PTSD is a mental disorder that is more common than it is assumed to be. This psychiatric condition is easy to identify yet hard to define. Various types of PTSD exhibit different symptoms and are managed according to the severity of the disease.

What is PTSD?

Post-traumatic stress disorder or PTSD is a psychiatric condition wherein a person develops a thought disorder following a single traumatic event, series of such events, or due to ongoing traumatic circumstances. According to the DSM-5, PTSD (Post-Traumatic Stress Disorder) is a psychiatric disorder resulting from exposure to a traumatic event. It involves symptoms such as intrusive memories, avoidance of reminders, negative thoughts and emotions, changes in arousal, and impairment in daily functioning. These symptoms must persist for more than one month and cause significant distress. The criteria help clinicians diagnose and treat individuals with PTSD.¹
This mental condition affects around 3.5 percent of the adult U.S. population annually. Women are more prone to develop various types of PTSD²
Back in the mid-1900, PTSD was thought to be a consequence of wars and was often considered a mental disease of military servicemen. However, later it was learned that the condition was not typically associated with war and soldiers only. The month of June is regarded as National PTSD Awareness Month to raise public awareness regarding the issue and to overcome the stigma associated with the disease.

Symptoms of PTSD

Traumatic events can have a profound impact on a person’s mental well-being, and transient feelings of depression may be observed. However, when it comes to PTSD, the effects are intensified and complex.

Individuals with PTSD may experience intense and uncontrollable disturbing thoughts, leading to feelings of sadness, anger, fear, and detachment from others.
Frequent flashbacks
Intrusive memories
Nightmares
Even ordinary triggers like loud noises, darkness, or accidental touch can evoke negative or exaggerated reactions in individuals with PTSD.

The severity of symptoms can vary depending on the type of PTSD experienced. Furthermore, research has shown that PTSD can impair memory function. In a study conducted on refugees with PTSD, it was found that their ability to learn efficiently was compromised compared to a control group.³
PTSD can affect individuals of all age groups, including children. However, symptoms in children may manifest differently. For children aged six and below, they may reenact the traumatic event through play, stories, or drawings.⁴
It is essential to recognize the diverse range of symptoms and manifestations associated with PTSD, as this understanding can help facilitate appropriate support and treatment for individuals affected by the condition.

Who is at Risk?

It is highly unlikely to develop PTSD all of a sudden. Typically, certain factors or warning signs put individuals at risk of developing different types of PTSD. Some of these risk factors include:

Experiencing emotional trauma or physical abuse, particularly during childhood or adolescence.
Having a family history of mental illnesses or substance abuse.
Experiencing the loss of a loved one, a near-death experience, or significant financial loss.

What are the Types of PTSD?

It is not easy to confine the definition and symptoms of PTSD under a common umbrella.
This psychiatric condition is a multidimensional disease that exhibits differently. Currently, five types of PTSD have been identified, each of which requires a different treatment strategy.

Normal Stress Response:

As the name indicates, it is the normal response of the brain toward an upsetting event. As it is usually transient, and you may recover from it with support from family and friends. Normal stress responses may exhibit fear, anger, or guilt in response to events that relate to the primary causative event, for instance, a disease, any surgical procedure, an accident, etc.
If allowed to persist, normal stress response may turn into full-blown PTSD.

Acute Stress Disorder:

The triggering events of an acute stress disorder are rather grave, such as loss of job, loss of loved ones, natural disasters, life-threatening diseases or accidents, life-threatening harassment, etc. Unlike normal stress response that occurs immediately after the trigger, acute stress disorder occurs within a month following the assault and usually resolves before 30 days.

Uncomplicated PTSD:

If the stress lasts more than a month, it is termed PTSD. PTSD may cause you to experience flashbacks of the event, nightmares, mood changes, disturbing thoughts, etc. You may find yourself more attentive toward the possibilities of dangers and may also be easily triggered by ordinary things such as crowds, darkness, loud noises, etc. Uncomplicated types of PTSD respond well to short-term psychotherapy sessions.

Complex PTSD:

It is a rather chronic type of PTSD wherein you may experience interpersonal dysregulation and personality changes along with the above-mentioned symptoms. Coping methods such as substance abuse are found in patients with uncomplicated as well as complex types of PTSD.

Comorbid PTSD:

It is the gravest among the types of PTSD. It is a term for patients exhibiting more than one mental condition coupled with PTSD and substance abuse. Chronic pain is also a feature of comorbid PTSD, which may cause physical disability to the patient.

C-PTSD Vs. PTSD

C-PTSD is an upregulated version of PTSD and is differentiated by the presence of emotional and personality disturbances in the patient. It is a fairly new term that has been recently introduced in the field of psychiatric disorders.

Complex PTSD is a result of a series of traumatic events or an ongoing stressful condition, which differs from uncomplicated PTSD, such that the latter is triggered following a single situation.
C-PTSD has a chronic impact on your mental well-being, such that forgetting the event and moving on becomes rather impossible. However, both these factors are reversible in the case of PTSD.
Uncomplicated types of PTSD are associated with reckless activities and behavioral issues. Patients may exhibit dysregulated eating and sexual patterns. They may even get involved in substance abuse as a coping method. C-PTSD, on the other hand, creates interpersonal issues and may even cause borderline personality disorder
PTSD may respond to short-term counseling and psychotherapies. However, the treatment of c-PTSD involves multiple sessions of therapies lasting for a long period of time.

PTSD Test & PTSD Screening

Post-traumatic stress disorder can affect anyone. It is not limited to any age group. However, women are more susceptible to this mental condition. A board-certified psychiatrist with expertise in diagnosing and treating patients with PTSD conducts screening and testing. The process begins with a questionnaire comprising a series of questions to evaluate your psychiatric status. Several online platforms provide different questionnaires for PTSD screening. However, their accuracy is not 100 percent. A personal evaluation by a professional psychiatrist, involving a comprehensive history and clinical examination, is necessary for an accurate PTSD diagnosis.

What Triggers PTSD?

Any sensory stimulus (sight, audio, smell, taste, and touch) that relates to the causative event can act as a PTSD trigger. Unrelated and unpleasant stimuli such as sudden loud noises, loneliness, and darkness can also trigger dysregulated behavior and overreaction in PTSD patients. Being affected with PTSD, you may find yourself generally distancing from people and places to avoid PTSD triggers.

Is PTSD a Disability?

Because complicated types of PTSD can hamper your ability to interact socially and to carry out ordinary day-to-day activities, the Social Security Administration (SSA) considers it a disability.⁵ When medically proven and certified, you can claim Social Security disability benefits. Given the circumstances, the employee can claim compensation from their employer company if the PTSD has been caused to them by extremely stressful conditions of their workplace caused by the company personnel (the law varies with different regions across the globe).
The Americans with Disabilities Act (ADA) guidelines define a disability as a mental or physical impairment that limits one or more significant life activities. PTSD is considered a disability, but meeting the criteria requires undergoing a comprehensive evaluation. Once your worker’s compensation claim is approved, you become eligible for healthcare benefits. The insurance provider must cover all the essential costs associated with your PTSD treatment.

How is PTSD Treated?

A mental health professional treats PTSD through psychotherapy, medications, or a combination of both. The kind of treatment required corresponds to the type of PTSD under consideration. Psychotherapy for PTSD includes exposure therapy (gradual exposure to the causative fear) and cognitive restructuring (helps you make sense of a traumatic event).

Cognitive Processing Therapy:

The aim of this strategy is to recognize the causative events that have caused you PTSD. First, you speak to your psychotherapist in detail regarding your thoughts and how they have affected your daily routine. Next, write in detail about your past trauma. This helps you regulate your thoughts and emotions and formulate ways to improve your condition.

Prolonged Exposure Therapy:

This strategy helps you confront your fears and trauma. It is common for PTSD patients to avoid factors that may trigger the memories of past trauma. With exposure therapy, the psychologist will gradually make it easier for you to discuss your fears and face them.

Pharmacological Therapy:

Moderate to severe types of PTSD are unlikely to respond to psychotherapy alone. Healthcare professionals commonly prescribe SSRIs (selective-serotonin reuptake inhibitors) and SNRIs (selective-norepinephrine reuptake inhibitors) as the most common medications to treat PTSD. These medications aid in overcoming anxiety and depression, thereby enhancing the effects of psychotherapy.

Alternate Therapies:

In addition to conventional approaches, exploring alternative strategies can be beneficial in addressing PTSD. Incorporating practices such as yoga, mind-body therapy, deep-breathing exercises, and Tai chi into your treatment plan can prove effective in managing various types of PTSD. Moreover, these approaches focus on promoting relaxation, mindfulness, and physical well-being, which can contribute to the overall healing process. It’s important to consult with healthcare professionals and experts in these alternative therapies to tailor them to your specific needs and integrate them into your comprehensive treatment approach.

Conclusion

In conclusion, post-traumatic stress disorder, or PTSD, originates from a single event or a series of traumatic and distressing circumstances. It is a multidimensional psychiatric disorder classified into five categories, encompassing mild-moderate types to severe (complicated) PTSD. The Social Security Administration (SSA) recognizes PTSD as a disability. Treatment approaches for this condition vary depending on the specific type. While emotional support from family and friends may suffice for some individuals, others may require extensive psychotherapy sessions to achieve long-lasting improvement.

Refrences

1
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2
What is posttraumatic stress disorder (PTSD)?. Psychiatry.org – What is Posttraumatic Stress Disorder (PTSD)? (n.d.). https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
3
Grethe E. Johnsen, Pushpa Kanagaratnam, Arve E. Asbjørnsen, Memory impairments in posttraumatic stress disorder are related to depression, Journal of Anxiety Disorders, Volume 22, Issue 3, 2008, Pages 464-474, ISSN 0887-6185, https://doi.org/10.1016/j.janxdis.2007.04.007.
4
Dyregrov, A. and Yule, W. (2006), A Review of PTSD in Children. Child and Adolescent Mental Health, 11: 176-184. https://doi.org/10.1111/j.1475-3588.2005.00384.x
5
Social Security Administration. (n.d.). Disability Evaluation Under Social Security: 12.06 Anxiety and obsessive-compulsive disorders. Retrieved from https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#12_06

Types of PTSD: Exploring the Different Variants of PTSD

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