Barbara E. Kaplan, MHDL

Counseling for Individuals, Couples, Partners, Marriages, Families



For information about counseling for Posttraumatic Stress Disorder or counseling in general, please call 704  333-1510.

This article is solely for information purposes.   It is not advice.   It is not intended for minors, and minors are instructed to leave the site.   It is not intended and it does not constitute professional or clinical advice.  The user of this page should not take any steps, or refrain from taking any steps, based on the information in this page, but should instead consult a qualified mental health professional.

Posttraumatic Stress Disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event directly or by witnessing it or learning of it (regarding a close friend or close family member).   It also may develop according to the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for this disorder by: “Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) … (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).  [This criteria] does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.”   This disorder does not discriminate in that anyone can develop it at any age greater than 1 year old, male or female, regardless of race.


According to the 2014 National Survey on Drug Abuse and Health, of people 12 years and older in the United States civilian (noninstitutionalized) population:

  • In 2014, of people 18 years and older, about 1 in 5 adults (43.6 million) had any mental illness (excluding substance use disorders and developmental disorders) in the past 1 year of which about 4.1% (9.8 million) had a serous mental illness.    Most of these people having any mental disorder were in the age group of 26 – 49 years old followed by 18 - 25 years old.  The 50 years or older category had the least number of people with a mental disorder. When including substance use disorders (20.2 million), the total number of adults (age 18 years or older) in 2014 having a mental disorder in the US (excluding developmental disorders) was 63.8 million.

In a 12-month prevalence (year 2005 survey), approximately 3.5% of the adult population had PTSD.  In about 36.6% of these adults, the PTSD is severe.   And it is estimated that 49.9% of people with this disorder received treatment, about 42% of which only received minimally adequate treatment.   There was about a 6.8% lifetime prevalence of PTSD.  The average age of onset of PTSD is 23 years old.

According to the American Psychiatric Association: Diagnostic And Statistical Manual of Mental Disorders, Fifth Edition, Arlington, VA, American Psychiatric Association, 2013:

  • "Rates of PTSD are higher among veterans and others whose vocation increases risk of traumatic exposure (e.g., police, firefighters, emergency medical personnel)."  The highest rates are "found among survivors of rape, military combat and captivity, and ethnically or politically motivated internment and genocide."
  • "PTSD can occur at any age after the first year of life.  Symptoms usually appear within 3 months after the trauma,  although there may be a delay of months, or even years, before criteria for the diagnosis are met."
  • In about half of adults with PTSD, there is a complete recovery in 3 months.  However, some people may continue to have symptoms for greater than a year and sometimes symptoms may occur for decades!
  • More females than males have PTSD over a lifetime with females having the occurrence of the disorder for a longer length of time.

About Posttraumatic Stress Disorder

Many people have experienced or witnessed a traumatic event that engendered symptoms such as fear, anxiety, sleep disturbance but do not develop PTSD.  Some common traumatic events are: serious accidents, child abuse, rape, being kidnapped, assault, terrorist attacks, natural disasters, combat, robbery, mugging, threats of physical or sexual violence.  It is common to feel fear, shock and be scared during and following a traumatic event.    Disturbing memories about the event may occur.  Usually, for most people, the initial symptoms remit naturally without professional assistance.  However, for a number of individuals, the symptoms persist, and other symptoms develop which may lead to PTSD.   With this disorder, usual functioning (e.g., social, occupation) may be impaired and/or the person experiences great distress from the symptoms they are experiencing.  The person may feel tense or on edge, have sleep difficulties, always be on alert for possible danger, be easily startled, feel as if the tauma is being relived, have disturbing memories of the event when being reminded of it such as in watching a television program similar to the trauma experience.  The person may feel detached from others or alienated from them.  Efforts are made to avoid speaking or thinking about the trauma.  Staying away from people, situations and objects that are reminders of the trauma may occur.  There may be difficulty in concentrating, may be engaging in self-destructive behavior (e.g., drive recklessly), having bad dreams/nightmares or a sustained negative mood state such as guilt and sadness.  Irritable behavior may be experienced, surroundings may seem distorted, not wanting to engage in activities that use to be enjoyable, not recalling key features of the trauma, having negative thoughts about the world (e.g., “No one can be trusted.”) or oneself, (e.g.,” I could have stopped my father from sexually abusing me when I was 5 years old”; “I am bad.”) feeling as if detached from one’s body, emotional numbness, verbal and physical agressive behavior, feeling as if what is happening around the person is not real.  Children may have symptoms that differ from adults regarding PTSD.

For a diagnosis of PTSD, symptoms must have continued for more than a month.

It is important to have an accurate diagnosis of PTSD by a mental health professional experienced in diagnosing and treating PTSD and co-occurring disorders  (disorders that occur simultaneously with PTSD).  People may have some of the above symptoms but not actually have PTSD!  The specific criteria for a diagnosis of PTSD in adults and children is specified in the American Psychiatric Association: Diagnostic And Statistical Manual of Mental Disorders, Fifth Edition, Arlington, VA, American Psychiatric Association, 2013.  This manual is a guide for mental health professionals in determining a diagnosis and treatment.

Some Risk Factors For Developing Posttraumatic Stress Disorder

  • Getting hurt
  • Seeing another person hurt, or seeing a dead body
  • Childhood trauma
  • Feeling horror, helplessness, or extreme fear
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
  • Having a history of mental illness or substance abuse
  • Seeking out support from other people, such as friends and family
  • Finding a support group after a traumatic event
  • Learning to feel good about one's own actions in the face of danger
  • Having a positive coping strategy, or a way of getting through the bad event and learning from it
  • Being able to act and respond effectively despite feeling fear


The primary treatment for PTSD is psychotherapy.   According to the U.S. Department of Veterans Affairs (http://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp) (ptsd.va.gov) research shows that Cognitive Behavioral Therapy “is the most effective type of counseling for PTSD.”  In Cognitive Behavioral Therapy (CBT), there is a focus on thoughts and perceptions of the trauma.  This therapy recognizes that one’s feelings and behavior are largely influenced by one’s thought(s).  It consists of identifying, testing and correcting erroneous thinking to change the view of self and the world in an effort to decrease psychological disturbance, improve functioning, and decrease unwanted, problematic and self-destructive behaviors.  There is a focus on acquiring skills.  These learned skills may be applied during and following counseling and throughout life to apply to other issues or problems such as relationship difficulties, stress, anxiety, depression, anger.  According to National Institute on Drug Abuse, CBT assists in “enhancing patients’ self-control by helping them develop effective coping strategies. ...  Research indicates that the skills individuals learn through cognitive-behavioral approaches remain after the completion of treatment."    With PTSD, the inaccurate thoughts that are causing distress are addressed, as well as, the self-destructive behaviors, self-blame, hopelessness, helplessness and the perceived trauma itself.  It also focuses on lifting the feeling of being trapped or stuck, confronting the frightening feelings and traumatic memories, working through the way the person experienced the trauma, gaining perspective, coping more effectively and emotional healing.  It is crucial to come to terms with the trauma that has had a devastating impact on the emotional well-being of the person, in an effort to relieve the suffering.  Essentially, the purpose of the therapy is to take back control of the self to be back in the driver’s seat.  CBT may include Exposure Therapy which consists of gradual exposure to the trauma in a safe and controlled way.  For instance, the person may do letter writing or imagine the trauma occurring or be in or at the place where the trauma happened.  With repeated exposure, the person may become desensitized to the trauma.  Initially, the avoidance of people, places and situations regarding the trauma may have helped the person to cope but later on it may be a hindrance.  Cognitive Behavioral Therapy may assist the person in facing the fear so that it no longer controls the person.

As with other disorders, there may be co-occurring disorders when PTSD is present such as substance use disorders, anxiety disorders and depressive disorders.   It is important that therapy address these mental health disorders.

Medications may be used to assist in controlling PTSD symptoms (e.g., sadness, anger, worry).  The two medications approved by the Food and Drug Administration for the treatment of this disorder are sertraline (Zoloft) and paroxetine (Paxil), both of which are antidepressants.  There are other medications being prescribed that may be helpful but are not FDA approved for this disorder.


For additional information on Posttraumatic Stress Disorder, please see the following websites:

This article was written some time between January 1, 2016 and January 22, 2019.