PTSD and Trauma:
Understanding the Lasting Impact of Difficult Experiences

Traumatic experiences are far more common than many people realize. In Northern Virginia and across Virginia, veterans, first responders, survivors of accidents and violence, and people who experienced childhood adversity make up a large part of the population living with the effects of past trauma. Not everyone who experiences a traumatic event develops PTSD, but for those who do, the impact can be profound and lasting.

This overview explains what trauma and PTSD are, who is most affected, and what evidence-based treatments are available today via telehealth in Virginia.

What Is Trauma?

Trauma is the lasting emotional response to an event or series of events that felt threatening, overwhelming, or inescapable. Traumatic events include physical assault, sexual violence, combat, serious accidents, natural disasters, childhood abuse or neglect, sudden loss, and medical emergencies, among others.

It is important to note that trauma is defined by its impact on the person, not by the event itself. Two people can live through the same experience and one may develop lasting symptoms while the other does not. This does not mean one person is stronger or weaker than the other. It reflects differences in biology, prior experiences, available support, and circumstances at the time of the event.

What Is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition that can develop after exposure to actual or threatened death, serious injury, or sexual violence. It affects roughly 7 out of every 100 people at some point in their lives, and rates are significantly higher among veterans, survivors of sexual violence, and first responders.

PTSD symptoms fall into four recognized clusters:

1. Re-experiencing: Intrusive memories, nightmares, flashbacks, and intense distress when reminded of the traumatic event. The nervous system behaves as if the danger is still present, even when it is not.
2. Avoidance: Actively avoiding thoughts, feelings, people, places, or situations that are reminders of the trauma. This can shrink a person's world significantly over time.
3. Negative changes in thinking and mood: Persistent negative beliefs about oneself or the world ("I am broken," "nowhere is safe"), feelings of guilt or blame, emotional numbness, loss of interest in activities, and a sense of estrangement from others.
4. Hyperarousal: Being easily startled, feeling constantly on guard, difficulty sleeping, irritability, angry outbursts, and trouble concentrating. The nervous system is stuck in a state of high alert.

For more on how PTSD is diagnosed and managed, see our page on trauma and PTSD care in Virginia.

Adverse Childhood Experiences (ACEs)

Some of the most consequential trauma happens early in life. Adverse Childhood Experiences (ACEs) is a term for a range of difficult childhood circumstances, including abuse, neglect, household dysfunction such as domestic violence or parental substance use, and parental incarceration.

The landmark ACE Study, conducted in the 1990s, found that ACEs are remarkably common and have dose-dependent effects on adult mental and physical health. People with four or more ACEs face significantly elevated risks of depression, anxiety, substance use disorders, heart disease, and other serious conditions. Recognizing this history is an important part of trauma-informed psychiatric care.

Who Gets PTSD and Who Does Not?

Trauma exposure is widespread, but PTSD develops in a subset of those exposed. Risk factors that increase the likelihood of PTSD include:

• Prior trauma, especially in childhood
• A personal or family history of anxiety or depression
• Lack of social support after the traumatic event
• High severity or prolonged duration of the traumatic experience
• Peritraumatic dissociation (feeling detached from yourself during or immediately after the event)

Protective factors include strong social support, a sense of agency, access to care shortly after trauma, and prior experience successfully coping with adversity.

Evidence-Based Treatments

PTSD is highly treatable. The most effective approaches include:

Trauma-Focused Psychotherapy

Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are the two most evidence-supported therapies for PTSD and are recommended by the American Psychological Association, the VA, and the Department of Defense. Eye Movement Desensitization and Reprocessing (EMDR) is another well-validated approach. These therapies work by helping the nervous system process traumatic memories rather than continuing to treat them as ongoing threats.

Medication

SSRIs (sertraline and paroxetine are FDA-approved for PTSD) and SNRIs are first-line pharmacological treatments. Prazosin is sometimes used specifically for trauma-related nightmares. Medication can reduce symptom severity and make engagement in therapy more manageable.

Trauma-Informed Care

Beyond specific therapies, trauma-informed care recognizes how past experiences shape a person's current responses and builds treatment around safety, trustworthiness, and collaboration. Alice Tran Psychiatric Care provides trauma-informed psychiatric evaluation and medication management via telehealth across Virginia, meeting patients where they are rather than requiring them to travel.

A Note on Safety

PTSD is associated with elevated rates of suicidal ideation. If you or someone you know is in crisis, please call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, 7 days a week.

See also: Trauma and PTSD care in Virginia · PTSD vs. anxiety: what is the difference? · Anxiety care in Virginia