PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the intended victim, or a witness to the event or series of events. The experience may be a mugging, rape, abuse, or other assault, a catastrophe seen or lived through (e.g., a car accident or natural disaster), or some other event causing intense situational anxiety.

People with PTSD will typically avoid things that remind them of the original incident, and the anniversaries of the trauma may be especially difficult. They are often plagued with replaying the ordeal in their minds, day (flashbacks) or night (bad dreams). They may startle easily, be irritable or aggressive, become emotionally numb (even toward people with whom they used to be close), lose interest in things they used to enjoy, and have trouble showing affection and emotional freedom. Depression or substance abuse often develop when PTSD is not effectively treated.

Treatment begins with establishing a secure, trusting relationship with the therapist, then sharing the details of the ordeal at whatever pace is comfortable to the patient. The goal is to tame the event and integrate it into one’s historical reality. A fairly new treatment, called Eye Movement Desensitization and Reprocessing (EMDR), has proven to be especially effective for some trauma victims. Exposure therapy is usually helpful, cognitive-behavioral treatment is effective, and group therapy can also extend the healing by further assimilating the past into the present.