Posttraumatic Stress Disorder

What Is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health condition brought on by a trauma.

Someone with PTSD has been through or witnessed a traumatic event. They have symptoms that last long after the trauma is over. These symptoms can be:

• bad memories, called flashbacks, that make it seem like the trauma is still happening
• bad dreams or trouble sleeping
• avoiding things that remind them of the trauma
• changes in mood, such as feeling sad, moody, angry, or detached
• not enjoying things like before
• feeling more easily scared, anxious, jumpy, sensitive, or startled

Therapy can help people recover from PTSD. They also need understanding, comfort, and support from people in their lives.

Not everyone who has been through a trauma will have PTSD. In fact, most won’t. Most people find ways to cope and get past trauma. Therapy and support soon after a trauma can help.

What Is a Trauma?

A trauma is a stressful event that makes a person fear for their or other people's life or safety.

Trauma events that can lead to PTSD include:

• physical or sexual abuse, or assault
• school or neighborhood violence
• natural disasters or fires
• car accidents
• military combat
• sudden or forceful loss of a parent
• arrests, evictions
• being the target of hate, or threats of harm

An event can be a trauma for someone even if they don’t go through the danger themselves. For example, seeing someone else be hurt or die from violence can be a trauma.

Hearing that someone close died by violence or suicide can be a trauma too. The grief can be intense with this type of loss. It is called traumatic grief.

Does Trauma Always Cause PTSD?

Traumas can lead to PTSD, but not always. Not everyone who has been through a trauma will have PTSD. In fact, most young people who go through trauma will not have PTSD.

But most will feel the effects of trauma. It’s natural to react to a deeply stressful event. Most people will feel upset, have thoughts of the trauma, and other signs of distress. These may be called PTSD-like symptoms.

Most people do find ways to cope with what they’ve been through. Some will get past trauma quickly on their own. It helps to have extra comfort and support from people in their lives. Therapy can also help. As people cope and adjust, their symptoms get better.

PTSD develops when a trauma overwhelms a person’s ability to cope. The deep stress of trauma keeps the brain’s threat sensors too active. That makes it hard for the person to feel safe again. People with PTSD need extra help to move through the coping process. Therapy helps them do that.

Whether or not a person will have PTSD partly depends on:  

• how severe the trauma was, or how harmful
• the help and support they get
• if they have a lot of other stress in their life
• if they have been through past trauma
• if they have depression or anxiety
• inherited risks like family history of depression and anxiety

After a trauma, a person may have PTSD-like symptoms that last for a short while, sometimes days or weeks. This may be called a stress reaction. Only if symptoms last longer than a month can it be diagnosed as PTSD.   

How Is PTSD Treated?

PTSD doesn’t usually go away on its own. Getting treatment and support can make all the difference.

Mental health providers (like psychologists, psychiatrists, and mental health counselors) have the experience to work with patients with PTSD. Treatment for PTSD can include therapy and/or medicines to help with anxiety, mood problems, and sleep issues.

Therapy for PTSD is called trauma-focused cognitive behavioral therapy (TF-CBT). This type of talk therapy uses talking and learning activities, guided by a mental health therapist. It can help anyone who has been through a trauma, not just people with PTSD. Getting therapy soon after a trauma helps them cope well.

PTSD therapy often includes:

• cognitive processing therapy (CPT) activities: to help with thoughts and feelings about the trauma
• prolonged exposure (PE) activities: to help someone lower anxiety and learn to safely face things they avoid after trauma
• eye movement desensitization and reprocessing therapy (EMDR): combined cognitive therapy with directed eye movements to reduce the power and pain of the trauma. This helps the brain reprocess memory of the trauma. There are therapists who specialize in this type of trauma therapy.

Trauma therapists also guide parents on how to listen and show they understand. The support of caring adults helps young people open up, feel safe, and do well.

How Does Therapy Help?

Trauma therapy gives people a way to safely share their feelings, tell their story, and get support. In therapy, they learn coping and calming skills to help them deal with anxiety after a trauma. This makes it easier to talk about what they have been through.

In therapy, people learn how trauma can affect their thoughts, feelings, and actions. They learn ways to adjust some of the difficult thoughts about the trauma. They learn to let go of any guilt or shame about what happened.

Slowly, people learn to face things they used to avoid. Therapy helps them gain courage and confidence. They use their strengths to cope and move forward.

How Can I Help Myself?

If you have been through trauma, or think you might have PTSD, here are things you can do:

• Confide in an adult you trust. Reach out to someone who will listen and care. It’s OK if you need extra time and support for a while. Pay it forward by being kind or helpful to someone else. Helping makes the helper feel good too. 
• Get treatment for PTSD or trauma. This can help you cope with what you have been through. It can help you discover strengths you never knew you had. Your parent, doctor, or school counselor can help you find the right person to work with.
• Practice ways to relax. Make time every day to take a few slow breaths. If you can, make the exhale just a bit longer than the inhale. Try this: Breathe in while you count to 3. Breathe out while you count to 5. Take 3–4 breaths like this. It seems so simple. But it has a powerful benefit. It helps to reset the brain’s threat sensor. The benefit adds up, so practice it often.
• Do things that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help you recharge. Play, laugh, enjoy nature, make music or art, cook. These activities can reduce stress, build your resilience. They even help you be a better learner when it’s time to focus.
• Know that you can do this. Believe in yourself. Everyone has the ability to adapt and grow, even with difficult challenges. It takes patience and effort. And there are people who will help you.