Post Traumatic Stress

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Trauma can lead to aggressive, violent behaviors... Post traumatic stress disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event.

You may feel afraid or feel that you have no control over what is happening. These symptoms may disrupt your life, making it hard to continue with your daily activities.

PTSD and Domestic Violence

There is a relationship between the experience of a traumatic event, PTSD and domestic violence. In fact, intimate partner abuse happens more than you may think.

National estimates indicate that, in a period of one year, 8 to 21% of people in a serious relationship will have engaged in some kind of violent act aimed at an intimate partner. Relationship violence has also been found among people who have experienced certain traumatic events or have PTSD.

Trauma, PTSD & Relationship Violence

Separate from PTSD, a connection has been found between the experience of certain traumatic events and relationship violence. In particular, studies have found that men and women who have experienced physical abuse, sexual abuse, or emotional neglect in childhood may be more likely to be abusive in intimate relationships as compared to people without a history of childhood trauma.

In addition, people with PTSD have also been found to be more likely to be aggressive and engage in intimate partner abuse than people without a PTSD diagnosis. The connection between PTSD and violence has been found for both men and women with PTSD.

How Are They Related?

Several studies have been conducted in an attempt to better understand what may lead people with a history of trauma or PTSD to engage in aggressive and violent behaviors.

In studies of U.S. veterans, it has found that depression played a role in aggression among people with PTSD. People who have both depression and PTSD may experience more feelings of anger and, therefore, may have greater difficulties controlling it.

In line with this, a couple of studies have found that violent and aggressive behavior, especially among men, may be used as a way of attempting to manage unpleasant feelings. Aggressive behavior may be a way of releasing tension associated with other unpleasant emotions stemming from a traumatic event, such as shame, guilt, or anxiety.

While aggressive and hostile behavior may temporarily reduce tension, it, of course, is ineffective in the long-run -- both in regard to relationships and dealing with unpleasant emotions.

Despite these findings, it is important to note that just because a person has experienced a traumatic event or has PTSD does not mean that they will exhibit violent behavior. There are many factors that contribute to aggressive behavior and much more research is needed to identify the specific risk factors for aggressive behavior among people exposed to traumatic events or who have PTSD.

What Can Be Done?

Mental health professionals have long recognized that trauma and PTSD increase risk for aggression. Therefore, many treatments for PTSD also incorporate anger management skills. Learning more effective ways of coping with stress is a major part of reducing aggressive tendencies, such as deep breathing and identifying the short- and long-term negative and positive consequences of different behaviors.

[ PSTD & Domestic Violence © 2012 The National Center for PSTD © 2007.   Thank you for making this information available. ]

How does PTSD develop?

All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things:

  • How intense the trauma was or how long it lasted
  • If you lost someone you were close to or were hurt
  • How close you were to the event
  • How strong your reaction was
  • How much you felt in control of events
  • How much help and support you got after the event
  • How many times the trauma was repeated

Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.

What are the symptoms of PTSD?

People who suffer from PTSD exhibit a variety of symptoms. These can include a deep sense of helplessness, problems at home or work, abnormal fear, feelings of devastation, flashbacks from the event, a feeling of numbness, aversion to social contact, or avoidance of situations that might trigger memories of the event.

Some physical responses may include depression, anxiety, sleep disturbances, panic attacks, irritability, anger outbursts, difficulty with concentration or memory, feelings of vulnerability, fear of normal every-day activities, or feeling overwhelmed by the smallest of tasks.

Symptoms of PTSD can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

4 types of PTSD symptoms

1. Reliving the event (also called re-experiencing symptoms)

Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger - a sound or sight that causes you to relive the event. Triggers might include:

  • Hearing a car backfire, which can bring back memories of gunfire and war for a combat Veteran.
  • Seeing a car accident, which can remind a crash survivor of his or her own accident.
  • Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped.
  • Witnessing abusive acts
  • Hearing couples or people fighting or arguing

2. Avoiding situations that remind you of the event

You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:

  • A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes.
  • A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants.
  • Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

3. Feeling numb

  • You may find it hard to express your feelings. This is another way to avoid memories.
  • You may not have positive or loving feelings toward other people and may stay away from relationships.
  • You may not be interested in activities you used to enjoy.
  • You may not be able to remember parts of the traumatic event or not be able to talk about them.

4. Feeling keyed up (also called hyperarousal)

You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:

  • Suddenly become angry or irritable
  • Have a hard time sleeping
  • Have trouble concentrating
  • Fear for your safety and always feel on guard
  • Be very startled when something surprises you
What are other common problems?

People with PTSD may also have other problems. These include:

  • Drinking or drug problems
  • Feelings of hopelessness, shame, or despair
  • Employment problems
  • Relationships problems including divorce and violence
  • Physical symptoms
Can children have PTSD?

Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

  • Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom.
  • Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.
What treatments are available?

When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better. There are good treatments available for PTSD.

  • Cognitive behavioral therapy (CBT) appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy.
  • A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD.
  • Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.
More from the DSM

The DSM-IV describes the following signs and symptoms of Post-Traumatic Stress Disorder:

  • The person witnessed, experienced, or was otherwise confronted with a traumatic event or series of events that involved threat of death or injury to him or herself or others.
  • The person's response to this event involved intense fear, feelings of helplessness, or horror.
  • The person repeatedly re-experiences the event in at least one of the following forms:
    • Repetitive, intrusive recollections of the event, including images, thoughts or perceptions (visions, hearing or smelling the same smell or sounds that occurred that day, etc.).
    • Recurrent dreams or nightmares about the event in question.
    • Feeling as if he or she is reliving the traumatic experience (i.e., experiencing flashbacks, hallucinations or other vivid sense of experiencing the event again).
    • The person experiences extreme psychological distress upon being reminded of or thinking about the traumatic experience.
    • The person has an actual physical reaction upon being reminded of or thinking about the traumatic experience.
    • The individual avoids experiencing stimuli associated with the traumatic event or shows signs of general numbing of feelings and interest in everyday life, in the form of three or more of the following:
      • Avoiding thinking about or discussing the traumatic event.
      • Avoiding the place, people, or activities that are associated with the traumatic event.
      • Blocking out (experiencing amnesia about) important memories associated with the precipitating event.
      • Diminished interest in or participation in formerly enjoyed activities.
      • Feelings of emotional detachment or estrangement from others.
      • Dampening of emotions -- feeling that emotions have a restricted range, i.e. unable to feel love towards others.
      • Expectations about future are foreshortened; that is, the person believes that his or her life will be cut short, or that he or she will never reach normal milestones, such as marriage, birth of children, career, etc.
    • The person experiences frequent and persistent symptoms of increased physiological arousal (his or her body appears ready to react rapidly in case of another stressful event), in the form of two or more of the following:
      • The person has difficulty falling asleep or staying asleep.
      • He or she appears irritable or has emotional or angry outbursts.
      • He or she experiences difficulty concentrating.
      • His or her senses are hypervigilant and she or he appears to be constantly on the lookout for threats.
      • He or she startles easily.
    • The symptoms related to this experience went on for more than one month and caused distress or impairment in social, occupational, or other important areas of functioning.

    You've experienced a traumatic event in your life, and are obviously suffering. A mental health professional can help guide you in the healing process and can help you learn to live with the memories of this difficult experience. The treatments for PTSD include Exposure Therapy, which slowly builds up from mildly frightening situations to more frightening ones, as well as relaxation techniques for handling anxiety and group therapy, among others.

    Historically, PTSD has been associated with military personnel and their reactions to traumatic experiences involving combat and warfare situations. More recently, PTSD has been linked to traumatic situations encountered by everyday individuals.

    The trauma can be triggered by large-scale ordeals, like terrorism attacks or devastating natural disasters, or highly personal events like a single-car accident, losing a job or business, divorce, failing to achieve a goal, loss of a loved one, seeing or hearing of a death, personal injury, childhood trauma or any other life-altering experience.

    PTSD can occur when living with repeated abusive behavior, whether they be physical, mental, sexual or emotional. Living with long-term repeated, or cyclic, abuse undoubtedly results in some form of post traumatic stress disorder.

    Long Term Effects

    If left untreated, PTSD symptoms can become worse. Some documented cases include addiction to drugs or alcohol; chronic pain, hypertension or physical maladies; self injury; overwhelming fear of death; compulsiveness; personality changes; and self destructive incidents, to name a few.

    Helping someone PTSD

    The good news is that PTSD is treatable. Unfortunately, many health care providers are not always able to link the symptoms with the diagnosis. By making people aware of PTSD, including individuals whose loved ones have experienced a traumatic situation, is one of the best ways to assist in accurate diagnosis and that can lead to treatment, and, eventually, healing, growth and recovery.

    [ This article paraphrased from The National Center for PSTD © 2007.   Thank you for making this information available. ]

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