Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after someone experiences or witnesses a traumatic event. While PTSD is often associated with combat veterans or survivors of physical trauma, it can also develop in response to emotional trauma such as severe bullying, domestic violence, or other distressing experiences.
What causes emotional PTSD?
Any traumatic event can lead to PTSD, but emotional trauma specifically refers to psychological or emotional abuse over a prolonged period of time. Examples of emotional trauma that can result in PTSD include:
- Ongoing verbal, emotional, or psychological abuse
- Bullying or harassment
- Domestic violence or intimate partner violence
- Childhood emotional neglect or abuse
- Experiencing or witnessing violence
- Sudden loss of a loved one
When someone experiences chronic emotional trauma, it can result in changes to their brain structure and function. Their nervous system essentially gets “stuck” in a constant state of fight, flight, or freeze. This causes both physical and emotional symptoms that can persist long after the traumatic situation ends.
What are the symptoms of emotional PTSD?
People with emotional PTSD often experience symptoms in the following areas:
- Re-experiencing – Intrusive thoughts, memories, nightmares, or flashbacks related to the trauma
- Avoidance – Avoiding people, places, objects, situations, or activities associated with the trauma
- Negative changes in thinking and mood – Difficulty remembering details, negative thoughts about oneself or the world, distorted blame, loss of interest
- Changes in arousal levels – Being easily startled, feeling tense or on edge, aggressive or irritable behavior
These symptoms can significantly impair a person’s ability to function in school, work, and relationships. Other common effects of emotional PTSD include anxiety, depression, insomnia, dissociation, and addictive behaviors such as substance abuse.
How is emotional PTSD diagnosed?
A mental health professional will diagnose emotional PTSD based on:
- The person’s trauma history and description of symptoms
- Ruling out other possible causes for the symptoms
- Assessing how the symptoms are impacting the person’s ability to function
There are no medical or lab tests that can definitively diagnose PTSD. The provider may have the person fill out a screening questionnaire about their trauma experiences and symptoms to help guide the diagnosis.
How is emotional PTSD treated?
Treatment for emotional PTSD often involves a combination of medication and psychotherapy. Some specific treatment approaches include:
- Cognitive processing therapy (CPT) – Helps identify unhelpful beliefs related to the trauma and replace them with more balanced thinking
- Prolonged exposure therapy – Gradually exposes the person to trauma reminders in a safe environment to help reduce fear and avoidance
- EMDR – Uses eye movements while recalling the trauma to help process memories and disturbing feelings
- Medications – Antidepressants like SSRIs can help manage PTSD symptoms
- Mindfulness practices – Helps ground the person in the present moment for symptom relief
Finding a support system through group therapy or support groups can also be very beneficial when recovering from emotional PTSD. Treatment is highly personalized and may incorporate various therapies or medication until symptoms are managed.
What is the prognosis for emotional PTSD?
With proper treatment, many people with PTSD can make a full recovery. However, PTSD can become a chronic disorder if left untreated. Severity and duration of symptoms can vary depending on factors like:
- The nature, intensity, and duration of the trauma
- If the traumatic situation has ended
- The person’s physical health, history of mental illness, and genetics
- The presence of a strong support system
- Willingness to adhere to treatment recommendations
While PTSD cannot be cured, long-term management of symptoms is possible. Most people see gradual improvement with ongoing treatment and healthy self-care habits. However, symptoms may worsen in response to reminders or new traumatic events.
Can emotional PTSD turn into physical symptoms?
Yes, PTSD from emotional trauma can sometimes manifest in physical ways. This is because mental and physical health are closely interconnected. Some common physical symptoms associated with emotional PTSD include:
- Headaches or migraines
- Dizziness, chest pain, gut issues
- Muscle tension, pain, tremors
- Insomnia or nightmares
- Skin reactions, sweating
- Appetite changes, weight loss/gain
These physical symptoms are the body’s way of expressing emotional inner turmoil. Chronic stress from PTSD can disrupt almost every body system. Getting treatment for the root emotional trauma can help alleviate associated physical symptoms.
Can children have emotional PTSD?
Absolutely. Children are especially vulnerable to lasting effects from chronic emotional trauma like abuse, neglect, loss of a parent, or household dysfunction. Childhood PTSD can present differently than adult PTSD with symptoms like:
- Regressive behaviors like thumb-sucking or bedwetting
- Trouble focusing in school
- Irritability, temper tantrums, aggression
- Clinginess, separation anxiety
- Somatic complaints like stomachaches or headaches
- Social withdrawal or difficultly relating to peers
Seeking evaluation from a child psychiatrist or therapist is important if PTSD is suspected. Early treatment and support can help minimize the impact on the child’s development and functioning.
Can you claim disability for emotional PTSD?
You may be able to claim disability benefits for PTSD related to emotional trauma, depending on the severity. To qualify for Social Security Disability benefits, your PTSD symptoms must:
- Prevent you from working for at least one year
- Be corroborated by medical documentation
- Significantly interfere with your ability to function independently, socially, or occupationally
The process involves submitting detailed medical records, evaluation forms, and undergoing an assessment by Social Security. Approval rates are higher when you have documentation of ongoing treatment and clear limitations caused by PTSD.
How is emotional PTSD different from complex PTSD?
Complex PTSD (CPTSD) may arise after prolonged, repetitive trauma – especially in childhood – as opposed to a single traumatic event. Some key differences include:
|Emotional PTSD||Complex PTSD|
|Results from single incident or limited trauma exposure||Results from chronic, repetitive trauma like abuse or violence|
|Primary symptoms relate to trauma memories, avoidance, hyperarousal||Additional emotional regulation and relationship difficulties|
|Flashbacks focused on traumatic event||More complex, dissociative flashbacks|
|Sense of self remains intact||Disturbed sense of self and difficulty with identity|
Treatment approaches for CPTSD focus more on attachment, emotional regulation, and reducing feelings of shame, guilt, or low self-worth. However, therapies like CBT, EMDR, and medication can be helpful for both emotional PTSD and CPTSD.
What is vicarious PTSD?
Vicarious or secondary PTSD can occur when someone close to you experiences trauma. Examples include:
- Partners, family members of combat veterans or assault victims
- First responders repeatedly exposed to trauma scenes
- Therapists working with traumatized clients
Even though they were not directly traumatized, constant exposure to others’ trauma can take an emotional toll. They may develop PTSD symptoms like hyperarousal, avoidance, intrusive memories, anxiety, and depression.
Vicarious PTSD shows just how contagious trauma can be. Self-care is essential for those exposed to others’ trauma, including allowing oneself to feel emotions, seeking counseling, and taking time off when needed.
Can emotional PTSD turn into depression?
Yes. PTSD and depression often co-occur. Nearly half of people with PTSD also have depression. Emotional blunting, loss of interest, fatigue, and low mood are common in both conditions. Possible reasons PTSD can lead to depression include:
- Trauma damaging centers of the brain that regulate mood
- Hormonal changes caused by chronic stress
- Negative thought patterns created by trauma
- Isolation, loss of interest in activities
- Feelings of hopelessness about recovery
Similarly, depression can also make someone more vulnerable to developing PTSD after a traumatic event. Having both PTSD and depression together is linked to more severe symptoms that are resistant to treatment. Integrated treatment that addresses both conditions simultaneously is usually recommended.
Does emotional PTSD qualify as a disability?
PTSD can be considered a disability if symptoms substantially limit one or more major life activities. This includes limitations in:
- Speaking, concentrating, thinking
- Adaptability and managing stress
- Regular social interaction
- Productivity and timeliness
- Regulating emotions
For PTSD to be considered disabling, the limitations must be long-term and impair normal functioning. Documentation from a mental health professional can help substantiate disability claims related to emotional trauma. However, each claim is evaluated on a case-by-case basis.
How is emotional PTSD treated differently than physical trauma PTSD?
The treatment approach for PTSD focuses on the individual person’s symptoms and challenges rather than the type of precipitating trauma. However, some key differences may include:
- Medications – Physical trauma more often requires pain management, whereas emotional trauma may rely more on antidepressants and anti-anxiety drugs.
- Exposure therapy – Gradual exposure is used for trauma memories but may need adaptation for physical re-traumatization fears.
- Talk therapy – More focus on trauma processing for physical PTSD versus regulating emotions for emotional PTSD.
- Group therapy – Beneficial for both, but the group composition often differs based on trauma type.
Adaptations can be made as needed, but the overall framework for therapy remains similar. Most importantly, developing feelings of safety, trust, and empowerment are critical regardless of the trauma origin.
Can therapy make emotional PTSD worse?
Reputable therapy for PTSD should not make symptoms significantly worse, especially in the long run. However, some short-term discomfort is expected as traumatic memories and emotions are processed. Potential triggers that may temporarily exacerbate symptoms include:
- Recalling traumatic memories and associated emotions
- Confronting fearful situations, objects, thoughts through exposure therapy
- Discussing sensitive topics like shame, blame, vulnerability
- Facing unhelpful coping behaviors and distortions
An experienced trauma therapist will implement safeguards and validate the client through challenging moments. Occasional emotional ups and downs are normal. But consistent deterioration in functioning or onset of self-harm may indicate the need to reevaluate the treatment approach.
What should you not say to someone with emotional PTSD?
It’s important to avoid insensitive or dismissive comments that could further traumatize someone with PTSD. Phrases to avoid include:
- “Just get over it already.”
- “You’ll be fine.”
- “I know how you feel.” (unless you lived their trauma)
- “Calm down! You’re overreacting.”
- “What’s wrong with you?”
- “You need to move on.”
These types of remarks invalidate their pain and make it seem like something they can just “snap out of”. It’s better to ask how you can help, validate their feelings, or just listen compassionately without judgment.
Can you ever fully recover from emotional PTSD?
With effective treatment and support, many people with PTSD can achieve full remission where they no longer meet diagnostic criteria. However, PTSD differs in that memories of the trauma may persist at some level for life. Important recovery factors include:
- Developing coping skills to manage symptoms and stress
- Processing emotions and memories related to the trauma
- Letting go of guilt/blame and reframing negative beliefs
- Re-establishing feelings of safety, trust, control, and self-worth
- Reconnecting with community and enjoying life again
Healing looks different for everyone. While memories may remain, the distressing emotions tend to decrease over time. Ongoing support, lifestyle changes, and occasional booster therapy can help maintain recovery.
Emotional PTSD can arise after chronic psychological trauma like abuse, violence, or severe loss. Symptoms like re-experiencing, avoidance, numbing, and hyperarousal significantly impair functioning. Integrated treatment including psychotherapy and medication provides the best chance for recovery. While PTSD symptoms may persist at some level, people can go on to live fulfilling, productive lives with proper support.