Post-traumatic stress disorder

Everyone has experienced a situation that was dangerous for theirs or a close relation’s safety, narrowly avoiding a road accident, for instance. In such a scenario, you may feel a heightened level of anxiety, characterised by an intense feeling of fear. This fear is accompanied by a strong physical reaction due to a rush of adrenaline, the hormone that allows the body to react to danger quickly. Fear and the associated physical reaction are part of a natural defense mechanism aimed at ensuring survival. Such reactions are therefore normal and generally subside a few hours after the event.

However, in people with post-traumatic stress disorder, these reactions do not disappear completely. Through dreams or flashbacks, they continue to relive the experience with the same intensity as when it first occurred. Flashbacks are mental images that cause you to relive the traumatic experience. You may also relive those reactions when faced with a situation similar to the one that caused the trauma.

An affected person may thus attempt to avoid situations or conditions that remind them of the trauma. The need to avoid any threatening situation may have significant impact on personal, family and social activities.

Symptoms of post-traumatic stress disorder usually appear within the first 3 months after a trauma. However, sometimes several months or even many years can go by before symptoms appear.

Characteristic signs of post-traumatic stress disorder are the following:

• A feeling of intense fear, horror and powerlessness accompanied by one or more of the following symptoms:
  • Heart palpitations (heart beating abnormally fast)
  • Rapid breathing
  • Trembling
  • Chills
  • Excessive sweating
• Flashbacks
• Thoughts that will not go away and that become uncontrollable. Due to these thoughts, you feel distress, which is manifested through anxiety and depression
• Difficulty feeling certain emotions, tenderness and sexual desire, for instance
• Difficulty concentrating
• Difficulty sleeping
• A need to be always in a state of alert, ready to react

Sleeping difficulties are often the first reason that brings people with post-traumatic stress disorder to consult a health professional.

Do not wait to be unable to conduct your usual activities in order to consult. If you have symptoms, you can consult certain organisations and associations working with anxiety disorders. They offer information, help and support.

However, see your family doctor or another health professional if you experience one of the following situations:

• You are experiencing distress
• You are continuously in a state of alert, and this situation lasts several weeks
• You relive a traumatic situation through dreams or flashbacks
• You avoid situations that could remind you of your trauma

A health professional can assess whether you have a post-traumatic stress disorder, or another health problem. You will be proposed a treatment plan that is adapted to your needs.

See the Help and resources section to find resources available to you.

If you have suicidal thoughts and fear for your safety, or that of people around you, see the Preventing suicide page. You will find further information on help and resources available.

Post-traumatic stress disorder is an illness that can be treated. There are known treatments available to treat this disorder. Treatments allow people affected to regain control of their lives and daily activities. The earlier an affected person consults with a doctor, the better their chances of recovery.

In most cases, post-traumatic stress disorder is treated effectively with psychotherapy, medication, or a combination of these 2 treatments.

Psychotherapy sessions

Experts in post-traumatic stress disorder generally recommend one of the following 3 therapies:

• Cognitive behavioural therapy, which aims to change the individual’s thoughts and problematic behaviour, and replaces them with thoughts and responses appropriate to reality. It helps understand the origins of the problem and to find solutions
• Hypnosis
• Eye movement desensitisation and reprocessing (EMDR). This technique associates the person’s eye movement to mental images that remind them of their traumatic experience. It aims to dampen the person’s sensitivity to the images and traumatising recollections

Medication

Different medication can be used to treat post-traumatic stress disorder, including antidepressants and anxiolytics. See the page with information on anxiety problems to learn more about:

• Effects of antidepressants and anxiolytics in the treatment of anxiety disorders
• Recommendations for taking medication

The condition of someone with post-traumatic stress disorder can worsen if it is not taken seriously. See the page with information on everything you need to know about anxiety disorder complications.

Avoid staying alone if you have just experienced a trauma. Confiding in someone is the best way to overcome it. Make sure you stay accompanied by someone you trust and who knows how to listen. You can also join a support group and do relaxation exercises.

Moreover, if you show symptoms of post-traumatic stress disorder, you can act now. Advice on maintaining good mental health will help you change certain lifestyle habits. These changes will help you eliminate factors that worsen or maintain your condition.

A severe trauma that causes a deep-seated fear is always at the root of post-traumatic stress disorder. Here are examples of events that can cause a trauma:

• Natural catastrophes such as flooding, tornadoes or earthquakes
• Serious accidents such as a plane crash, road accident, explosion or fire
• Voluntary attacks such as an assault, armed robbery, rape, hostage taking or war
• The sudden death of a loved one
• The fight against a possibly deadly disease
• Death threats

About 50 to 60% of people will experience something traumatic in their life. However, only a small number will develop post-traumatic stress disorder.

It is a combination of several factors resulting in the onset of symptoms of post-traumatic stress disorder. These factors can be biological, hereditary, individual or environmental. See the anxiety disorder information page to learn more about the risk factors of anxiety disorders.

Information and support resources

There are resources available for help and further information about post-traumatic stress disorder:

• Veterans Affairs Canada  (Helpline: 1 800 268-7708)
  This resource is for veterans and their immediate families only
• Plus qu’un souvenir - Institut universitaire en santé mentale de Montréal  (in French only)
• Crime Victims Assistance Centre 
• Québec coalition of sexual assault centers 
• Association des médecins psychiatres du Québec  (in French only)

You can consult the anxiety disorder information page to find other available resources for anxiety disorders.

Resources for care and services

To receive care or services, or to find a psychotherapist with whom you are comfortable, contact one of the following resources:

• Your family doctor
• Your integrated health and social srevices centre (CISSS) or your integrated university health and social services centre (CIUSSS)
• The Ordre des psychologues du Québec