Post Traumatic Bitterness Disorder

Post-traumatic embitterment disorder is a mental adjustment disorder. People with this condition have trouble coping with failure.

Post Traumatic Bitterness Disorder

What is Post Traumatic Bitter Disorder?

Post -traumatic embitterment disorder is also known as post-traumatic embitterment disorder (PTED) and is one of the adjustment disorders. The medical term is still relatively new and was coined in 2003 by the German psychiatrist and neurologist Michael Linden. See healthknowing for What is the Definition of Herniated Intervertebral Disc.

The mental disorder occurs when people suffer extraordinary stress, which is not unusual in life. These include, for example, the loss of a job, losses suffered, interpersonal conflicts or problems in the partnership. The people affected experience the associated processes as humiliating, insulting and unjust.

As a result, they consistently behave bitterly and aggressively toward themselves or other people. Post-traumatic embitterment affects all areas of life and is associated with hopelessness, despair, mental blocks and anger. According to Michael Linden, post-traumatic resentment disorders appear after intense social upheaval.

The clinical picture was first defined after the reunification of Germany in 1990. However, no major social changes play a role in the outbreak of bitterness, but rather stresses that are considered normal in life. It is estimated that two to three percent of all Germans suffer from post-traumatic embitterment.


Bitterness usually comes from a great personal hurt. Those affected feel misunderstood by other people or treated unfairly. At the same time, however, they feel unable to do anything about the injustice they have suffered.

However, if people cannot defend themselves effectively, this leads to feelings of helplessness, resignation and finally resentment. It is not uncommon for the strong bitterness to trigger extreme feelings, such as punishing the alleged tormentor, which are associated with aggressive fantasies and sometimes even result in acts of violence or extended suicides.

Typically, however, bitterness is an emotion that subsides over time. It has not yet been clarified what causes an abruptly occurring post-traumatic bitterness disorder. According to Michael Linden, psychologists and psychiatrists also contribute to the disease.

This is because they don’t see their patients’ real problems and therefore only treat them for aggression or depression. Post-traumatic resentment disorder occurs in both men and women and can affect both young and old people.

Symptoms, Ailments & Signs

There are some symptoms that are considered typical of post-traumatic bitterness disorder. The people affected are generally in a bad mood and make a bitter impression. They also feel that life has treated them unfairly, they are disappointed in their fellow human beings, blame other people as well as themselves and behave aggressively.

They rarely have friends as they withdraw more and more from social life. Other possible symptoms of PTED are listlessness, inner restlessness, sleep disorders and physical complaints. In extreme cases, sufferers develop aggressive thoughts that include death or an extended suicide. Furthermore, the patient avoids certain people or places associated with the traumatic experience.

Diagnosis & course of disease

In order to be able to diagnose post-traumatic bitterness disorder, several criteria must be met. The patient is well aware of his mental stress, which he sees as the reason for it. He views the triggering experience as offensive, deeply unjust, and humiliating.

This makes him feel helpless, angry and bitter. If the patient remembers the triggering event, he reacts emotionally excited. The intruding memories cause a permanent deterioration in his mental health. Prior to the triggering experience, there were no mental illnesses that could explain his behavior.

In addition, the symptoms last longer than six months and limit the affected person in his everyday life. A differential diagnosis to other mental illnesses such as depression or post-traumatic stress disorder is also important. In addition, most adjustment disorders are temporary. Since post-traumatic bitterness disorder is a relatively new mental disorder, its exact course is still unclear. In addition, there are large individual differences.


Suicidal and homicidal thoughts can occur as serious complications in post-traumatic embitterment disorder. If the person concerned kills both others and himself, there is also talk of extended suicide. However, the suicidal thoughts can also be limited to the person concerned. In both cases, prompt treatment is required.

Depending on how acute the suicidality is, outpatient or inpatient therapy can be considered. In the event of a risk to oneself or others, accommodation is also possible in order to ensure the safety of the person concerned and other people. Post-traumatic bitterness disorder often leads to a depression-like thought pattern.

The resentment that arises from a tragic event can negatively impact job seeking. According to the principle of the self-fulfilling prophecy, the person concerned may sabotage themselves. Self-damaging behavior is a further complication, for example in the form of drug, alcohol and tobacco consumption.

A negative attitude can also lead to difficulties in many other areas of life. Family and social conflicts often occur as a complication of post-traumatic embitterment disorder. Aggressive behavior can also occur.

Without proper treatment, complications are more likely than with treatment. Bitterness can promote other mental illnesses, such as depression, anxiety disorders and psychosomatic complaints.

When should you go to the doctor?

If bitterness persists over a longer period of time and has an increasingly negative effect on the well-being of the person affected or those around them, it is advisable to talk to a therapist. People who have a personality disorder after a traumatic event or as a result of a long-standing mental health condition should seek treatment. The earlier the disease is diagnosed and treated, the better the chances of recovery.

Therefore, the first signs of bitterness should be examined by a therapist or doctor. If the underlying medical history is long, the responsible physician must be informed if the symptoms worsen or are associated with other, possibly self-injurious, symptoms. In addition to the psychologist, a specialist in neurological diseases can be consulted if there is a suspicion that the condition is due to a physical illness. Adolescents showing signs of resentment should be referred to an adolescent psychologist. Otherwise, the disorder will develop further and, in the course of this, cause further mental and physical illnesses.

Treatment & Therapy

Treating post-traumatic bitterness disorder is not easy. Patients often give up or resist offers of treatment. The so-called wisdom therapy is considered a helpful therapeutic approach. This is a variant of cognitive behavioral therapy developed by Michael Linden.

As part of the psychotherapeutic process, the patient processes the event that triggered his bitterness in order to finally be able to distance himself from it, giving him a new perspective on life. Proven cognitive strategies are used for this purpose, including behavioral analysis, analyzing automatic thoughts, building activity, cognitive renaming, and an exposure procedure.

At the same time, the patient reestablishes social contacts. To calmly deal with life’s problems, patients role-play, putting them in the shoes of people who have offended others. For some patients, wisdom therapy is definitely successful. Others are at least regaining their ability to function. However, it is not uncommon for the treatment to take months or even years before it is successful.


In order to prevent post-traumatic bitterness disorder, it is advisable to counteract negative thoughts and feelings. Relaxation methods such as meditation, yoga, Qi Gong or hypnosis are suitable for this purpose.


Psychotherapy over a longer time frame is recommended as an effective follow-up treatment for PTSD. Psychotherapy should ensure that the patient can lead a joyful life in the long term without being burdened by various symptoms. Follow-up care is important to develop effective strategies for everyday life.

While outpatient accompaniment is recommended for milder cases, patients with severe bitterness disorders should consider rehabilitation. In the course of rehabilitation, the patient can work through what he has experienced and thus be prepared to return to everyday life. Rehabilitation as an aftercare measure strengthens the patient’s body and mind and helps them regain a sense of responsibility for themselves and the environment.

Even after difficult experiences, one’s own limits should be recognized and the self-esteem of the patient should be strengthened. Personal resources can be mobilized in the course of aftercare so that the patient is fit for everyday life again. In the further course, relaxation methods such as autogenic training or progressive muscle relaxation can also be used in everyday life to minimize restlessness or anxiety.

Concentration exercises, yoga or Qi Gong are also excellent aftercare measures and can be easily integrated into everyday life. Creative approaches, such as art or music, can also have a positive effect on the patient’s soul and increase the quality of life.

You can do that yourself

In addition to psychotherapeutic treatment, those affected can exchange ideas with each other, especially in self-help forums on the Internet. In many cities there are self-help groups for people who have experienced trauma. Since the clinical picture of post-traumatic embitterment disorder is still relatively unknown, there are currently only a few self-help groups that are specifically aimed at those affected by this disease. It is therefore advisable to attend a group that deals with the related condition of post-traumatic stress disorder.

Visiting a group is also recommended because it helps those affected to get in touch with other people and to have conversations. In general, rebuilding social contacts is particularly important. Those affected should maintain relationships with family members, friends and acquaintances or make new friends. If there are no opportunities for this in the private sphere, it is advisable to visit sports clubs or cultural associations. It is just as important to pursue regular activities and interests and to deepen them.

Those affected should live according to a regular daily routine. Stress must be avoided or significantly reduced. In addition, activities such as yoga, meditation, Reiki, progressive muscle relaxation, autogenic training, Qi Gong, hypnosis or prayer can help to deal with negative thoughts in everyday life and also contribute to stress reduction.