SPECIAL ISSUE: PTSD 101 for Caregivers of Veterans

Posttraumatic stress disorder (PTSD) can occur after a person has been through a traumatic event. A traumatic event is something terrible and scary that someone sees, hears about or that happens to the person, such as: Combat exposure/military sexual trauma Child sexual or physical abuse Terrorist attack Sexual or physical assault Serious accidents, like a car wreck Natural disasters, like a fire, tornado, hurricane, flood or earthquake During a traumatic event, the person thinks their life or others' lives are in danger. They may feel afraid or feel that they have no control over what is happening around them. Most people have some stress-related reactions after a traumatic event; but, not everyone gets PTSD. If these reactions don't go away over time and they disrupt life, then the person may have PTSD. Most people have some stress-related reactions after a traumatic event. If the reactions don’t go away over time and they disrupt your life, you may have PTSD.

How does PTSD develop? Most people who go through a trauma have some stress-related symptoms at the beginning. Only some will develop PTSD over time. It isn't clear why some people develop PTSD and others don't.Whether or not a person gets PTSD depends on many things: How intense the trauma was or how long it lasted If the person was injured or lost someone important to him or her How close the person was to the event How strong the person’s reaction was How much the person felt in control of events How much help and support the person got after the event Ssymptoms of PTSD PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause the person great distress, or interfere with work or home life, the person might have PTSD. There are four types of symptoms of PTSD: Reliving the event (also called re-experiencing symptoms) The person may have bad memories or nightmares and may even may feel like he or she is going through the event again. This is called a flashback. Avoiding situations that remind you of the eventThe person may try to avoid situations or people that trigger memories of the traumatic event. The person may even avoid talking or thinking about the event. Feeling numbThe person may find it hard to express his or her feelings or may not be interested in activities he or she used to enjoy. This is another way to avoid memories. Feeling keyed up (also called hyperarousal)The person may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal.

Oother Issues People with PTSD may also have other problems. These include: Feelings of hopelessness, shame or despair Depression or anxiety Drinking or drug problems Physical symptoms or chronic pain Employment problems Relationship problems, including divorce In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills learned in treatment can work for both PTSD and these related problems. What treatments are available? Treatment for PTSD can help. There are two main types of treatment,psychotherapy (sometimes called counseling) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD Psychotherapy, or counseling, involves meeting with a therapist. There are different types of psychotherapy. Cognitive behavioral therapy (CBT) is the most effective treatment for PTSD. There are two different types of CBT for PTSD that are broadly offered at VA. One type is Cognitive Processing Therapy (CPT) where patients learn skills to understand how trauma changed their thoughts and feelings. Another type is Prolonged Exposure (PE) therapy where patients talk about their trauma repeatedly until memories are no longer upsetting. They also go to places that are safe, but that they have been staying away from because they are related to the trauma. Medications 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. Another medication called Prazosin has been found to be helpful in decreasing nightmares related to the trauma. IMPORTANT: Benzodiazepines and atypical antipsychotics should generally be avoided for PTSD treatment because they do not treat the core PTSD symptoms. __________________________