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Living with PTSD

Contributor: Kerry Ressler, MD, PhD
7 minute read
A sad woman hugs her knees on a sofa while her therapist talks to her.

Post-traumatic stress disorder, or PTSD, is a mental health condition that affects people who’ve witnessed or experienced a traumatizing or life-threatening experience. The effects of PTSD can negatively impact your day-to-day life and increase the risk of suicide or self-harm.

“If you or a loved one is experiencing signs of stress and PTSD symptoms, please seek help. We have good options for treatment,” says Kerry Ressler, MD, PhD, Mass General Brigham psychiatrist and chief of the Division of Depression and Anxiety Disorders at McLean Hospital.

New treatments for PTSD are also emerging, thanks to research being done at Mass General Brigham. Studies are looking at transcranial magnetic stimulation (TMS), which uses magnetic fields to stimulate areas of the brain and may help improve functioning in PTSD patients. Mass General Brigham researchers are also developing new drugs to target the biology of PTSD. 

“One of the most exciting future opportunities is preventing PTSD from ever happening. At Mass General Brigham, we have large studies identifying people in emergency departments after trauma. Eventually, we might be able to have interventions, just like we do for heart attacks or strokes, to prevent the trauma from ever developing into PTSD in the first place,” Dr. Ressler says.

What is PTSD caused by?

When you experience a traumatic or life-threatening event, your body might react with an instinctive “fight-or-flight” response. According to the American Psychological Association (APA), this response can include an increased heart rate, faster rate of breathing, and hormonal changes in the short term. The systems of the body usually return to normal once the crisis or threat has passed. However, some people are left with long-term mental stress in the form of PTSD and may feel frightened or distressed months after the fact.

 Examples of traumatic events may include:

  • Military combat

  • Physical assault

  • Sexual abuse

  • Accidents

  • Natural disasters, like earthquakes or forest fires

  • Serious health conditions like cancer or heart attack

PTSD is commonly associated with military veterans, but it affects civilian survivors of trauma as well. “We’ve known since the 1970s that assaults, sexual trauma, those with childhood trauma, and those living in high-risk neighborhoods or high-violence areas may have PTSD rates as high or higher than in the veteran community,” Dr. Ressler says.

PTSD risk factors

According to the National Center for PTSD, most people who experience a traumatic event won’t develop PTSD. For those who do develop PTSD, the following influences may have an impact:

  • Underlying biology, genetics, or family history

  • Prior traumatic experiences over a person’s lifetime

  • Resilience factors, like using positive coping skills and community or social support

The National Center for PTSD has also found that women are twice as likely to develop PTSD than men. “This may be due to increased interpersonal assault and sexual assault rates in females. We also believe that it’s in part due to biology, such as differences in sex hormone levels that may have both protective and risk factor roles,” Dr. Ressler explains.

It’s important to remember that PTSD is treatable despite the need for more progress. We actually have good treatments at the therapy and medication level that work in most people.

Kerry Ressler, MD, PhD


Mass General Brigham

Signs and symptoms of PTSD

While PTSD can develop at any age, things like age, gender, and previous traumas can affect the severity of the symptoms.

Signs and symptoms of PTSD may include:

  • Intrusive thoughts (unwanted, involuntary thoughts that repeatedly enter a person’s mind, and may include nightmares and flashbacks)

  • Avoidance of reminders of the trauma

  • Hypervigilance (an overwhelming sense of alertness and sensitivity to potential danger)

  • Decreased concentration, often associated with increased depression

People with PTSD also may experience other conditions at the same time, including anxiety and substance use disorder, according to the National Institute of Mental Health (NIMH).

If you or a loved one is experiencing suicidal thoughts, or is in a crisis, call or text 988 in the United States to access the Suicide and Crisis Lifeline. The 988 lifeline provides free and confidential support 24/7 to anyone in suicidal crisis or emotional distress. In a life-threatening situation, call 911 in the United States to connect with emergency services.

Treatments for PTSD

“There are two general approaches to treating PTSD: talk therapy and medications. Our first line of treatment is generally patient education and skills training to help the patient better deal with the emotional symptoms that come with the trauma reminders and the symptoms of PTSD,” Dr. Ressler says.

Exposure therapy is another form of treatment, where a therapist works closely with a patient to revisit their trauma in a safe, controlled environment. This can help a person learn to manage their fears.

Medication treatments like antidepressants and sleep aids can also help patients manage their PTSD symptoms, according to the NIMH. Some PTSD treatment plans may use a combination of therapy and medication, depending on the needs of the person.

As a first step, speak with your primary care provider (PCP) to help decide which path is right for you and your situation. They can help make referrals to mental health care providers that specialize in PTSD.

If you need help accessing mental health treatment near you, the Substance Abuse and Mental Health Services Administration (SMASHA) has an online treatment locator to help you find mental health services in your area.

Coping with PTSD

With the right treatment plan, PTSD can be a manageable condition. Other helpful lifestyle changes to support your treatment may include:

  • Reduce stress with meditation and other mindfulness activities.

  • Exercise.

  • Eat a healthy, balanced diet to support your mood.

  • Avoid drugs and alcohol.

  • Get enough sleep.

  • Spend time with family, friends, and other members of your support system.

  • Ask your care team about community resources like support groups.

What questions should I ask my doctor about PTSD?

Dealing with PTSD can raise a lot of emotions and questions. If you have questions about your treatment, it might be helpful to bring a list with you to your next appointment.

Some topics you might consider asking about:

  • How is PTSD diagnosed?

  • What qualifies as a traumatizing event?

  • What are my treatment options for PTSD?

  • If I’m prescribed medication for PTSD, are there any over-the-counter medications that might interact with my prescription?

  • When should I seek emergency medical attention? Who should I contact?

  • How long will it take me to recover from PTSD?

  • Are there any community or local resources for people with PTSD that you recommend?

If you or someone you love has been diagnosed with PTSD, it’s easy to feel overwhelmed. Fortunately, there are effective treatments and resources available.

“It’s important to remember that PTSD is treatable despite the need for more progress. We actually have good treatments at the therapy and medication level that work in most people,” confirms Dr. Ressler.

Kerry Ressler, MD, PhD