Post-Traumatic Stress Disorder (PTSD): Your GoodRx Guide

Definition

Post-traumatic stress disorder (PTSD) is a condition that occurs after a traumatic event such as a serious accident, natural disaster, war, sexual assault, or abuse. PTSD can also occur after experiencing an indirect trauma, such as witnessing violence or working as a first responder.

PTSD can present in various ways that may lead to symptoms such as nightmares, flashbacks, insomnia, losing interest in your favorite activities, and intrusive thoughts. It is also closely tied with other mental health conditions, such as anxiety or depression. About 3.5% percent of U.S. adults experience PTSD each year.

This guide will review the causes, symptoms, and treatment options for PTSD.

Causes

A wide range of stressful or traumatic events can trigger PTSD, especially situations that make you believe your life is in danger. These include:

• Sexual trauma or domestic violence

• Mass conflict or displacement

• Being exposed to a warzone, military combat, or community violence

• A traumatic injury, such as a motor vehicle accident

• Medical trauma like a heart attack or stroke

• Trauma in childhood, such as physical or sexual abuse

• Serving as a first responder or healthcare professional 

Many people will experience stressful events and traumas in their lifetime, but not all will go on to have PTSD. There are some known risk factors that can increase your risk of developing PTSD, including: 

• Young age at the time of the trauma

• A history of childhood adversity or abuse

• Poor social support

• A history of substance use or other mental health issues

Other factors may increase your likelihood for developing PTSD including genetics, hormonal and brain changes, and environmental factors.

Symptoms

Adults with PTSD can have a wide range of symptoms that fall into the following categories:

• Intrusion: This includes distressing memories, flashbacks, or nightmares as well as dissociation, which is when you feel detached from your surroundings, experiences, or sense of self. 

• Avoidance: This includes avoiding any reminders of the traumatic event such as specific people or places.

• Cognitive and mood changes: This could be guilt, loss of interest in activities, or the development of depressive symptoms.

• Arousal and reactivity: This may include increased irritability, anxiety, paranoia, or difficulty concentrating.

Young children may have different symptoms from PTSD such as:

• Beginning to wet the bed after being potty trained

• Regressing in verbal skills, such as no longer talking

• Reenacting the traumatic event when playing

• Having trouble sitting still or paying attention

Older children or teens could also develop aggressive or risky behaviors. 

Diagnosis

You will need a full psychological evaluation to be diagnosed with PTSD. A healthcare provider will make a diagnosis based on the DSM-5 criteria for PTSD, which includes the following:

1. Exposure to a traumatic event, which can be direct or indirect trauma.

2. At least one intrusion symptom such as distressing memories, dreams, or flashbacks.

3. At least one symptom related to avoiding trauma triggers, such as avoiding people, places, or situations that may remind you of the traumatic event.

4. At least two symptoms of arousal and reactivity such as irritability or angry outbursts, hypervigilance, difficulty concentrating, or sleep trouble. 

5. At least two mood or cognition symptoms related to the traumatic event such as memory loss, emotions like guilt or fear, or isolating from others.

Your symptoms need to be going on for more than 1 month to receive a PTSD diagnosis. Symptoms must also be severe enough that they affect your relationships or work.

Treatment

The right PTSD treatment for you will depend on many factors. It’s important to talk with your healthcare provider about the best options for you.

Psychotherapy is a key component of treatment for PTSD. There are different forms of psychotherapy. Some of the most effective therapies for PTSD include: 

• Eye movement desensitization and reprocessing (EMDR)

• Prolonged exposure therapy

• Cognitive processing therapy (CPT)

In addition to psychotherapy, many with PTSD also benefit from medication. The right medication for you will depend on many factors. Some medication options for PTSD include:

• Antidepressants including SSRIs or SNRIs such as sertraline (Zoloft), paroxetine (Paxil), or venlafaxine (Effexor)

• Prazosin (Minipress), an alpha-adrenergic receptor blocker otherwise used for high blood pressure, to treat PTSD sleep issues like nightmares

• Antipsychotics such as quetiapine (Seroquel) or risperidone (Risperdal), which are sometimes added to treatment if antidepressants alone aren’t helping you enough