Post-Traumatic Stress: A Closer Look

Author: IAFF Center of Excellence Staff

August 29, 2018

With increased awareness and discussion around post-traumatic stress in the fire service, it’s important to know what post-traumatic stress is and what it’s not. While the term post-traumatic stress (sometimes called PTS) is often used interchangeably with the term post-traumatic stress disorder (PTSD), the two are quite different. At some point in their career, most fire fighters and paramedics will experience post-traumatic stress, while only a relatively small fraction of these individuals will develop the mental health disorder known as PTSD. The fact remains that fire fighters and paramedics are an extremely resilient population.

What Is Post-Traumatic Stress? 

Post-traumatic stress is a normal reaction to any event that threatens violence or the loss of life. You may personally experience the event, see the event occur to someone else or have direct exposure to aversive details of the event in its aftermath. Post-traumatic stress is NOT recognized as a mental health disorder and often requires no treatment intervention. Symptoms usually subside within a few days or weeks and do not significantly impair daily functioning.

Post-traumatic stress is considered the experience of one or more symptoms listed below for any period of time following a traumatic event. Symptoms are classified in categories B-E:

B) Reliving the event (intrusion symptoms)

  • Intrusive memories or thoughts.
  • Distressing dreams.
  • Dissociative reactions (flashbacks).
  • Intense psychological or physical distress when exposed to related cues.

C) Avoiding things that remind you of the event (avoidance symptoms)

  • Avoidance of people, places, and things that remind you of the event.
  • Avoidance of feelings or thoughts associated with the event.

D) Negative changes in emotions and thoughts (altered mood and cognition)

  • Persistent exaggerated negative beliefs about self, others, or the world.
  • Self-blame caused by distorted beliefs about the cause of the event.
  • Sustained negative emotional state (horror, anger, guilt. etc.).
  • Inability to experience positive emotions.
  • Difficulty recalling parts of the event.
  • Loss of interest in usual activity.
  • Feeling detached from others.

E) Feeling on edge (arousal and reactivity)

  • Irritability or verbal outburst to others or objects.
  • Reckless self-destructive behavior.
  • Hypervigilance (constantly scanning environment to detect threats).
  • Exaggerated startled response.
  • Poor concentration.
  • Sleep disturbances.

What Is Acute Stress Disorder (ASD)? 

Acute stress disorder is the experience of nine or more symptoms of post-traumatic stress in any category (B-E). Symptoms must persist for at least three days but less than a month AND cause significant daily impairment. This means it is very difficult for the individual to function at work, at home or with others. ASD is considered a mental health disorder and some individuals with ASD will go on to develop PTSD.

What Is PTSD? 

PTSD occurs when an individual experiences symptoms in all four categories of post-traumatic stress listed above (intrusion, avoidance, altered mood/cognition and arousal/reactivity). Additionally, symptoms persist longer than one month AND cause significant daily impairment. PTSD is NOT a normal reaction to a traumatic event and is a considered a mental health disorder that warrants treatment.

 Traumatic Stress Reactions:  Key Differences

Post-Traumatic Stress

Acute Stress Disorder (ASD)

Post-Traumatic Stress Disorder (PTSD)

  • Lasts any duration.
  • Minimal impaired daily functioning.
  • One or more symptom in any area.
 
  • Last between three days and one month.
  • Daily functioning impaired.
  • Nine or more symptoms in any area.
 
  • Lasts one month or longer.
  • Daily functioning impaired.
  • Required symptoms in all areas:
  • Intrusion (1 symptom).
  • Avoidance (1 symptom).
  • Altered mood and cognition (2 symptoms).
  • Arousal and reactivity (2 symptoms).
 
   

The IAFF Center of Excellence for Behavioral Health and Treatment and Recovery is a 64-bed comprehensive residential treatment center designed exclusively for IAFF members struggling with PTSD, addiction and other co-occurring mental health problems. You can start the recovery process by reaching out to a representative today for a free and confidential screening.

Post-Traumatic Stress: A Closer Look
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