Post Traumatic Stress Disorder
by Edward Murphy, Psy.D


John sustained serious injuries in a motor vehicle accident. Despite the fact he showed rapid recovery from his physical injuries, he was experiencing symptoms of significant emotional distress. He was depressed, anxious, losing weight, and having sleep difficulties. He had been experiencing nightmares, intrusive recollections of the accident, and had feelings of impending doom. His personality and behavioral changes were noticeable to friends and family. John had difficulty adjusting back to work and was more distant in his relationships. John was puzzled feeling guilty he was not grateful for his recovery and felt responsible for his inability to be more responsive to his family and work. It was only after months of battling his feelings that he sought psychological treatment. His symptoms were clear to the therapist: They were characteristic of post-traumatic stress disorder (PTSD).

Post-traumatic stress disorder is an anxiety disorder that's triggered by one's memories of a traumatic event witnessed. The disorder commonly affects survivors of traumatic events, such as sexual assault, physical assault, war, torture, a natural disaster, an automobile accident, an airplane crash, a hostage situation or a death camp. PTSD can also affect rescue workers at the site of a tragic accident or event.

Not everyone involved in a traumatic event experiences post-traumatic stress. The Mayo Clinic statistics indicate the disorder affects more than 5 million adults each year in the United States. Post-traumatic stress disorder is twice as common in women as it is in men.

Signs and symptoms of post-traumatic stress disorder typically appear within three months of the traumatic event. However, in some instances, they may not occur until years after the event and may include:

  • Flashbacks and distressing dreams associated with the traumatic event.
  • Distress at anniversaries of the trauma.
  • Efforts to avoid thoughts, feelings and activities associated with the trauma.
  • Feelings of detachment or estrangement from others and an inability to have loving feelings.
  • Markedly diminished interest or participation in activities that once were an important source of satisfaction.
  • Hopelessness about the future - no hope of a family life, career or living to old age.
  • Physical and psychological hypersensitivity - not present before the trauma - with at least two of the following reactions: trouble sleeping, anger, difficulty concentrating, exaggerated startle response to noise, and physiological reaction to situations that remind you of the traumatic event.

Your doctor or a mental health professional may suggest a combination of medications and behavior therapy to treat post-traumatic stress disorder. The objectives of treatment are to reduce your emotional distress and the associated disturbances to your sleep and daily functioning, and to help you better cope with the event that triggered the disorder. Treatment may involve a combined approach including medications and behavior therapy designed to help you gain control of your anxiety.

Selective serotonin reuptake inhibitors (SSRIs). These antidepressants act on the chemical serotonin, the neurotransmitter in your brain that helps brain cells (neurons) send and receive messages. These medications can help control anxiety as well as depression.


Cognitive-behavior therapy. This treatment teaches you effective ways of managing thoughts or situations that remind you of the trauma you've experienced. The goal of this therapy is to promote a sense of recovery and a feeling of mastery over your anxiety.

Stress management training. This approach also involves learning to manage your anxiety through relaxation. You work with the help of a therapist to develop skills to decrease your preoccupation with negative thoughts and the sense of being overwhelmed by the traumatic event.

Cognitive therapy. You identify distorted thoughts and beliefs that arouse psychological stress and learn ways you can view and cope with a traumatic event differently. There is special emphasis on learning to develop a sense of mastery and control of your thoughts and feelings.

Effective treatment is often successful in helping patients in their adjustment back to life and work.