POST-TRAUMATIC STRESS DISORDER

PTSD stands for Post-Traumatic Stress Disorder. It is classed as an anxiety disorder and is often associated with military personnel, or those who have served in the armed forces, but it is not exclusive to that group of people.

Here, you can find out everything you wanted to know about Post-Traumatic Stress Disorder (aka PTSD...or at least we hope so!). You can click (or touch) each of the headings below to find out more about specific aspects of the condition.

We hope you find the information useful and if you do, please feel free to share it.

WHAT IS PTSD? . . .

Post-Traumatic Stress Disorder can be caused as a consequence of any traumatic event that has proved to be incredibly stressful, frightening or extremely distressing in your life. The incident, whatever it was, doesn't have to have affected you directly. You may have witnessed it or it could have impacted on someone close to you.

To understand how PTSD and its associated memories keep re-emerging, we'll try and explain the brain and how it processes memories, in the most basic way. Bear in mind the brain is an incredibly complex piece of biological engineering (apart from mine, which is basically an abacus) and no-one REALLY knows, so this, as we said, is a very basic explanation.

Despite what Pixar's Inside Out (or the Numbskulls for older readers) might have taught us, memories aren't stored in library-like racks in our brains which allow us to simply pick and choose which ones to remember. The memory of 'anything' is built up from a collection of 'images' that our brains combine to make a memory.

Think of your favourite meal. You might be able to see it in your mind's eye as a singular, beautiful plate of food, but your brain is bringing all those elements together from a collection of thoughts spread throughout your brain. How it smells comes from one area, how it tasted from another, how it looked from another again, where they all coalesce and, voila, a memory is recalled.

When memories are first made, they all start off as short-term memories. Your brain takes all its cues from the senses associated with it; what it looks like, how it makes you feel, its taste, sound, smell and so on. Given the amount of information we take in on a daily basis, it also acts as a filter to disregard the stuff we don't need (so we forget it) and logging that we do. Try and remember what you had for lunch three weeks ago last Wednesday and you may struggle to remember, unless some memorable also occurred at the same time.

Once the memory is processed, all the important information is eventually moved into long term memory across different areas of the brain. This process occurs in an area of the brain called the hippocampus, which is responsible for memory functions. It also helps us differentiate between new memories and those that occurred in the past.

When a traumatic incident occurs, the hippocampus can, given all the information it has, struggle to process the memory properly and so doesn't confine it to long- term memory, causing it to be relived in the mind of the victim. It effectively becomes stuck in a loop. Rather than being processed, it comes back around again and again with the brain struggling to differentiate it from present and past memories.

Trauma affects people in different ways and PTSD can manifest itself a short time after the event or up to years afterwards. Those with PTSD will experience panic attacks, vivid nightmares and flashbacks to the traumatic event.

WHAT CAUSES PTSD? . . .

Here's the part where we would like to put a definitive reason why some people get PTSD and others don't. Sadly we can't do that. Like almost all mental illnesses there simply isn't an easily identifiable cause.

PTSD, as the name suggests, is triggered by a traumatic event in someone's life. Of course, what you find traumatic and what I find traumatic may be very different.

Events can include serious road traffic accidents, violent assaults, prolonged sexual abuse, witnessing serious incidents or death (even if you aren't directly involved), surgery, natural disasters such as earthquakes, floods, etc. or even terrorist incidents. If you are (or were) in the armed forces and saw service in war up close and personal, then you may well have seen traumatic incidents quite regularly. The list, as always, can go on and it's not exclusive to those listed here.

OK, BUT DO MEN GET IT? . . .

They do, but given how synonymous PTSD is with the military, you'd think that the gender differences would be massively stacked towards men, but you'd be wrong. Whilst it's true that those in the forces are predominately men and what they experience must be horrendous, the prevalence of PTSD in men is 'only' around 5-6% compared with around 10-12% in women. Women are 2-3x more likely to develop PTSD than men.

Men and women tend to be exposed to different types of trauma and it affects different areas of the brain and at different ages. It was thought that women experience more trauma than men, but research showed just the opposite. Women report trauma about a third less than blokes, but this means they are at a higher risk of developing PTSD.

Women are more likely to be victims of high-impact sexual trauma than men, and at a younger age. They also experience more incidents of sexual abuse, domestic violence and sexual assault, whilst men are more likely to experience trauma in combat and accidents (natural disasters and human error).

Women handle stressful situations differently than men and have evolved differentially to support those differing behaviours. This includes the perception of a threat and something called 'peritraumatic dissocciation'. In essence, this means that, at the time of a traumatic experience, how much dissociation to the event a person feels. In other words, the brain will offer protection by emotionally distancing itself from what's happened, either through out-of-body experience (like it's happening to someone else), emotional numbness (so you don't feel anything), amnesia (blocking it out) or depersonalisation (the thought that it's not happening to a real person).

WHAT ARE THE SYMPTOMS OF PTSD? . . .

This constant negative cycle on the brain means that it changes how people with PTSD feel about themselves, sometimes leaving them incapable of exhibiting positive emotions. They become emotionally numb and develop a less effective memory. They can also quickly become irritable, angry and short-tempered as their emotions can be affected too. They can be easily startled and scared (known as an exaggerated startle response) by loud, unexpected noises like balloons popping, things falling, etc. Jumping up behind them and screaming "boo" is certainly not to be recommended either.

If that wasn't enough, they often have overwhelming feelings of guilt or shame, even if the incident wasn't of their making or fault.

Those with PTSD can also be susceptible to triggers that can occur without warning. These triggers can be anything that reminds them of the traumatic incident. They can occur from images they may see on TV, words they hear in conversation or read in a book or magazine. They can also begin to avoid anything that even remotely reminds them of the incident, such as people, places or situations. This is known as phobic avoidance.

They can also develop something known as psychological reactivity when confronted with reminders, even in the most innocuous surroundings. They will often become panicked, anxious, sweating, etc.

If any of this sounds familiar and you've experienced these symptoms for a month or more, you can be diagnosed with PTSD. You should arrange to see your doctor immediately.

WHAT TREATMENTS ARE AVAILABLE? . . .

Treatments for PTSD tend to be a combination or therapy and medication. Classic!

In terms of therapy, there are usually 3 options for you; Group Therapy (aka support groups), Cognitive Behavioural Therapy (CBT) or something called 'Eye Movement Desensitisation and Reprocessing' or EMDR. You can find out more about those on our Guide to Treatments.

As for medication, there are certain antidepressants that are used to to treat PTSD, including sertraline, phenelzine, paroxetine, mirtazapine and amitriptyline. The last two are specifiically licensed for PTSD. It's worth noting that medication will only be used if psychological treatments have been refused (by you), you tried them and they haven't helped, there's an ongoing threat of more trauma or there's another medical condition underlying it all.

Like any medication for mental ill-health, it can be a case of chopping and changing until you find one that helps. This can take some time and whilst frustrating, it's worth being patient with it.

WHAT CAN BE DONE TO HELP SOMEONE WITH PTSD? . . .

When you have PTSD, it's a roller-coaster of emotions, for those living with it and for those around them. Feelings can be overwhelming and those with PTSD can isolate themselves, becoming distant and 'moody'. If they know you're there for them, this can make a world of difference.

Having PTSD can make someone short-tempered, angry, bad tempered and living in state of constant alert that they just can't switch off, as much as they'd like to. It's important to give them social support. This might means, doing 'normal' stuff with them, letting them take the lead in what to do or where to go. You will need to be patient for sure.

As with many illness, but particularly with PTSD, there will be triggers that are personal to them. It's important that you know what they are and how to manage them. Read their signs, understand their emotions and be there for them.


If you suffer with PTSD, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.

Also, if you'd like to share your experiences of living with PTSD with our community so they can better understand how it feels, please take a look at our 'Men Tell' section.