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What is Post Traumatic Stress Disorder (PTSD)?

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

• Combat or military exposure
• Child sexual or physical abuse
• Terrorist attacks
• Sexual or physical assault
• Serious accidents, such as a car wreck
• Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake

After the event, you may feel scared, confused, and angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

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How Does PTSD Develop?

All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

Many people who go through a traumatic event don't get PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:

• How intense the trauma was
• If you lost a loved one or were hurt
• How close you were to the event
• How strong your reaction was
• How much you felt in control of events
• How much help and support you got after the event

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. About half (40% to 60%) of people who develop PTSD get better at some time. But about 1 out of 3 people who develop PTSD always will have some symptoms.

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What are the Symptoms of PTSD?

Symptoms of post traumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

Even if you always have some symptoms, counseling can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships. Most people who go through a traumatic event have some symptoms at the beginning but don't develop PTSD.

There are four types of symptoms: re-living symptoms, avoidance symptoms, numbing symptoms, and feeling keyed up.

Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:

• Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
• Seeing a car accident, which can remind a crash survivor of his or her own accident
• Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped

Avoiding situations that remind you of the event:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.

• A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
• A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
• Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event

Feeling numb:
You may find it hard to express your feelings. This is another way to avoid memories.

• You may not have positive or loving feelings toward other people and may stay away from relationships
• You may not be interested in activities you used to enjoy
• You may forget about parts of the traumatic event or not be able to talk about them

Feeling keyed up (also called arousal or hyper-arousal symptoms):
You always may be alert and on the lookout for danger. This is known as increased emotional arousal. It can cause you to:

• Suddenly become angry or irritable
• Have a hard time sleeping
• Have trouble concentrating
• Fear for your safety and always feel on guard
• Be very startled when someone surprises you

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PTSD in Children and Teens

Children can have PTSD too. They may have the symptoms above or other symptoms depending on how old they are. As children get older their symptoms are more like those of adults.

• Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom
• Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event

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Other Common Problems

People with PTSD may also have other problems. These include:

• Drinking or drug problems
• Feelings of hopelessness, shame, or despair
• Employment problems
• Relationships problems including divorce and violence
• Physical symptoms

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What Treatments are Available for PTSD?

Today, there are good treatments available for PTSD. When you have PTSD dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But talking with a therapist can help you get better.

Cognitive behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. There is also a similar kind of therapy called eye movement desensitization and reprocessing (EMDR) that is used for PTSD. Medications have also been shown to be effective. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.

At First Choice we offer a clinical and medical integrated care model.  What this means is that we offer both the counseling therapies in conjunction with assessment and treatment by a medical prescriber.  This allows us to work as a team to provide you with all the best treatments that are based in research and are clinically proven.  It is our belief that having both the therapist and the medical prescriber within the same team allows for ease of access, seamless flow of information, and overall better care.  Each client first meets with a trained trauma mental health therapist who then will work with obtaining an appointment with our medical prescriber, if this is indicated.  After completion of the intake process, your therapist will work with you on an individualized treatment plan that will help to design the right treatment for you and your family. 

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How Common is PTSD?

Post Traumatic Stress Disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or that you have no control over what is happening.

Experiencing a traumatic event is not rare. About 60% of men and 50% of women experience this type of event in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, or disaster or to witness death or injury.

But going through a traumatic event doesn't mean you'll get PTSD. About 8% of men and 20% of women develop PTSD after a traumatic event.

Here are some facts:

• In the United States, about 8% of the population will have PTSD symptoms at some point in their lives.
• About 5.2 million adults have PTSD during a given year. This is only a small portion of those who have experienced a traumatic event.
• Women are more likely than men to develop PTSD. About 10% of women develop PTSD compared with 5% of men.
• Women are more likely than men to develop PTSD for all types of traumatic events, except sexual assault or abuse. When these traumas occur, men are just as likely as women to get PTSD.

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Who is Most Likely to Develop PTSD?

Most people who experience a traumatic event will not develop PTSD. However, you are more likely to develop PTSD if you:

• Were directly exposed to the traumatic event as a victim or a witness
• Were seriously injured during the event
• Went through a trauma that was long lasting or very severe
• Believed that you were in danger
• Believed that a family member was in danger
• Had a severe reaction during the event, such as crying, shaking, vomiting, or feeling apart from your surroundings
• Felt helpless during the trauma and were not able to help yourself or a loved one

You are also more likely to develop PTSD if you:

• Had an earlier life-threatening event or trauma, such as being abused as a child
• Have another mental health problem
• Have family members who have had mental health problems
• Have little support from family and friends
• Have recently lost a loved one, especially if it was unexpected
• Have had recent, stressful life changes
• Drink a lot of alcohol

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PTSD and the Military

If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTSD.

Experts think PTSD occurs:

• In about 30% of Vietnam veterans, or about 30 out of 100 Vietnam veterans
• In as many as 10% of Gulf War (Desert Storm) veterans, or in 10 veterans out of 100.
• In about 6% to 11% of veterans of the Afghanistan war (Enduring Freedom), or in 6 to 11 veterans out of 100
• In about 12% to 20% of veterans of the Iraq war (Iraqi Freedom), or in 12 to 20 veterans out of 100

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war.
Among veterans using VA health care, about:

• 23 out of 100 women (23%) reported sexual assault when in the military
• 55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military

Even though military sexual trauma is far more common in women, over half of all veterans with military sexual trauma are men.

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What to do if You Think You Have PTSD

If you think you have PTSD, it's important to get treatment. Treatment can work, and early treatment may help reduce long-term symptoms. If you think you have PTSD:

• Call FIrst Choice Counseling Center at (719) 572-6190 and we will have a mental health therapist talk with you and/or set up an assessment and intake to discuss options for treatment.  First Choice is a member of Pikes Peak Mental Health.
• Talk to your family doctor. 
• If you're a veteran, contact your local VA hospital or Vet Center.
• Talk to a close friend or family member. He or she may be able to support you and find you help.
• Talk to a religious leader.
• Fill out a PTSD screen and give us a call First Choice Counseling to discuss what it indicates.  An online PTSD screen is available for PTSD related to stressful military experiences, but you can also answer the questions as they would apply to any other traumatic event.

Many people who might need assistance with something like the symptoms of PTSD are afraid to go for help.

• 1 out of 5 people say they might not get help because of what other people might think
• 1 out of 3 people say they would not want anyone else to know they were in therapy

A study that's been done of soldiers coming home from Iraq found that only 4 in 10 service members with mental health problems said they would get help. Some of the most common reasons they gave were:

• Worried about what others would think
• Thought it might hurt their military career
• Might be seen as weak

If you have PTSD or PTSD symptoms you may feel helpless. But, there are things you can do.
Here are ways you can help yourself:

• Learn more about PTSD from this website or from other places
• Talk to your doctor or a chaplain or other religious leader
• Go for a PTSD evaluation by a mental health professional specifically trained to assess psychological problems

In a few cases, your symptoms may be so severe that you need immediate help. if you think that you cannot keep from hurting yourself or someone else, call our Crisis Center at (719) 635-7000 or dial 911.

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Why Seek Help?

Here are some of the reasons why you may want to seek help. Seek help because:

• Early treatment is better
  Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.
  
  
• PTSD symptoms can change family life
  PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.
  
  
• PTSD can be related to other health problems
  PTSD symptoms can worsen physical health problems. For example, a few studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD you could also improve your physical health.
  
  
• It may not be PTSD
  Having symptoms of PTSD does not always mean you have PTSD. Some of the symptoms of PTSD are also symptoms for other mental health problems. For example, trouble concentrating or feeling less interested in things you used to enjoy can be symptoms of both depression and PTSD. And, different problems have different treatments. While it may be tempting to identify PTSD for yourself or someone you know, the diagnosis generally is made by a mental health professional. This will usually involve a formal evaluation by one of our trained mental health specialists, who can provide a thorough assessment for psychological problems.

If you have PTSD or PTSD symptoms you may feel helpless. But, there are things you can do.
Here are ways you can help yourself:

• Learn more about PTSD from this website or from other places.
• Talk to your doctor or a chaplain or other religious leader
• Go for a PTSD evaluation by a mental health professional specifically trained to assess psychological problems.

In a few cases, your symptoms may be so severe that you need immediate help. You can call our Crisis Center at (719) 635-7000 or 911 or other emergency services immediately if you think that you cannot keep from hurting yourself or someone else.

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Helping a Family Member Who Has PTSD 

When someone has PTSD, it can change family life. The person with PTSD may act differently and get angry easily. He or she may not want to do things you used to enjoy together.  At First Choice, we use a family strengths model that focuses on the family structure and work to treat the whole family, not just the identified client.  Our staff is trained in family therapy, couples therapy, and childhood and adolescent therapies.

You may feel scared and frustrated about the changes you see in your loved one. You also may feel angry about what's happening to your family, or wonder if things will ever go back to the way they were. These feelings and worries are common in people who have a family member with PTSD.

It is important to learn about PTSD so you can understand why it happened, how it is treated, and what you can do to help. But you also need to take care of yourself. Changes in family life are stressful, and taking care of yourself will make it easier to cope.

You may feel helpless, but there are many things you can do. Nobody expects you to have all the answers.
Here are ways you can help:

• Learn as much as you can about PTSD. Knowing how PTSD affects people may help you understand what your family member is going through. The more you know, the better you and your family can handle PTSD.
• Offer to go to doctor visits with your family member. You can help keep track of medicine and therapy, and you can be there for support.
• Tell your loved one you want to listen and that you also understand if he or she doesn't feel like talking.
• Plan family activities together, like having dinner or going to a movie.
• Take a walk, go for a bike ride, or do some other physical activity together. Exercise is important for health and helps clear your mind.
• Encourage contact with family and close friends. A support system will help your family member get through difficult changes and stressful times.

Your family member may not want your help. If this happens, keep in mind that withdrawal can be a symptom of PTSD. A person who withdraws may not feel like talking, taking part in group activities, or being around other people. Give your loved one space, but tell him or her that you will always be ready to help.

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How to Deal With Anger or Violent Behavior

Your family member may feel angry about many things. Anger is a normal reaction to trauma, but it can hurt relationships and make it hard to think clearly. Anger also can be frightening.

If anger leads to violent behavior or abuse, it's dangerous. Go to a safe place and call for help right away. Make sure children are in a safe place as well.

It's hard to talk to someone who is angry. One thing you can do is set up a time-out system. This helps you find a way to talk even while angry. Here's one way to do this.

• Agree that either of you can call a time-out at any time.
• Agree that when someone calls a time-out, the discussion must stop right then.
• Decide on a signal you will use to call a time-out. The signal can be a word that you say or a hand signal.
• Agree to tell each other where you will be and what you will be doing during the time-out. Tell each other what time you will come back.

While you are taking a time-out, don't focus on how angry you feel. Instead, think calmly about how you will talk things over and solve the problem.

After you come back:

• Take turns talking about solutions to the problem. Listen without interrupting.
• Use statements starting with "I," such as "I think" or "I feel." Using "you" statements can sound accusing.
• Be open to each other's ideas. Don't criticize each other.
• Focus on things you both think will work. It's likely you will both have good ideas.
• Together, agree which solutions you will use.

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How Can I Communicate Better?

You and your family may have trouble talking about feelings, worries, and everyday problems. Here are some ways to communicate better:

• Be clear and to the point.
• Be positive. Blame and negative talk won't help the situation.
• Be a good listener. Don't argue or interrupt. Repeat what you hear to make sure you understand, and ask questions if you need to know more.
• Put your feelings into words. Your loved one may not know you are sad or frustrated unless you are clear about your feelings.
• Help your family member put feelings into words. Ask, "Are you feeling angry? Sad? Worried?"
• Ask how you can help.
• Don't give advice unless you are asked.

If your family is having a lot of trouble talking things over, consider trying family therapy. Family therapy is a type of counseling that involves your whole family. A therapist helps you and your family communicate, maintain good relationships, and cope with tough emotions.

During therapy, each person can talk about how a problem is affecting the family. Family therapy can help family members understand and cope with PTSD.

Your health professional or a religious or social services organization can help you find a family therapist who specializes in PTSD.

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When Helping Others, Take Care of Yourself

Helping a person with PTSD can be hard on you. You may have your own feelings of fear and anger about the trauma. You may feel guilty because you wish your family member would just forget his or her problems and get on with life. You may feel confused or frustrated because your loved one has changed, and you may worry that your family life will never get back to normal.
All of this can drain you. It can affect your health and make it hard for you to help your loved one. If you're not careful, you may get sick yourself, become depressed, or burn out and stop helping your loved one.

To help yourself, you need to take care of yourself and have other people help you.

Care for yourself

• Don't feel guilty or feel that you have to know it all. Remind yourself that nobody has all the answers. It's normal to feel helpless at times.
• Don't feel bad if things change slowly. You cannot change anyone. People have to change themselves.
• Take care of your physical and mental health. If you feel yourself getting sick or often feel sad and hopeless, see your doctor.
• Don't give up your outside life. Make time for activities and hobbies you enjoy. Continue to see your friends.
• Take time to be by yourself. Find a quiet place to gather your thoughts and "recharge."
• Get regular exercise, even just a few minutes a day. Exercise is a healthy way to deal with stress.
• Eat healthy foods. When you are busy, it may seem easier to eat fast food than to prepare healthy meals. But healthy foods will give you more energy to carry you through the day.
• Remember the good things. It's easy to get weighed down by worry and stress. But don't forget to see and celebrate the good things that happen to you and your family.

Get help

During difficult times, it is important to have people in your life who you can depend on. These people are your support network. They can help you with everyday jobs, like taking a child to school, or by giving you love and understanding.  Please call us to discuss what options you might have and how we can help support you and your family, (719) 572-6190.
You may get support from:

• Family members.
• Friends, coworkers, and neighbors.
• Members of your religious or spiritual group.
• Support groups.
• Doctors and other health professionals

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How Do I Locate Specialists or Support Groups for PTSD?

If you are in an immediate crisis, please call (719) 635-7000 or go to your nearest Emergency Room or call 911.
To schedule an intake or evaluation, please call (719) 572-6190.  You will be offered an intake appointment with a mental health counselor who will help to provide an initial assessment and offer treatment recommendations.  All of the therapists are licensed and have extensive training in working with PTSD and trauma issues. 

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American Veterans:- Who to Contact for Help with PTSD

You can contact your local VA Hospital or Veterans Center located in your telephone book, or call the VA Health Benefits Service Center toll free at 1-877-222-VETS. In addition to its medical centers, VA also has many CBOCs (Community Based Outpatient Clinics) around each state so you can look for one in your community. You can also use any of the information on treatment for the general public.

For online help, the VA also offers the MyHealtheVet and Seamless Transition websites. Please also see Specialized PTSD Treatment Programs in the U.S. Department of Veterans Affairs.

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American Veterans: How to File a Claim for Disability Due to PTSD

A formal request ("claim") must be filed by the veteran using forms provided by the VA's Veterans Benefits Administration. After the forms are completely submitted, the veteran must complete interviews concerning her or his "social history" (a review of family, work, and educational experiences before, during, and after military service) and "psychiatric status" (a review of past and current psychological symptoms, and of traumatic experiences during military service). The forms and information about the application process can be obtained from Benefits Officers at any VA Medical Center, Outpatient Clinic, or Regional Office.

The process of applying for a VA disability for PTSD can take several months, and can be both complicated and quite stressful. The Veteran's Service Organizations (VSOs) provide "Service Officers" at no cost to help veterans and family members pursue VA disability claims. Service Officers are familiar with every step in the application and interview process, and can provide both technical guidance and moral support. In addition, some Service Officers particularly specialize in assisting veterans with PTSD disability claims.

Even if a veteran has not been a member of a specific Veterans Service Organization, the veteran still can request the assistance of a Service Officer working for that organization. In order to get representation by a qualified and helpful Service Officer, you can directly contact the local office of any Veterans Service Organization -- or ask for recommendations from other veterans who have applied for VA disability, or from a PTSD specialist at a VA PTSD clinic or a Vet Center.

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Brochures/Handouts/Videos Available

Any material on our website is free for you to use, reproduce, and distribute as needed (in the Public Domain).  We also have brochures and other informational handouts provided upon request.

The National Center for PTSD's website: www.ncptsd.va.gov , contains great information that could be helpful, as well as looking at the other links available offered in the links section.

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How to Locate Books on PTSD

You can contact your local library for books or articles on trauma, PTSD, and related subjects. The National Center for PTSD's PILOTS database is another way to locate information. It is an electronic index to the worldwide literature on traumatic stress. You can search for citation information and electronic links to full text articles. The National Center for PTSD's Resource Center houses this information at our Executive Division in VT. Also see our recommended reading lists.

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