Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include: Being easily startled or frightened. Always being on guard for danger. Self-destructive behavior, such as drinking too much or driving too fast.
Studies have shown that someone with PTSD will continue producing these hormones when they're no longer in danger, which is thought to explain some symptoms such as extreme alertness and being easily startled.
After a traumatic event or childhood maltreatment, you may be more easily startled and/or the experience of being startled can be more distressing. If you notice yourself getting startled fairly easily but you haven't had a recent traumatic event, then it is possible that you endured a relationally traumatic childhood.
Elevated heart rate response to startling stimuli represents a highly consistent finding in PTSD; larger skin conductance and orbicularis oculi (eye blink) electromyographic (EMG) responses, and slower skin conductance and EMG response habituation, have also been found (10–15).
PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
Note: type I = single event; sudden and unexpected, high levels of acute threat; type II = repeated and/or protracted; anticipated. Missing for a participant (in type I trauma group).
The startle easily symptom may precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself. The startle easily symptom can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur 'out of the blue' and for no apparent reason.
If someone is stressed, or upset, it tends to increase the startle response. There's also a connection to anxiety. For anxious people, a higher startle response tends to be part of the personality profile. Or, the startle response could be tied to a specific anxiety, like fear of flying or fear of spiders.
In the major form, hyperekplexia is characterized by an unusually extreme startle reaction to sudden unexpected noise, movement, or touch.
The exaggerated startle reflex in HPX is probably caused by brainstem pathology. This is supported by the concentration of glycine receptors in the brainstem and spinal cord (Rousseau et al., 2008). In addition, symptomatic excessive startling is usually caused by brainstem damage (Bakker et al., 2006).
People with PTSD may feel constantly alert after the traumatic event. This is known as increased emotional arousal, and it can cause difficulty sleeping, outbursts of anger or irritability, and difficulty concentrating. They may find that they are constantly “on guard” and on the lookout for signs of danger.
Patients with psychogenic myoclonus may have an excessive startle response to sensory stimuli, such as loud noises. In one study, about one-third of patients sited a preceding event, such as a minor surgery, as the triggering factor. Psychogenic myoclonus may be difficult to distinguish from organic myoclonus.
Some interesting facts about PTSD include:
70% of adults experience at least one traumatic event in their lifetime. 20% of people who experience a traumatic event will develop PTSD. About 13 million people have PTSD in a given year. 1 in 13 people will develop PTSD at some point in their life.
PTSD can leave people feeling on edge and looking out for danger (hypervigilance). Really, what it boils down to is that people feel more anxious. Their startle response is exaggerated. They're jumpy or looking over their shoulder more often.
In animals, including humans, the startle response is a largely unconscious defensive response to sudden or threatening stimuli, such as sudden noise or sharp movement, and is associated with negative affect. Usually the onset of the startle response is a startle reflex reaction.
A child who retains the Moro reflex will be hypersensitive to outside stimuli, startle easily, and may appear fidgety or restless — symptoms commonly seen in children with ADHD.
Ludewig et al. (2005) reported an increased general startle reactivity in unmedicated patients with panic disorder. Kumari et al. (2001) found that patients with obsessive-compulsive disorder had an enhanced startle reactivity and shorter latency as compared to those measured in healthy individuals.
Hyperekplexia is a pathological exaggeration of the physiological startle response [8]. It consists of an exaggerated response to unexpected stimuli, especially sounds. Compared with normal startle, the response is more intense and longer lasting; it can be triggered more easily; and it usually does not habituate.
3. Rescue Stage (including Intrusive or Repetitive stage) In the rescue phase, the affected individual begins to come to terms with what has happened to them. This stage can include returning to the site of the trauma, including returning to a home following a bushfire or natural disaster.
Complex PTSD (CPTSD) is influenced by multiple traumatic events, including repeated traumas of the same type or separate encounters, and is considered the most severe type.
DSM-5 pays more attention to the behavioral symptoms that accompany PTSD and proposes four distinct diagnostic clusters instead of three. They are described as re-experiencing, avoidance, negative cognitions and mood, and arousal.