According to the National Institute of Mental Health, 7.7 million adults suffer from Post-Traumatic Stress Disorder (PTSD). There are many misconceptions in our culture regarding this disorder. Historically, and even now many erroneously think it is a diagnosis only for combat veterans. This cannot be farther than the truth. Although it has been historically associated with military veterans and multiple deployments, many other events that can cause post-traumatic stress. For example, prolonged exposure to emotional and psychological abuse can cause PTSD symptoms. Some of the misconceptions may be due to the recent development and recognition of the disorder in 30-40 years.
History
In 1980 the American Psychiatric Association (APA) formally recognized PTSD as an actual mental health diagnosis. This had been recognized as “shell shock” among military war veterans. Additionally, PTSD has historically been thought of as something that someone “gets over” over time. This may be true for some but not for others. Researchers continue to discover situations that can cause PTSD and traumatic responses. This includes emerging research on the study of what happens in childhood and how it affects adults in their lifetime (Van Der Kolk, 2014). For example, some clients of my clients may have grown up with “tough love” and disciplined with physical violence. They say “that’s just the way it was back then, teachers hit us too”. As adults, they may suffer from PTSD symptoms from developmental trauma and not even know it.
PTSD is a mental injury, not a mental illness
It is important not to look at the symptoms as a mental illness but as a mental injury (Zimbardo et al., 2012). PTSD symptoms are a natural reaction to a distressing event where you felt your life or a loved one’s life was in danger. I often ask clients, if you cut yourself, would you bleed? Yes, you would bleed because this is your body’s natural response to trauma. However, the amount of blood would be based on the severity of the wound, previous injuries, etc. This is similar to the development of PTSD symptoms because there are factors that put you at risk and factors that protect you from developing PTSD.
Who develops PTSD?
Some people develop PTSD symptoms and some do not. Symptoms can develop right after the event and reduce quickly (acute reaction) or could develop into PTSD. Risk factors that contribute to developing the disorder include the severity of exposure, previous unresolved traumas (i.e., multiple deployments, multiple sexual assaults, childhood abuse), lack of social support, previous poor coping skills, age, and self-esteem. According to the National Center for PTSD, protective factors for PTSD include an attitude of optimism, expecting the positive, spiritual beliefs, and social support.
What are the symptoms of PTSD?
First, you need the help of a mental health professional to determine if you have a diagnosis of PTSD. It really does not matter if you meet the full criteria for the diagnosis or not, what matters is if symptoms are causing problems in your life.
Criteria/Symptoms:
- There was a real or perceived life event that you believed your life was in danger. This experience does not have to happen to you directly. For example, you can learn it happened to a close friend or family member.
- You could work in an environment with repeated exposure to disturbing details (i.e., disaster relief personnel, police officers hearing about abuse, etc.).
- The reaction to the event caused feelings of helplessness, horror, and intense fear.
- You may avoid thinking of the event including avoiding memories and places that remind you of the event.
Symptoms include:
- Feelings of irritability, angry outbursts
- Problems with concentration
- Sleep disturbance
- Hypervigilance
- Nightmares or flashbacks of the event
- Feelings of detachment from others
- Persistent negative beliefs (i.e. “No one can be trusted”) or continuous negative state (horror, anger, guilt, shame).
What are the best treatments for PTSD?
There are many different treatments for PTSD that can help you feel better. EMDR therapy is one of the most effective treatments for PTSD. In fact, this treatment is used by the US Department of Defense to help our veterans with PTSD. It is also important that you find a therapist with expertise in trauma to minimize psychological harm. This is because researchers have found that recalling previous traumatic memories for some people may be detrimental. Also, your therapist can determine if you are ready to process your trauma and if you have the appropriate coping skills to do so. Many survivors have an intense fear of “going back there”.
Some survivors think that if they go back to the trauma, they won’t be able to “get out”. This is why it is important to create many coping skills that will allow you to process your memories. Some of them may include safe places, mindfulness, containment exercises, and guided imagery. A skilled therapist has many tools to help you with this process. The purpose of the skills is to help you know you can reduce your emotional arousal (intense anxiety, fear) if you become flooded by the distressing memory. In essence, the skills will help you feel that you can process the trauma with confidence.
Overall, humans are very resilient. It is also important to highlight that many people become even more resilient and grow after traumatic events. There is an entire field of research called post-traumatic growth that investigates how people grow and flourish after a traumatic event. Once you face what is disturbing you and process it, you will be able to look at the experience in a different light. It will release its hold on you and you will be able to experience more positive emotions instead of negative ones.