UNC Health Talk

Finding Relief from Post-Traumatic Stress Disorder

If you’ve been in a serious car crash, experienced sexual assault or another type of physical violence, or witnessed a loved one being seriously injured, it is normal to be traumatized. You might have nightmares or flashbacks, feel on edge and have no desire to engage in normal activities, such as going to work or school.

If you continue to feel this way after more than a month, you may have post-traumatic stress disorder (PTSD).

“PTSD is a prolonged experience of the normal reactions to trauma that people have,” says UNC Health psychologist Mary Hill, PhD. “If the symptoms last longer than a month, you experience really significant distress or you’re not able to engage in the life that you’re used to, that’s PTSD.”

PTSD affects about 3.5 percent of adults in the United States every year, and an estimated 1 in 11 people will be diagnosed with PTSD in their lifetimes. PTSD can happen to anyone and is not a sign of weakness. Rather, it means you have survived a traumatizing event and need help to get back to your life.

We talked to Dr. Hill to learn more about PTSD and how to treat it.

Common Symptoms of PTSD

There are four categories of symptoms that are considered to be indicative of PTSD, Dr. Hill says:

  1. Re-experiencing or intrusion symptoms: Recurrent unwanted memories, flashbacks or nightmares about the traumatic event that tend to elicit the same kind of fear, helplessness or anger experienced at the time of the trauma. Strong emotional distress when reminded of the traumatic event.
  2. Avoidant symptoms: Avoiding places, situations or activities that remind you of the traumatic event. Trying to avoid talking about or thinking about the traumatic event or topics related to it; this may involve substance use or other methods of attempting to numb or distract from trauma memories and related emotions.
  3. Changes in beliefs or behaviors: Developing new or worsening negative beliefs about yourself, others or the world because of the trauma. For example, feeling like the world is completely dangerous or that nobody can be trusted. Symptoms also include the inability to experience positive emotions, such as feeling happy, or experiencing a loss of connection with loved ones. You also may not be able to remember important parts of the traumatic event, and you may experience persistent uncomfortable emotions, such as anger, fear, guilt or shame.
  4. Changes in reactivity: Feeling keyed up, on edge, easily startled or on high alert for possible danger, potentially affecting your ability to concentrate and sleep.

If you’re experiencing any category of these symptoms—or any combination of them—for a prolonged time or if they are negatively affecting your daily life, it’s important to seek treatment from a healthcare provider.

Treatment for PTSD

Psychotherapy, or talk therapy, in which you meet with a professional therapist to talk about your experiences and thought processes, is the best treatment for PTSD, Dr. Hill says.

“The most effective psychotherapy is trauma-focused therapy with a therapist who can help the individual process what happened to them and help change how they think about the trauma memories, as well as the unhelpful beliefs that might have developed post-trauma, such as excessive self-blame,” Dr. Hill says.

For PTSD, Dr. Hill recommends two trauma-focused therapies in particular:

Prolonged exposure therapy helps address problematic avoidance that developed as a result of the trauma. A therapist will help you gradually but systematically expose yourself to places, situations and even memories that you fear.

“Essentially, prolonged exposure helps you to face your fears in a safe way,” Dr. Hill says.

A therapist will help you talk through a traumatic event and reorganize and process the memory and your reactions to the memory.

“With the help of a therapist, you will go back into activities or places that you started to avoid because of the trauma,” Dr. Hill says. Over time, these situations become less stressful because of your new skills. “It improves quality of life as you are able to re-engage in meaningful activities that you had previously avoided.”

Cognitive process therapy focuses on the thoughts that you have developed about yourself or other people, such as beliefs about the trauma itself and the impact that it has on you and others.

“The primary focus is trying to help shift unhelpful beliefs or cognitions that impair your functioning,” Dr. Hill says.

With the help of a therapist, you will be able to begin to notice when your thoughts are unrealistic or unhelpful, and “then you and the therapist can help shift perspective or find more balanced ways of thinking about the situation,” Dr. Hill says.

Medication may also be helpful in managing the symptoms of PTSD.

“In addition to participating in trauma-focused therapy, medications can be used effectively to help with managing anxiety, irritability, sadness or sleep problems,” Dr. Hill says.

No matter what, remember that if you have experienced or witnessed a traumatic event, you don’t have to suffer alone. We need to do better as a culture to give people permission to struggle after experiencing trauma, Dr. Hill says.

“I think our views as a society of what you should do or how you should feel after a traumatic event can make it worse, if you think you should just get over it or if you blame yourself,” Dr. Hill says. “You’re going to probably feel worse and maybe struggle more than if you were more easily able to acknowledge that it’s OK to have a hard time post-trauma.”


If you think you are experiencing symptoms of post-traumatic stress disorder, talk with your doctor. If you don’t have one, find one near you.

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