Post-Traumatic Stress Disorder

What is Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a complex anxiety disorder that may develop after having experienced or witnessed an exceptionally threatening traumatic event.

What is a trauma?  PTSD

A traumatic event is defined by Medical Encyclopaedia as “an experience that causes physical, emotional, psychological distress or harm. It is an event that is perceived and experienced as a threat to one’s safety or to the stability of one’s world”. 

A traumatic experience may involve actual or threatened death or a serious injury for the person or other people; the reactions may vary from intense fear, helplessness or horror.  Examples of these kind of traumatic experiences are: aggressions, rapes, earthquakes, accidents, natural cataclysms, etc.

Experiencing such a traumatic event is a strong threat to some beliefs that are basilar in our everyday life, such as the sense of being invulnerable and the belief that the world is a safe and comprehensible place. After such a shocking experience, it is normal to feel intense anger, guilt, shame or powerlessness.

PTSD symptoms

If PTSD develops, the person re-experiences the trauma for at least one month in several different ways:

  • intrusive, recurrent and distressing memories (through thoughts, feelings or images);
  • recurrent distressing dreams;
  • acting or feeling as the trauma is reoccurring, through flashbacks, illusions, hallucinations, dissociative episodes;
  • if exposed to stimuli similar to the traumatic ones, the person may feel extremely distressed and may experience an intense physical activation.

Usually this re-experiencing is accompanied by strong avoidances of every stimulus that represents and remembers the trauma, such as:

  • thoughts, feelings, conversations;
  • activities, places or people;
  • specific aspects of trauma;
  • diminished interest or participation in significant activities;
  • sense of detachment or estrangement from others;
  • restricted range of affects;
  • sense of a foreshortened future.

The person experiences as well an intense arousal (problems in sleeping, irritability or anger, problems in concentrating, hyper vigilance or exaggerated startle response).

After experiencing such a traumatic event, it is normal to experience some of the aforementioned symptoms; usually little by little they disappear.

But if after one month there is no spontaneous remission then is possible that a PTSD has developed.

What has happened?

In PTSD it is like if the trauma is not processed and integrated, and the person is stuck in the memories and feelings once experienced.

The cortical pathways responsible for anxiety seem to be abnormally regulated, reacting often and intensely to stimuli that remind the traumatic situation.

Risk factors

Not everyone experiencing a trauma develop a PTSD and PTSD is not the only psychological consequence that can follow a trauma.

There seem to be several risk factors that increase the likelihood of developing the disorder.

Pre-trauma risk factors are:

  • being a woman;
  • age;
  • lower levels of education;
  • having experienced other traumas;
  • difficult childhood experiences (rejections, abandonments, abuses, neglect, etc.)
  • suffering from a psychiatric disorder;
  • family history of psychiatric disorders;
  • ADHD;
  • inadequate stress coping mechanisms;
  • personality disorders.

Features of trauma:

  • severity;
  • nature;
  • participation to trauma (victim, witness or perpetrator).


  • lacking of social support;
  • developing an acute stress disorder;
  • post-traumatic reaction following the trauma.

Very often people suffering from PTSD have another disorder in comorbidity. The most frequent ones are alcohol/substance abuse, depression, Panic Disorder and Social Anxiety.

If you recognise yourself or someone close to you having these symptoms after being exposed to a trauma, then keep your eyes opened on what is going on.

Monitor the situation and if the symptoms persist, seeking a specialistic help is highly recommended.

Cognitive Behavioural Therapy can help you in elaborating what happened and managing the symptoms.

Useful links:

“Risk factors for PTSD”, by S. Halligan, R. Yehuda.

NICE guidelines for PTSD