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Post-Traumatic Stress Disorder

PTSD can develop after exposure to a potentially traumatic event that is beyond a typical stressor. Events that may lead to PTSD include, but are not limited to, violent personal assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. Exposure to events like these is common.

About one-half of all U.S. adults will experience at least one traumatic event in their lives, but most do not develop PTSD. People who experience PTSD may have persistent, frightening thoughts and memories of the event(s), experience sleep problems, feel detached or numb or may be easily startled. In severe forms, PTSD can significantly impair a person’s ability to function at work, at home, and socially.

What are the symptoms of PTSD?

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.

The course of the disorder varies. Some people recover within 6 months, while others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things rather than experiencing them. A mental health professional who has experience helping people with PTSD, such as a psychiatrist, psychologist, or clinical social worker, can determine whether symptoms meet the criteria for PTSD.

PTSD and Heart Attacks

Reference:  Kubzansky L.D., Koenen, K.C. et al. Prospective Study of Posttraumatic Stress Disorder Symptoms and Coronary Heart Disease in the Normative Aging Study. Arch Gen Psychiatry. 2007;64:109-116.

Claims that heart attacks may be caused by PTSD (Post Traumatic Stress Disorder) have been rejected by courts and governmental review panels because of the lack of scientific support. However, that may change as a result of a published report on almost 2,000 male veterans participating in a continuing study that began in 1986. Average age at the start of the study was 62 at which time none had a history of pre-existing heart problems. All subjects received periodic medical examinations as well as evaluation for symptoms of PTSD. During the 10-16 years of follow-up, 255 participants developed either fatal or non-fatal coronary events or anginal symptoms. Researchers reported that the number and severity of PTSD symptoms were significantly associated with deaths due to coronary heart disease as well as non-fatal heart attacks. The link with angina was not as strong.

These relationships persisted even when confounding influences such as depression, smoking, family history of heart disease, cholesterol levels and alcohol consumption were taken into consideration. Although the mechanism of action is not clear, PTSD is associated with increased levels of stress related hormones and fatty acids that can contribute to coronary heart disease and arterial damage. Since the study group was largely limited to older white men who served in the military, it is not known if similar results would be seen in women, nonwhite men or civilians. In addition, PTSD symptoms and severity data were derived from self-reports by the veterans, which may be less reliable than assessments based on interviews by qualified health professionals. Stress-related psychological problems are not uncommon in patients with coronary heart disease but it is often difficult to determine which came first. This report was impressive because of the correlation between the severity of PTSD symptoms and the frequency of fatal and non-fatal heart attacks in a prospective study.

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