Severe anxiety triggered by a deadly or life-threatening event is how post traumatic stress disorder appears.
Until 1980, when it was given its name, PTSD was not even on the radar as a clinically treatable condition.
The Vietnam War changed all that.
Soldiers who fought there brought home the realities of war and continued to struggle with the effects of post traumatic stress years after the conflict ended, which brought the disorder into the public eye. No longer dismissed as "shell shock," medical science caught on to PTSD and began treating it as a real and severe condition that triggers visible signs of hyperactivity in the part of the brain that reacts to fear.
"It's become an item in the news these days largely because of concerns with military people or people in uniform but it goes way beyond that -- post traumatic stress disorder is everywhere in our community," said clinical psychologist Ken Prkachin, a UNBC psychology professor.
"Military people and police and firemen are more prone to it, just because they see more horrific things. It can be something like being caught in a military attack, being involved in a horrible car accident. Most, in my experience, are work-related."
The sawmill explosions earlier this year in Prince George and Burns Lake that killed two workers in each instance and left dozens with severe injuries are two local examples of disasters that created PTSD, not only for the workers involved but the emergency staff who treated them.
Flashbacks and nightmares are common outward signs in PTSD patients as they relive their traumatic experiences.
Other symptoms include sleep disturbances, difficulty concentrating, irritability, and angry outbursts. A soldier who has seen combat can show arousal symptoms of PTSD when an unexpected noise suddenly startles him.
People start to lose the ability to feel emotions, good or bad, and that can adversely affect intimate family relationships. They distance themselves from the emotions they feel, which can worsen the condition. PTSD sufferers tend to avoid places or people who remind them of the event that touched off their condition.
"People love to talk about disaster, and if you're someone who has PTSD, people always want to talk about it, and that's the last thing you want to do, so you start avoiding conversations and you start avoiding people," said Prkachin. "Behavioural therapies often involve doing things to counteract this avoidance. If you avoid conversations about the event, then in therapy you talk about the event a lot with the idea being this helps you process the emotion and work through it."
Only rarely, Prkachin said, does PTSD lead to violent outbursts, such as the July 20th incident when a gunman in a Colorado theatre killed 12 and injured 58.
"People with a psychiatric history tend to have a lower rate of violence than those who do not, but every once in awhile somebody who has a disorder will do something so visible and extreme then everybody associates the unusual act with the disorder," Prkachin said.
While help is available to PTSD patients, chances are the patients will have to seek out those health services themselves, said Prkachin. Once in therapy, he said most people get noticeably better after two or three months of treatment.
"It's still a largely unrecognized condition not only from health professionals but from the people who suffer it," Prkachin. "People often think if you're suffering these symptoms it's a sign of weakness and they don't understand that it is a brain disorder.
"When a person gets scared like that, there are so many profound changes that take place. Certain regions of your brain become hyperactivated. It's not a personal failing or something people have any choice over when it happens to them. It is fundamental change in the way your brain and body are reacting to the world."