PTSD

PTSD is a persistent threat response after exposure to actual or threatened death, serious injury, or sexual violence. The danger has ended, but the brain continues to respond as though it may recur: intrusive memories break into the present, reminders are avoided, mood and beliefs change, and arousal remains high. Dysregulation of fear-conditioning circuitry—including a hyper-responsive amygdala, hippocampal changes, and altered hypothalamic-pituitary-adrenal-axis activity—helps explain this pattern, but PTSD is diagnosed clinically rather than by imaging. The nurse’s first question is not, What treatment should be started? It is, Is this person safe right now? Suicidality, psychosis, severe dissociation, substance-related risk, and inability to maintain basic safety determine the immediate priority. Once safety is established, trauma-informed care reduces the chance that assessment or treatment will recreate the patient’s loss of control.