroke)
- Accidents (e.g. serious traffic accident, chemical accident)
The patient does not necessarily have to be affected by the disaster themselves. Observing a disaster (e.g. a child burns to death in a car accident) can also lead to PTSD.
War experiences lead to PTSD in many soldiers © Photographee.eu | AdobeStock
The psychological stress consists of
- Severe helplessness,
- horror and
- the feeling of existential threat.
The experience challenges their understanding of themselves and the world.
The causes of post-traumatic stress disorder are diverse and vary from person to person. The bio-psycho-social disease model best explains the development of the disease.
Biological factors increase the risk of reacting with PTSD after a very stressful event. These include an innate vulnerability. Women fall ill more often than men, young people more often than older people.
People with generally reduced mental resilience are considered to be particularly susceptible. This can be inherited or caused by past trauma. Pre-existing mental illnesses such as
increase the risk of illness.
Social components, such as a low level of education and a lack of reliable relationships, are also considered risk factors.
There is an official recommendation for the treatment of post-traumatic stress disorder, the S3 guideline of the AWMF specialist associations. According to this, treatment should be provided by a psychotherapist or specialist with experience in trauma therapy. There is a risk of PTSD worsening if the wrong treatment measures are taken.
The first step is to offer the affected person a safe environment as far as possible.
Further treatment consists primarily of talk therapy. The person affected is informed about the illness and its symptoms. Basically, the aim of the therapy is to deal with the traumatic content in a targeted and measured way.
To do this, the person affected must be sufficiently stable. For this reason, the first focus is on dealing with difficult feelings (affect regulation). In addition, the therapist clarifies possible suicidal tendencies.
Medication can make an important contribution to the success of treatment. They are not effective as the sole therapy. Patients are given an antidepressant to help them become more stable and deal with the trauma.
Some patients find it helpful to talk to other sufferers in a self-help group. Participation must be voluntary. When choosing a group, you should make sure that it is professionally supervised. The German Institute for Psychotraumatology offers information on the subject of self-help and relatives on its website.
For a long time, scientists concentrated on the negative consequences of mental disorders. They asked, for example: How does PTSD develop? What are the dynamics behind the disorder? How can it be treated?
One phenomenon has only recently come to the attention of scientists: post-traumatic growth. Researchers found that the majority of those affected emerge from a trauma in a mature state.
Here are a few examples:
- I like myself more than before.
- I have realized how valuable life is.
- My self-confidence has increased.
- I maintain close and trusting relationships.
- I am in control of my life.
- I am open to new experiences and challenges.
CONCLUSION: Psychological trauma is part of the human experience and can have serious consequences. Modern medicine has effective treatment options to help people with post-traumatic stress disorder.
In addition, the latest research findings show that experiencing a disaster also has a learning effect on the rest of life and that those affected emerge from the crisis stronger.
Healthy people also benefit from this knowledge.
