What is PTSD?
PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event — combat, a natural disaster, a car accident, sexual assault. It is normal to have upsetting memories, feel on edge, or have trouble sleeping after something like that. If the symptoms last more than a few months, it may be PTSD.
The numbers, as they stood in 2020
- About 7 or 8 out of every 100 people will have PTSD at some point in their lives.
- About 8 million adults have PTSD in a given year — a small portion of everyone who has been through a trauma.
- About 10 of every 100 women develop PTSD at some point, compared with about 4 of every 100 men.
Watch: What is PTSD? — a whiteboard explainer covering types of trauma and symptoms.
In their words
PTSD affects first responders too
“And you can't be a first responder, doing the things that we do, seeing the things that we see, experiencing things that we experience, and not be affected. And there's no shame in that.”
Read the article (The Mighty)
How my trauma brain reacts to COVID-19 restrictions
“Every time new COVID-related restrictions are mandated, I feel a surge of panic shoot through my veins. I still have to consciously remember to breathe.”
Read the article (The Mighty)
My proposed 12 steps for healing from PTSD
Read the article (The Mighty)
The research on serotonin and substance P
Researchers at Uppsala University and the Karolinska Institutet used PET imaging to look at two chemical systems in the brain together, in 16 people with PTSD and 16 people without: the serotonin system, and the substance P system. Both had been linked to stress and anxiety separately; the question was what happens where they meet.
In the amygdala, the region they set out to examine, the PTSD group had more substance P receptors. More striking was what the two systems did together: in people with PTSD the two overlapped less than in the control group, and the less they overlapped, the more severe that person's symptoms were. The overlap explained more about symptom severity than either system did on its own.
That is a study of 32 people, and it is about an association rather than a cause. We have kept it because it is a clear example of something worth understanding: the interesting question is often not how much of one chemical there is, but how the systems work with each other. Our Brain Tour entry on the amygdala covers what that region does.
How does treatment help?
The main treatments for PTSD are short-term talking therapies, and the one with the strongest evidence is cognitive behavioral therapy focused on the trauma itself. Two specific forms are well supported:
- Cognitive Processing Therapy looks at the way you see yourself, other people and the world after a trauma, and at the inaccurate thinking that can keep someone stuck — particularly self-blame.
- Prolonged Exposure works on the avoidance instead: gradually approaching the memories, situations and feelings you have been steering around, because avoiding them helps in the short term and prevents recovery in the long term.
Eye Movement Desensitisation and Reprocessing (EMDR) is also effective, though research suggests the back-and-forth eye movement may not be the part that works. Medication — usually an SSRI — is sometimes used alongside therapy rather than instead of it. As the ADAA puts it:
“Everyone is different, so a treatment that works for one person may not work for another.”
Books that portray PTSD
Waiting For First Light: My Ongoing Battle With PTSD, by Roméo Dallaire
The former force commander in Rwanda on what witnessing genocide did to him, and on continuing to work afterwards. Book review
I'm Fine and Neither Are You, by Camille Pagán
Two friends, one apparently coping and one not, and what happens when both stop pretending. Book review
All The Light We Cannot See, by Anthony Doerr
A blind French girl and a German boy whose paths cross in occupied France. Book review
Celebrities who advocate
Lady Gaga
“I developed PTSD as a result of being raped and also not processing that trauma,” she told Oprah. “Mental health is a medical condition. It should be treated as a medical condition, it should not be ignored.”
Read the article (Health.com, via the Internet Archive — the original page has been taken down)
Ariana Grande
“I know those families and my fans, and everyone there experienced a tremendous amount of it as well.”
A note from the team
We are not experts and do not seek to diagnose or act in place of professional psychiatric treatment. We are an organization seeking to raise awareness. If you have concerns about any of this material, please email us.
Sources
- US Department of Veterans Affairs — How common is PTSD in adults? (the source of the 2020 figures; the VA has since revised them)
- Frick A et al. (2016) — Overlapping expression of serotonin transporters and neurokinin-1 receptors in posttraumatic stress disorder: a multi-tracer PET study, Molecular Psychiatry (the serotonin and substance P section)
- Anxiety & Depression Association of America — PTSD treatment and facts (the treatment section)