Post-Traumatic Stress Disorder

Post Traumatic Stress Disorder occurs when the brain has been overwhelmed by a stressor to the point where it cannot discern what is a real danger and what is not. If you recall our previous discussion on anxiety, what the mind deems a threat can elicit the same physical symptoms of a dangerous situation.

For many people, PTSD develops after a singular traumatic experience like a car accident, assault or natural disaster. When overwhelmed by the horror of the experience, the brain will do nearly anything to avoid the danger again. That includes subjecting the brain's human host to flashbacks (vivid recollections of the experience that often make one feel like they are reliving it all over again) nightmares (often accompanied by terrified thrashing and yelling), and a feeling of pervasive emptiness and boredom that often leads them to revisit their horrific experiences over and over again.

PTSD can also occur over many years as traumatic experiences such as ongoing abuse and neglect. This long term trauma often leads to dissociation, derealization, and self harm as the sufferer tries to find ways to manage the constant flood of fear and stress, as well as the confusion when this trauma comes directly from someone they love or depend on like a parent or partner.

In his book “The Body Keeps the Score”, Dr Bessel van der Kolk described PTSD well in the following: “When you can’t be fully here, you go to the places where you did feel alive, even if those places are filled with horror and misery”. So too do those managing the symptoms of PTSD, unable to process and release the traumatic experience(s) despite the perpetuation of the pain that reliving it brings.

Treatment for PTSD may include trauma-informed psychotherapy, medication management, sleep support, grounding skills, nervous-system regulation, and careful attention to co-occurring anxiety, depression, substance use, or mood symptoms.

Psychotherapy can help explore how trauma shaped your sense of self, safety, trust, anger, grief, relationships, and emotional patterns.

Medication may help with symptoms such as anxiety, depression, sleep disruption, irritability, or intrusive symptoms. Medication decisions should be individualized and collaborative.

Trauma treatment should move at a pace that supports stability. The goal is not to force disclosure or relive painful memories, but to build capacity, agency, and a more integrated relationship with what happened.

PTSD can involve intrusive symptoms, avoidance, mood and thought changes, and increased nervous-system activation.

Diagnosis involves understanding the traumatic exposure, the symptoms that followed, how long they have been present, and how they affect daily functioning.

A psychiatric evaluation also considers depression, anxiety, bipolar disorder, substance use, sleep disorders, dissociation, grief, medical issues, and other factors that may overlap with trauma symptoms.

The purpose of diagnosis is to guide care in a way that is respectful, accurate, and stabilizing.

Support begins with believing the person’s experience and respecting their pace. Pressure to talk, explain, forgive, or move on can feel destabilizing.

Helpful support includes consistency, patience, emotional steadiness, and asking what feels supportive rather than assuming. Predictability and choice can help rebuild a sense of safety.

It is also important to remember that trauma responses are often protective adaptations. They may not make sense from the outside, but they developed for a reason.