PTSD - What We’re Learning Now & Why it Matters
Traumatic events—such as an accident, assault, military combat or natural disaster—can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of Post-traumatic Stress Disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety. A comprehensive medical evaluation resulting in an individualized treatment plan is optimal.
PTSD affects 3.6% of the U.S. adult population—about 9 million individuals. About 37% of those diagnosed with PTSD are classified as having severe symptoms. Women are significantly more likely to experience PTSD than men.
Symptoms
A diagnosis of PTSD requires a discussion with a trained professional. Symptoms of PTSD generally fall into these broad categories:
Re-experiencing type symptoms, such as recurring, involuntary and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams and intrusive thoughts.
Avoidance, which can include staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
Cognitive and mood symptoms, which can include trouble recalling the event, negative thoughts about one’s self. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can in some instances extend to include out-of-body experiences or feeling that the world is "not real" (derealization).
Arousal symptoms, such as hypervigilance. Examples might include being intensely startled by stimuli that resembles the trauma, trouble sleeping or outbursts of anger.
Young children can also develop PTSD, and the symptoms are different from those of adults. (This recent recognition by the field is a major step forward and research is ongoing.) Young children lack the ability to convey some aspects of their experience. This isn’t to negate the brilliance of children, as most of their experiences tend to be discounted, however this is to say that words may not be the best indicator of what’s going on internally. The entire situation with both adults AND children needs to be evaluated with care. Behavior in children (e.g. clinging to parents) is often a better clue than words, and developmental achievements in an impacted child might slip back (e.g. reversion to not being toilet trained in a 4-year-old).
It is essential that a child be assessed by a professional who is skilled in the developmental responses to stressful events. A pediatrician or child mental health clinician can be a good start.
Causes
PTSD can occur at any age and is directly associated with exposure to trauma. Adults and children who have PTSD represent a relatively small portion of those who have been exposed to trauma. This difference is not yet well understood but we do know that there are risk factors that can increase a person’s likelihood to develop PTSD. Risk factors can include prior experiences of trauma, and factors that may promote resilience, such as social support. This is also an ongoing area of research.
We do know that for some, our “fight-or-flight” biological instincts, which can be life-saving during a crisis, can leave us with ongoing symptoms. Because the body is busy increasing its heart rate, pumping blood to muscles, preparing the body to fight or flee, all our physical resources and energy are focused on getting out of harm’s way. Therefore, there has been discussion that the post-traumatic stress response may not a disorder per se, but rather a variant of a human response to trauma. This is similar to the responses we see with those who are diagnosed with depression. Often people who err on the side of depression go through a “freeze” phase and are unable to feel as deeply as they did before their mental illness reached its peak.
Whether you think of these symptoms as a stress response variant or PTSD, consider them a consequence of our body’s inability to effectively return to “normal” in the months after its extraordinary response to a traumatic event.
Diagnosis
Symptoms of PTSD usually begin within three months after experiencing or being exposed to a traumatic event. Occasionally, symptoms may emerge years afterward. For a diagnosis of PTSD, symptoms must last more than one month. Symptoms of depression, anxiety or substance use often accompany PTSD.
Treatment
Though PTSD cannot be cured, it can be treated and managed in several ways.
Psychotherapy, such as cognitive processing therapy or group therapy
Medications
Self-management strategies, such as self-soothing and mindfulness, are helpful to ground a person and bring her back to reality after a flashback
Service animals, especially dogs, can help soothe some of the symptoms of PTSD
Related Conditions
Someone with PTSD may have additional disorders, as well as thoughts of or attempts at suicide:
Anxiety Disorders
Obsessive-Compulsive Disorder (OCD)
Borderline Personality Disorder
Depression
Substance use disorders / Dual Diagnosis
These other illnesses can make it challenging to treat PTSD. For example, medications used to treat OCD or depression may worsen symptoms of PTSD. Successfully treating PTSD almost always improves these related illnesses and successful treatment of depression, anxiety or substance use usually improves PTSD symptoms.
Post-traumatic stress disorder (PTSD) is a disorder of not being able to recover after experiencing or seeing something terrifying. According to PTSDUK, one in ten people have PTSD along with one in five firefighters, 70% of rape victims, one in three teens who have been in a car crash, and 40% who have dealt with sudden loss. You can either feel your life is in danger, threatened, or you have seen someone else dying or being injured. Having PTSD is about not having control over your thoughts as every day feels like the nightmare you have been trying to avoid since your first encounter.
According to The Mighty, people described their feelings of PTSD as having smells, looks, vibes, dreams, or how someone treats you as a trigger from the experience you wish you could forget. It feels like you are constantly on alert the way you feel when you watch a scary movie but you feel that way everyday. Someone also described PTSD as putting items like dissociative episodes, panic attacks, flashbacks, unwelcome thoughts, anxiety, and depression in a closet until there is no more. Once the closet is full, all of the items burst out and you do not know what to do with all of your cluttering items all around you. Treatment is about learning how to deal with those items and finding a better place for them.
It feels scary being alive when you are constantly on alert. Everyday feels like you are gonna die where you cannot sleep because you are afraid of what dreams you will have. You are afraid of the sound of every car door, loud bangs, someone’s footsteps, when someone calls your name in the distance, and feel like someone is hiding behind you. Flashes of memories consume your daily life. You feel like there is a monster hiding under your bed but you are the only one who can see this monster.
Your survival instincts are always running and you tend to react without thinking. Your anger takes over when the stress hits and it bypasses your rational way of thinking. You feel guilty for not being able to control yourself or always being afraid of things that other people are able to walk away from. All the more reason why people with PTSD need to get help immediately before they hurt themselves or hurt others from their inescapable pain.
Helpful Links:
https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder
https://themighty.com/2017/01/what-ptsd-feels-like/
https://www.youtube.com/watch?v=QnfRGQp6ZPA&ab_channel=KatiMorton
Baking-ish is a podcast produced and edited by Fahrenheit Co., a U.S. based entity run and organized by Ren Newman.
**I am not a mental health professional. Please talk to a healthcare professional before doing or changing anything within your daily life. These experiences and opinions reflect only my personal experiences.
