Primary Care in Rochester and Kasson

PTSD: Symptoms, resilience and evidence-based treatments

7/13/2023 by Rachel Wassan, Ph.D., C.Y.T.; Anne Roche, Ph.D.; Craig Sawchuk, Ph.D., L.P.


Many individuals experience some kind of traumatic event at least once throughout their lives. Most people have a brief reaction to the stressor and recover naturally. However, some will continue to experience negative outcomes following the traumatic incident, which can lead to something called post-traumatic stress disorder, or PTSD. 

What is PTSD?

There are several main features that define PTSD. 

  • Exposure to actual or threatened death, serious injury or sexual violence. 
  • Intrusion symptoms, such as flashbacks and nightmares. 
  • Avoidance of things that remind one of the trauma, such as people, places or sensations. 
  • Negative thoughts and depressed mood. 
  • Reactivity and hyperarousal (e.g., "jumpy" or "on edge"). 
  • May experience dissociation or derealization (extreme feelings of detachment). 
  • Causes significant impairment in one's life and/or significant distress. 
  • Symptoms present for at least one month. 

Approximately 6.8% of adults in the U.S. will have PTSD at some point in their lives. Types of trauma may include physical assault or injury, sexual trauma, accidents, combat/war, race-based trauma, gender- and sexual orientation-based trauma, natural disasters, refugee trauma and medical trauma, among others. Individuals are more likely to develop PTSD if the event was interpersonal in nature.

PTSD affects the central nervous system causing the body to be in a chronic state of stress. The brain and body are on high alert to help you look out for potential danger. however, this chronic stress response is difficult for the body to maintain and has been linked to increased risk of several other health concerns, including: 

  • Sleep disturbances. 
  • Substance use disorders. 
  • Mood disorders (e.g., depression). 
  • Irritable bowel syndrome. 
  • Hypertension. 
  • Type II diabetes. 
  • Cardiovascular disease. 
  • Autoimmune diseases. 

Fortunately, many individuals recover and no longer meet the criteria for the disorder. Recovery can occur through resilience-promoting factors and/or receiving evidence-based treatment. 

Resilience can be characterized as the process of "bouncing back" or adapting to maintain functioning following a stressful or traumatic experience. Importantly, resilience is not a characteristic that some people possess and others do not, but instead can be fostered in various ways. Examples of things we can do to help promote resilience may include: 

  • Connecting and spending time with supportive others such as friends, family or community-based groups. 
  • Taking care of your health to the extent possible through prioritizing sleep, moving your body, eating well and hydrating. 
  • Engaging in activities that you find enjoyable and meaningful, even when it may feel challenging. 
  • Allowing yourself to feel what you feel and having compassion for yourself and your experience. 

It's also important not to think of resilience as simply an individual-level process. Societal and policy-level change is critical in fostering the resilience of our communities. 

Finally, seeking professional psychological treatment can be very effective in promoting recovery from PTSD. When seeking this type of support, it's important to be aware of the types of psychotherapies that are evidence-based (i.e., supported by research) to be the best consumer of your care. Many of the symptoms of PTSD are maintained by avoidance of people, places, emotions, thoughts or memories associated with a traumatic event. Therefore, evidence-based treatments for PTSD typically focus on approaching these experiences in ways that are safe and structured with support from a clinician. Through approaching, we learn new ways of relating to difficult thoughts, memories and emotions, and they tend to become less distressing over time. 

Two common research-supported therapies are prolonged exposure (PE) therapy and cognitive processing therapy (CPT). PE focuses on helping an individual specifically approach trauma memories as well as situations in the person's life they may be avoiding due to trauma and associated emotions. CPT focuses on helping individuals understand how trauma may have led to thoughts and beliefs that are unhelpful for recovery. In CPT, patients work with their therapist to examine these thoughts and to build skills to think more flexibly about their trauma. Finally, trauma-focused cognitive behavioral therapy (TF-CBT) is a trauma-focused treatment for children and adolescents and their parents/guardians. TF-CBT focuses on identifying the associations between thoughts, emotions and behaviors in the context of trauma and helping children and adolescents to build coping skills. 

If you believe that you or a loved one are struggling with trauma symptoms, consider reaching out to your primary care clinician and talking about your concerns. Ask your clinician about mental health resources and supports that may be available to you. 

Rachel Wasson, Ph.D., C.Y.T., and Anne Roche, Ph.D., are clinical health psychology fellows in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health at Mayo Clinic. 

Craig Sawchuk, Ph.D., L.P., is a clinical psychologist in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health. He is the co-chair of the Division of Integrated Behavioral Health and co-chair of Clinical Practice with the Department of Psychiatry and Psychology at Mayo Clinic.