Post-traumatic stress disorder (PTSD) is one of the most frequently misunderstood psychological disorders. PTSA is unique in that it has a known origin in a traumatic event such as war, sexual assault, childhood abuse (physical or sexual), natural disasters, or auto or other accidents. The event represents a threat to one’s life or serious injury, although indirect exposure (learning about a serious threat or harm to a friend or family member) can now qualify as a traumatic event. One of the most consistent discoveries is that the greater the trauma, the higher likelihood of developing PTSD.
PTSD is defined as chronic anxiety expressed through:
- Great fear and helplessness
- Re-experiencing the trauma
- Avoidance or unresponsiveness
- Anxiety, both physical or psychological
Re-experiencing describes intrusive thoughts and recollections that seem to come without any triggers and are very upsetting. Nightmares and distressing dreams are also considered re-experiencing symptoms. Flashbacks fall into this category and describe a realistic situation that feels as if the trauma is happening again. Emotional and physical upset can also occur when one is reminded of the traumatic event through some cue, such as through the news media or in daily life.
Avoidance Or Unresponsiveness
Individuals with PTSD turn away from focusing on the trauma and will avoid thoughts, feelings, or conversations about the event. They may avoid activities, places and people that bring the event to mind. An individual who experienced a highway driving crash may refuse to drive on highways. A combat veteran may avoid anything associated with danger.
People with PTSD find they are rather disinterested in activities that they once enjoyed. While they may not have any particular reason for their disinterest, they simply don’t care about things that once held their attention. To block out the fear experienced in PTSD, people often turn off or numb their emotions. In doing so, they numb all of their emotional responses, both the negative and positive ones. Symptoms include feeling detached from other people and emotionless. There is also a common sense that one’s days are numbered and that the individual with PTSD will experience a shortened life.
Some of symptoms, such as difficulty sleeping, irritability or trouble concentrating, are similar to other anxiety disorders. Distinguishing symptoms are: hypervigilance and exaggerated startle response. People with PTSD tend to be extremely guarded, alert, and cautious. They are engrossed in fears about their own safety or the safety of loved ones, establishing elaborate safety practices to avoid threat. While hypervigilance does not keep anyone safer, it provides a physical action to counter helplessness.
How prevalent is PTSD? Here are some quick facts according to a National Comorbidity survey:
- More than 60 percent of men and 50 percent of women reported experiencing at least one qualifying traumatic event in their lifetime. More than 25 percent have experienced more than one such event.
- The most common events for men were witnessing someone being injured or killed (36 percent), involvement in a life-threatening accident (25%), and being threatened with a weapon (19 percent).
- The most common events for women were experiencing a fire or natural disaster (15 percent), witnessing someone being injured or killed (14 percent), experiencing an accident (14 percent) and molestation (12 percent).
- Of the many men and women who experience a trauma, approximately 7 percent develop PTSD at some point in their lives.
- Women develop PTSD twice as often as men.
- Combat-related PTSD seems to be a particularly insidious type of trauma. Combat PTSD has a higher lifetime likelihood of occurring, a greater probability of later onset, and a greater likelihood of resistance to treatment.
- Individuals with PTSD have an increased risk of other disorders such as depression, anxiety of many kinds and substance abuse. They are more likely to have a reduced quality of life and poorer physical health.
- Individuals with PTSD are 40 times more likely to have academic failure, 60 times more likely to experience marital problems, and 150 times more likely to be unemployed.
PTSD usually presents itself within the first few months after a trauma, and the vast majority of cases occur within the first two years. PTSD can develop many years after the trauma occurred, although minor symptoms of PTSD might have been apparent for many years before a full-fledged onset. For a diagnosis of PTSD, the individual must experience conditional symptoms for at least one month.
While PTSD is often an enduring, chronic condition, early intervention can prevent the most severe cases. The Veteran’s Administration finds that community social support is enormously helpful, along with any assistance that reduces life stresses such as unemployment or homelessness.
Cognitive behavioral therapy (CBT) is an effective tool that utilizes several well-researched methods of treatment. EMDR, eye movement desensitization and reprocessing, is also approved by the VA as a valid treatment for trauma, although some specialists find this method controversial.
Pharmacological treatments can be effective, but as with all anxiety disorders, psychological treatment is preferred. For those who use medications, SSRIs, selective serotonin reuptake inhibitors, and other antidepressants may be effective.