Крашкина Ирина Ивановна

Врач-психотерапевт, кандидат медицинских наук, член Российской профессиональной психотерапевтической лиги

Крашкина Ирина Ивановна

Стаж 31 год

Post-traumatic stress disorder is a mental health disorder. The disease occurs as a result of the impact of various external situations and traumatic factors on the psyche. This problem is often encountered by those who have gone through military action or by people who have suffered severe trauma that has caused psychological shock. Anxiety is characteristic of the illness.

PTSD is the impact of those situations that are difficult for a person to endure because they are outside of normal standard boundaries. This affects the human psyche. According to statistics, 1.2% of women and 0.5% of men who have taken part in military actions encounter this problem. Between 50 and 80% of citizens who have had to deal with traumatic mental events suffer from post-traumatic stress disorder.

Post-traumatic stress disorder is often observed in children. Elderly people also suffer. This is because patients in this category have low mental stability. As for children, for example, their defence mechanisms are still poorly developed. Older people, who have accumulated the effects of various stressful situations throughout their lives, are losing the adaptive capabilities of their psyche. Treatment of PTSD should be supervised by a psychiatrist, psychologist or psychotherapist.


The causes of post-traumatic stress disorder can be different, among the main ones we can highlight:

  • military operations;
  • accidents with severe consequences;
  • mass catastrophes;
  • natural/technogenic catastrophes;
  • terrorist acts.

Post-traumatic stress disorder occurs not only as a result of mass widespread disasters, вut also as a result of personal trauma.

Among the reasons should be noted such factors as:

  • death of a loved one;
  • rape;
  • robbery;
  • hostage-taking,
  • assassination attempt;
  • torture,
  • domestic violence,
  • beating.

If a trauma happened to the person personally, PTSD can appear in the aftermath of events and incidents. These symptoms may occur once or may be expressed regularly in brief episodes. For example, after a natural disaster, the patient may experience PTSD once and not have it again, but after a criminal robbery or burglary, attacks will appear periodically and occasionally for short periods.

If the patient has suffered a long illness and has been held as a hostage, PTSD will be long-lasting. The person will constantly have a picture in his head of what happened and will experience a feeling of helplessness in the face of danger.

Post-traumatic state and stress disorders depend not only on the situation, but also on how this situation was perceived and experienced by the patient. This is influenced by such factors as: age, gender, stress tolerance, emotional, psychological perception, physical and psychological condition.

But not only the above-mentioned causes can lead to the development of the disorder. Neuroticism should also be pointed out among the causes. If the patient has had some unpleasant events in his life, such as accidents, robberies, and serious quarrels, he/she may constantly mentally return to these events, imagining their course differently, which leads to more serious consequences than what actually happened.

Individuals who avoid showing emotions in stressful situations may have such problem. This type of people are more prone to PTSD than people with antisocial behaviour.

Symptoms and signs

Symptoms of post-traumatic stress disorder do not appear immediately. After the incident, the patient may encounter the disorder in a week, there are cases where patients face the disorder after six months.

It is connected with the fact that mentally patients constantly return to the negative events, which affects their emotional condition. The difficulty also arises when people try to avoid the problem and talk to those who want to discuss what has happened.

Symptoms of post-traumatic stress disorder are divided into the following types:

  • acute form;
  • chronic form;
  • delayed form.

The duration of the first form does not exceed three months, but if the symptoms persist after that time, the disease develops into a chronic form. If signs of the disorder began to appear after six months, it is a delayed form.

PTSD symptoms are often accompanied by alienation. The patient does not show or shows (but in an inactive form) interest in the actual events. On the contrary, he/she demonstrates a lack of reaction. Patients can't stop thinking about what happened to them in the past.

All this leads to the fact that people lose interest in life, they become withdrawn, they do not communicate much and almost do not respond to the environment.

Obsession takes on a twofold character - with the past and with the future. In the first case, the events and stressful situations are recalled in the daytime, while at night they cause nightmares. In the second case, the future is perceived by the patient indistinctly, unclearly, and he or she may not be completely aware of it. In the future, the patient will try to anticipate possible repetitions of past events. This develops fear, anxiety, nervousness, which leads to depression, alcohol dependency and drug addiction.


There are four types of the disorder:

  • severe;
  • asthenic;
  • dysphoric;
  • somatoform.

The severe form is accompanied by unreasonable anxiety, constant restlessness, sleep disturbances, insomnia, nightmares and panic attacks. While communicating with people, the person's condition normalises, and the patient is interested in communication.

The asthenic type is accompanied by lethargy, bad mood, and indifference to everything that surrounds the person. The patient oppresses himself because he thinks he/she cannot go back to a normal life. Apathy leads to the fact that it is even difficult to get out of bed.

The dysphoric type is a difficult form manifested by aggression, resentfulness, anxiety, and distrust of others. Such people like to be confrontational, are difficult to treat and rarely voluntarily accept treatment.

The somatoform type is accompanied not only by psychological distress but also by other symptoms. For example, patients complain of heart pain and headaches. The difficulty with this type is that the symptoms are not immediately apparent, but may become apparent six months after the event.

When should you see a doctor?

If you have experienced severe trauma, difficult stressful situations, widespread events and disasters, violence and other emotional situations, you should make an appointment with a psychotherapist. There are qualified specialists and psychotherapists with a long experience of work at JSC "Medicina" (Academician Roytberg Clinic). Our multidisciplinary medical centre also employs experienced neurologists. Our clinic is located in the centre of Moscow, at the 2-nd Tverskaya-Yamskaya Lane, house 10, not far from "Chekhovskaya", "Mayakovskaya", "Belorusskaya", "Novoslobodskaya" and "Tverskaya" underground stations.


Post-traumatic stress disorder is diagnosed on the basis of the patient's complaints. A specialist determines the level of severity of the psychological trauma by using special questionnaires. The ICD classifies post-traumatic stress disorder as a threatening situation that causes people to despair. The experiences will come back to his/her mind. The patient will try to compare present events with the stresses and traumas he or she has experienced in the past. This will lead to the fact that the patient will try to avoid all situations which in some way remind him/her of the events of the past.


Treatment for post-traumatic stress disorder is individually planned for each patient, based on his/her personal situation. A doctor takes into account the following factors:

  • patient's personality;
  • type of post-traumatic stress disorder;
  • somatization;
  • presence of co-occurring disorders.

Effective treatments for post-traumatic stress disorder include:

  • cognitive-behavioural therapy;
  • hypnotherapy;
  • psychotherapy;
  • medication therapy.

If a patient is diagnosed with severe PTSD, desensitisation is prescribed. Medication may include antidepressants, anabolics and tranquillisers.

How can you make an appointment with a psychotherapist?

You can make an appointment with a psychotherapist and neurologist by calling +7 (495) 266-95-40. The line is open 24 hours a day, and calls from English-speaking citizens are accepted.

In the case of acute attacks it is recommended to call an ambulance at +7 (495) 229-00-03. Calls are accepted around the clock, the clinic operates both on weekdays and weekends, there is a stationary clinic on the territory of the medical center. You can also use the appointment form on the website.

Call +7 (495) 775-73-60 or leave a request,
we will call you back