Is Stress the Same As PTSD?

What is a traumatic event?

First, it is important to identify what a stressor is and what a traumatic event is. Traumatic events that are covered by the term PTSD (Post-traumatic stress disorder) include

“exposure to serious physical injury, sexual violence, threatened death, and the sudden or violent death of another person. Car accidents, physical assault, rape, military combat, and natural disasters qualify as traumatic events” (Joy & Turk, 2018).

What is a stressor?

A stressor can be either traumatic or non-traumatic. For example, a stressor could include graduation, moving to a new city, losing a job, or having a child. Although it is true that when someone is under a state of stress, the brain may send signals of high levels of stress hormone cortisol throughout the body which could seem similar to the body’s response to a traumatic event. However, in the case of a stressful event, normally the highest level of the brain is still functioning letting the body know that everything will be ok.

The mind can talk the body through the situation. Many of us have been in stressful situations and have been our own best cheerleaders, saying, “You got this!” or, “Just two more hours!” This is because the stressor has not caused a trauma response. When someone is at a moment of bodily threat, the mind quickly sends signals to the brain to prepare for an attack, to fight, flee, or freeze. The higher functioning brain can’t even catch up, that’s why many people who have experienced grave harm recount like they were swimming, in slow motion, or looking down on the event from above.

So, what is meant by ‘stress?’

According to Van der Kolk (2015), when someone experiences a threat, the brain sends signals to the body that alert the fight, hide or flight response which produces an enormous amount of stress. When the threat is gone, sometimes the body stays on high alert. This is a hormonal and electrical state that impacts the entire nervous system and keeps it from “settling” or being calm even in safe situations.

Stressors might be a sign of an adjustment disorder and not PTSD

If you have severe difficulties in functioning and relationships and mood that seem to be excessive, within three months of experiencing a stressor, you could be facing an adjustment disorder. This is mostly shown in the inability to cope with the stressor or adapt to the changes presented. Often there is an unhealthy response, either characterized by problems in relationships, inability to carry out responsibilities, or changes in mood and conduct. Be aware that depending on one’s culture, responses to stressors may vary and may not constitute a disorder. The same is true for bereavement, which would not be categorized as an adjustment disorder.

Symptoms of an adjustment disorder

According to John Hopkins (n.d.), some of the signs of adjustment disorder include:

• Depressed mood

• Constant crying

• Jumpiness

• Breaking rules, recklessness

• Nervousness

• Worrying

• Feeling hopeless 

• Suicidal thoughts and ideation or behaviors

These symptoms begin within 3 months of the stressor’s occurrence, and last no longer than 6 months after the event, although if the stressor continues, one could potentially have chronic adjustment disorder (Mayo Clinic, n.d.). According to the APA (2017), people with adjustment disorder could show other symptoms of anxiety, depressed mood, or conduct problems. In addition, adjustment disorder with anxiety and depressed mood are the most adjustment disorders diagnosed in clinical settings (Joy &Turk, 2018). In some cases, adjustment disorders can be precursors to other disorders such as PTSD or depression.

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Resources
American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. American Psychological Association. 

John Hopkins Medicine. (n.d.). Adjustment disorders. https://www.hopkinsmedicine.org/health/conditions-and-diseases/adjustment-disorders#:~:text=An%20adjustment%20disorder%20is%20an,three%20months%20of%20it%20happening.

Joy, E.E., & Turk, C.L. (2018). The diagnosis and treatment of trauma and stressor related disorders. Continuing Education Article for Free State Social Work, LLC.

Mayo Clinic. (n.d.). Adjustment disorders. https://www.mayoclinic.org/diseases-conditions/adjustment-disorders/symptoms-causes/syc-20355224
Van der Kolk, B. (2015). The body keeps the score: Brain, Mind, and Body in the healing of trauma. Penguin Books.