Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder characterized by intense stress, fear, and helplessness after an individual experiences a traumatic event. Traumatic events may include natural disasters, accidents, war, abuse, rape, or serious illness. Each individual responds differently to trauma; however, PTSD is diagnosed when symptoms persist for an extended period after the trauma. This article provides a scientific review of the definition, symptoms, causes, and treatment methods for PTSD.

Definition of Post-Traumatic Stress Disorder

PTSD is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association as symptoms that develop after one or more traumatic events and persist for at least one month. These symptoms typically negatively impact an individual's functionality and cause significant distress in daily life.

DSM-5 PTSD Diagnostic Criteria

1. Experience of a Traumatic Event:
   • Personally experiencing a traumatic event
   • Witnessing a loved one experience trauma
   • Continual exposure to disturbing details of traumatic events (e.g., first responders or healthcare workers)
2. Re-experiencing Symptoms:
   • Nightmares or flashbacks related to the trauma
   • Intrusive thoughts about the traumatic event
3. Avoidance Behaviors:
   • Avoiding places, people, or situations that remind them of the trauma
   • Efforts to suppress thoughts and feelings related to the trauma
4. Negative Changes in Mood and Thoughts:
   • Persistent negative emotions like guilt, shame, or anger
   • Negative beliefs about oneself or the world ("I am not safe," "I cannot trust anyone")
   • Withdrawal from loved ones or emotional numbness
5. Increased Arousal Symptoms:
   • Restlessness, exaggerated startle response
   • Sleep problems
   • Difficulty concentrating and irritability

Epidemiology of PTSD

PTSD is a prevalent disorder that varies across different traumatic events:

• The general prevalence of PTSD is between 3-6% in the population.
• It is twice as common in women as in men.
• It has been more frequently reported among war veterans, sexual abuse victims, and natural disaster survivors.

Causes of PTSD

The development of PTSD involves the interaction of biological, psychological, and environmental factors.

1. Biological Factors
   • Brain Structures:
     • Decreased hippocampal volume has been observed in individuals with PTSD.
     • The amygdala shows heightened sensitivity to traumatic events, increasing fear responses.
   • Neurotransmitter Imbalances:
     • Imbalances in serotonin and norepinephrine systems are associated with PTSD.
     • Excessive activation of the hypothalamic-pituitary-adrenal (HPA) axis enhances the stress response.
2. Psychological Factors
   • Pre-existing mental health issues, such as anxiety or depression, can increase the risk of developing PTSD.
   • Low self-efficacy and negative coping strategies may exacerbate post-traumatic stress.
3. Environmental Factors
   • The duration and severity of the trauma
   • Lack of social support after the trauma
   • History of childhood abuse or neglect

Treatment for PTSD

Treatment for PTSD requires a multidisciplinary approach, involving psychotherapy, pharmacotherapy, and lifestyle changes.

1. Psychotherapy
   1. Supportive Therapy:
      • Aims to strengthen the individual's social support system and improve coping skills for managing stress.
   2. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT):
      • Aims to restructure negative thoughts and beliefs related to the trauma.
   3. Exposure Therapy:
      • Helps individuals face traumatic events in a safe environment.
   4. Eye Movement Desensitization and Reprocessing (EMDR):
      • Targets unprocessed traumatic memories and helps restructure them in the brain.
2. Pharmacotherapy
   1. Antidepressants, anxiolytics (anti-anxiety), and antipsychotic medications may be used in treatment.
3. Supportive Approaches
   1. Mindfulness and Meditation:
      • Can be effective in regulating traumatic thoughts and increasing awareness.
   2. Group Therapies:
      • Provides a supportive environment for individuals with similar experiences.
   3. Physical Activity:
      • Regular exercise reduces stress hormones and improves mood.

Long-Term Effects of PTSD

If left untreated, PTSD can affect an individual’s life in various ways:

• Psychiatric Effects: Depression, anxiety disorders, substance abuse
• Physical Effects: Chronic pain, cardiovascular diseases
• Social Effects: Challenges in work life, relationship problems, social isolation

PTSD is a serious mental health disorder that can deeply affect an individual's quality of life. However, with early diagnosis, appropriate treatment, and social support, recovery is possible. When psychotherapy, pharmacotherapy, and holistic approaches are combined, it is possible to alleviate the effects of PTSD and help individuals lead a healthy life.

Awareness of post-traumatic stress disorder should be increased in society, and individuals should be encouraged to seek professional help without fear of stigma.

Sources:

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
2. World Health Organization (WHO).
3. Bisson, J. I., & Cosgrove, S. (2015). Post-traumatic stress disorder. BMJ.
4. National Center for PTSD.