Signs & Symptoms

Popularized by Hollywood in the film Lethal Weapon , in which actor Mel Gibson is haunted by flashbacks of harrowing days in Vietnam, the diagnosis of posttraumatic stress disorder used to be reserved exclusively for survivors of extraordinary events. These events could include a plane crash, abductions or hostage situations, and, most frequently, war. They could also include the Holocaust or torture - even knowing someone who underwent torture can cause posttraumatic stress disorder in someone who was witness to it, but not themselves a victim.

Possibly incorrectly, the same diagnosis may now be made in people who have undergone a lesser trauma such as a car crash, possibly because the legal climate in the United States encourages lawsuits based on presumed medical sequellae. In general, the worse the trauma, the greater the chances a person will develop posttraumatic stress disorder: About one-quarter of survivors of heavy combat, and up to two-thirds of prisoners of war, for example, do develop this disorder.

People will try hard not to think about the catastrophic event, yet they end up reliving it, again and again, in nightmares, distressing recollections and more-real-than-real flashbacks. Many people also try to avoid activities, people or places that might bring back memories of the trauma, and lose interest in activities that used to fulfill them. They can be hypervigilant as well, and unable to trust or love others.

The same disorder also tends to make people irritable and they have difficulties concentrating and sleeping. Symptoms usually begin within three months of experiencing the event but they can take years to appear. Interestingly, approximately 50% of people who develop posttraumatic stress disorder recover completely within three months, but the severity and the duration of symptoms may be influenced by such things as good family and social support and personality traits.