When you have PTSD, your body stays in “fight-or-flight” mode long after the danger is over. You can have ongoing fear, anxiety and stress.

PTSD can cause intense, disturbing thoughts, feelings and behaviors. Certain things, such as loud noises, may remind you of the trauma and trigger symptoms.

You may develop symptoms of PTSD within three months of the trauma. Sometimes, symptoms develop months or years later. The symptoms last at least one month and cause major problems in your daily life.

PTSD can also lead to depression, anxiety, substance use disorder, and memory problems.

Causes of PTSD

Originally, PTSD was called “shell shock” because it showed up in people who fought in war. But it doesn’t only happen to combat veterans. 

Other causes of PTSD include:

• Serious illness or accidents
• Natural disasters
• Mass-casualty events, such as mass shootings or terrorist acts
• Rape, sexual assault, or intimate partner violence
• Historical trauma (a multigenerational experience of oppression)
• Bullying
• Verbal or emotional abuse
• Childhood trauma

You can also get PTSD after learning the details of a close friend or family member’s trauma. Repeated exposure to graphic details of trauma, such as social workers who handle child abuse cases, can also trigger PTSD.

PTSD in kids and teens

Trauma can trigger subsets of PTSD in children: 

• Disinhibited social engagement disorder: Kids have a hard time forming emotional bonds. They may be overly friendly or familiar with strangers. They may display impulsive behavior and hyperactivity.
• Reactive attachment disorder: Kids struggle to form healthy emotional bonds with their caregivers. They may withdraw, have a hard time managing feelings and be aggressive or self-harming.

Conditions related to PTSD

Other mental health issues that cause PTSD-like symptoms include:

• Acute stress disorder: PTSD-like symptoms start within 3 days to 1 month after the trauma. Half will get PTSD. 
• Adjustment disorder: This is when people have PTSD-like symptoms after a job loss, romantic breakup or illness, such as cancer. Symptoms start within 3 months but stop less than 6 months after the event. The symptoms are severe and intense—often out of proportion to the event that caused them.

At Carilion, our PTSD, Trauma, and Recovery Program is here to help you. The program aims to empower you to heal, regain control, and build resilience. 

During an initial planning meeting, we'll review your goals and treatment options. Your care may include any of the following types of treatments.

Outpatient therapy

An essential part of PTSD treatment is group or one-on-one talk therapy. We have several programs that provide this treatment.

Complex PTSD skills group therapy

We offer several group therapy programs that last 4 weeks each and help build skills to deal with your PTSD symptoms. 

• Distress tolerance: It can be harder to tolerate the stronger reactions to stressors that come with PTSD. This group helps build skills to tolerate this distress better.
• Emotion regulation: PTSD can make it harder to control your feelings. This group builds skills to lower the intensity of your feelings. This can help limit how they impact your daily life.
• Boundaries: Safety and trust issues that come with PTSD can make it hard to set and communicate healthy boundaries effectively. This group helps build assertiveness skills.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is the gold standard to help manage PTSD. It teaches you different ways of thinking, behaving, and reacting to your symptoms.

Types of CBT we use for PTSD include:

• Cognitive processing or restructuring therapy: Helps change negative feelings and beliefs, such as guilt, shame or the thought that the world is dangerous. Our Cognitive Processing Therapy Group Program is for female participants only. You can also have one-on-one sessions with your talk therapist.
• Prolonged exposure therapy: In a safe, controlled way, the therapist guides you through your trauma or triggers. This helps you gain control over your feelings. For combat veterans, virtual reality programs can recreate the battlefield.
• Eye movement desensitization and reprocessing (EMDR): A therapist guides you through the trauma while you follow a light bar with your eyes. Eye movements can cause changes in thoughts, images, and feelings. Over time, these treatments can help you think about your trauma in a less negative way, improving PTSD symptoms.

Medicines

Mental health medicine can help get troubling symptoms under control. They can also help talk therapy work better. Antidepressants treat the core symptoms of PTSD. Other medicines can help manage symptoms, including nightmares and insomnia.

Interventional psychiatry

For PTSD that's severe or doesn't improve with talk therapy and medicine, other procedures may help.

• Transcranial magnetic stimulation
• Electroconvulsive therapy
• Vagus nerve stimulation
• Ketamine therapy

Inpatient programs

When symptoms turn severe, you may need more intensive treatment. We can provide this through our inpatient programs.

Emergency mental health care

PTSD can increase your risk of self-harm or suicide. If you or a loved one is in crisis, call Carilion CONNECT at 540-981-8181 or toll-free at 800-284-8898. You can also call or text 988 Suicide and Crisis Lifeline. Learn more about emergency mental health care options.