The National Center for PTSD

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months. If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time. If thoughts and feelings from a life-threatening event are upsetting you or causing problems in your life, you may have PTSD.
Here’s the good news: you can get treatment for PTSD — and it works. In this booklet, you’ll learn about types of treatment that are proven to help. For some people, treatment can get rid of PTSD altogether. For others, it can make symptoms less intense. Treatment also gives you the tools to manage symptoms so they don’t keep you from living your life.

Any experience that threatens your life or someone else’s can cause PTSD. These types
of events are sometimes called trauma. Types of traumatic events that can cause
PTSD include:

• Combat and other military experiences
• Sexual or physical assault
• Learning about the violent or accidental death or injury of a loved one
• Child sexual or physical abuse
• Serious accidents, like a car wreck
• Natural disasters, like a fire, tornado, hurricane, flood, or earthquake
• Terrorist attacks

During this kind of event, you may not have any control over what’s happening,
and you may feel very afraid. Anyone who has gone through something like this
can develop PTSD.

There are 4 types of PTSD symptoms, but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

Reliving the event
Unwelcome memories about the trauma can come up at any time. They can feel very real and scary, as if the event is happening again. This is called a flashback. You may also have nightmares. Memories of the trauma can happen because of a trigger — something that
reminds you of the event. For example, seeing a news report about a disaster may trigger someone who lived through a hurricane. Or hearing a car backfire might bring back memories of gunfire for a combat Veteran.

Avoiding things that remind you of the event
You may try to avoid certain people or situations that remind you of the event. For example, someone who was assaulted on the bus might avoid taking public transportation. Or a combat Veteran may avoid crowded places like shopping malls because it feels dangerous to be around so many people. You may also try to stay busy all the time so you don’t have to talk or think
about the event.

Having more negative thoughts and feelings than before
You may feel more negative than you did before the trauma. You might be sad or numb — and lose interest in things you used to enjoy, like spending time with friends. You may feel that the world is dangerous and you can’t trust anyone. It may be hard for you to feel or express happiness, or other positive emotions. You might also feel guilt or shame about the traumatic event itself. For example, you may wish you had done more to keep it from happening.

Feeling on edge
It’s common to feel jittery or “keyed up” — like it’s hard to relax. This is called hyperarousal. You might have trouble sleeping or concentrating, or feel like you’re always on the lookout for danger. You may suddenly get angry and irritable — and if someone surprises you, you might startle easily. You may also act in unhealthy ways, like smoking, abusing drugs and alcohol, or driving aggressively.

Trauma-focused Psychotherapies: Trauma-focused Psychotherapies are the most highly recommended type of treatment for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event or its meaning. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.

In PTSD therapy, you and your therapist work together to set goals and develop new skills. The work may be hard, but the outcome will be worth it.

The trauma-focused psychotherapies with the strongest evidence are:

• Prolonged Exposure (PE): Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
• Cognitive Processing Therapy (CPT): Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
• Eye Movement Desensitization and Reprocessing (EMDR): Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).

If you’re a Veteran, check with the VA about whether you can get treatment there. Visit http://www.va.gov/directory/guide/PTSD.asp to find a VA PTSD program near you.
If you’re looking for care outside the VA, ask your doctor for a referral to a mental health
care provider who specializes in PTSD treatment, or visit https://findtreatment.samhsa.
gov/ to search for providers in your area.

When choosing a mental health care provider, here are some important things to consider:

• Find a provider who uses PTSD treatments proven to work. 
• What if I can’t find anyone who offers these treatments? Many doctors can treat PTSD with medication, but it may be hard to find therapists who use the other treatments we’ve talked about. If you can’t find a therapist who offers CPT, PE, or EMDR, ask about trauma-focused cognitive behavioral therapy. General cognitive behavioral therapy can also be a good alternative.
• Find out what your insurance will cover. If you have health insurance, check to see what mental health services are covered.
• Find someone who is a good fit for you. You and your therapist or doctor will work closely together, so it’s important that you feel comfortable asking questions and talking about problems in your life. It’s always okay to look for a different therapist or doctor if you’re not happy with the person you’re seeing.