PTSD can occur after experiencing or witnessing traumatic events such as military combat, natural disasters, serious accidents, terrorist attacks, violent deaths, personal assaults including rape, and other situations in which the person felt extreme fear, horror or helplessness. Many people develop PTSD because someone close to them died suddenly (around 40%). Around 30% of people exposed to such a stressful event will develop PTSD.
PTSD can affect anyone. It is common, and affects around 5% of men and 10% of women some time in their life. It can happen at any age, including in childhood. An individual with PTSD often relives the experience through nightmares and flashbacks, has problems with concentrating and sleeping, with feelings of isolation and detachment from life. These symptoms can be lasting and severe enough to significantly impair the person's daily life. Symptoms usually develop immediately or within three months of a traumatic event, although occasionally they do not begin until years later.
PTSD can develop at any age, including in childhood. PTSD has been called shell shock or battle fatigue syndrome, because it first came to prominence in the First World War with soldiers memories of the trenches. It has only recently been recognised that traumatic events outside the war situation can have similar effects. The term post-traumatic stress disorder was first used after the Vietnam War and formalised in 1980 with its inclusion in the Diagnostic and Statistical Manual of Mental Disorders developed by the American Psychiatric Association.
It is not yet completely understood why certain people develop PTSD after a traumatic experience, and others do not. However, there are some risk factors which seem to make PTSD more likely to happen to some people. For example, if you have already had depression or anxiety, or you have not had a lot of support from family or friends, you are more susceptible to the condition. Having a parent who had a mental health problem, or experiencing abuse as a child can also be risk factors. There may also be a genetic factor involved, so some people will be more likely to develop PTSD. The hippocampus (part of the brain that is important to memory and emotions) appears different in MRI scans in those with PTSD. Researchers believe that changes to the hippocampus are related to memory problems and flashbacks. Studies have also shown that in people with PTSD, there are abnormal levels of hormones involved in their response to stress. People in danger normally produce natural opiates. These chemicals trigger a reaction in the body when put under extreme stress or into a fight or flight situation. They deaden the senses and dull the pain. It has been found that people with PTSD continue to produce high levels when there is no danger. This may cause them to have feelings of detachment and blunted emotions.
Your GP can diagnose PTSD by discussing all your symptoms with you. They will need to know various things, such as your feelings, your overall health, and how you are sleeping. Often they will use a specially-designed questionnaire to help them diagnose PTSD. It can include questions such as: Have you had difficulty remembering the event? or Have you felt distant or cut off from other people?