7 Truths about PTSD

There are a number of misunderstandings about the nature of post-traumatic stress disorder, also known as PTSD. This condition, an extreme form of anxiety disorder, is caused when a person experiences a traumatic event and subsequently experiences anxiety and depression, among other psychological and physical symptoms, for months or years following the event.

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What Are The Misunderstandings About PTSD?

• Getting PTSD does not mean a person is weak or cowardly.
• PTSD can result from a wide range of experiences.
• The observance of multiple types of symptoms is used to diagnose PTSD.
• Young children may demonstrate different symptoms of PTSD.
• PTSD can contribute to high levels of substance abuse.
• Stigma often prevents people with PTSD from getting help.

1. Getting PTSD does not mean a person is weak.

One of the biggest myths perpetuated about PTSD is that it somehow indicates the individual who is experiencing symptoms is mentally or physically weak or cowardly. Some people may even deny that PTSD exists, instead claiming that the individual complaining of the symptoms is oversensitive or childish.

The fact is, PTSD is a real mental health disorder that happens every day. According to the American Psychiatric Association, PTSD affects about 3.5 percent of adults at any given time, while 8.7 percent of people will have experienced PTSD at some point in their lives.

PTSD can result when a person experiences a trauma that presents a serious risk of injury or death to that individual or to people with whom the person has a close relationship. According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), these experiences can include:

• Directly experiencing a violent or extreme event that threatens the person’s life or physical health
• Witnessing a traumatic event in person
• Hearing that a close family member or friend experienced a traumatic event
• Directly experiencing repeated exposure to disturbing aspects of a traumatic event (generally does not include watching media reports or seeing it on television or in movies).

While not everyone who experiences trauma this way will develop PTSD, there are those who will. This is not based on the person’s character, but instead is a more complex manifestation of the individual’s experience of trauma.

2. PTSD can result from a wide range of experiences.

As described by the Sidran Institute, many people mistakenly believe that PTSD only affects war veterans or soldiers who have experienced the trauma of battle. It is true that a large percentage of veterans develop PTSD based on their experiences. In fact, a variety of studies, as presented by the website Veterans and PTSD, show that anywhere from 4 percent to 20 percent of Iraq War veterans have PTSD or depression. PTSD is also the third most common diagnosed mental health condition for veterans using Veterans Affairs hospitals.

Nevertheless, there are other causes of PTSD, which can affect a wide range of people. As an example, according to research reported by the American Psychological Association, women are about twice as likely as men to develop PTSD. In fact, 10 percent of women experience PTSD in their lifetime due to experiences like rape and domestic violence alone. They are also more likely to have the symptoms last for a longer period of time, and be more sensitive to “triggering” events – that is, situations, people, or other stimuli that remind them of the traumatic event.

Children can also develop PTSD for a variety of reasons, including:

• Mental or physical abuse
• Witnessing a violent event
• Experiencing the death or suicide of a family member or friend
• Living through a disaster, such as a flood or earthquake

According to the US Department of Veterans’ Affairs, 3-15 percent of girls and 1-6 percent of boys experience PTSD as a result of experiencing some kind of trauma.

Ultimately, it’s important to realize that anyone may develop PTSD if exposed to life-threatening violence or another type of traumatic event that presents the risk of death or other extreme personal risk. As stated by the Sidran Institute, it is estimated that PTSD affects approximately 20 percent of all people who experience these types of events.

3. The observance of multiple types of symptoms is used to diagnose PTSD.

People who have PTSD generally experience four types of symptoms, according to the National Institute on Mental Health. These include:

• Regularly re-experiencing the event in some way
• Displaying avoidance behaviors
• Being hyper-aroused or reactive
• Experiencing changes in mood or cognitive abilities

These four types of symptoms may manifest in multiple ways.

Re-experiencing

can result in flashbacks, bad dreams, or apprehension about being in similar situations. In some cases, people may fully relive the event on a regular basis, depending on circumstances.

Avoidance

behaviors may manifest through the person being unwilling to go places or see people that represent a reminder of the event. It can also mean repressing thoughts or refusing to engage in conversation about the event or similar situations.

Hyperarousal

leads to the individual being continually on guard, tense, or anxious about situations. This can include insomnia related to a desire to avoid dreams or being unable to control fears about the trauma, and it can result in the person becoming suddenly angry, paranoid, or even violent.

Cognition and mental health

can be damaged through trauma. A person with PTSD may literally be unable to remember the event that triggered the condition, develop depression, or experience inappropriate emotions, such as survivor’s guilt or an unhealthy blame of another person or group of people based on the event.

In general, PTSD is diagnosed in people who, for at least one month, experience the following:

• At least one symptom each of re-experiencing and avoidance types
• At least two symptoms each of hyperarousal and mood or cognition issues

Some people even develop physical issues because of PTSD. As just one example, the National Center for PTSD demonstrates that children who experience neglect or abuse have higher rates of cancer, certain types of heart disease, and lung disease than the general population. People who report having PTSD symptoms are also more likely to have higher rates of physical health problems.

4. Young children may demonstrate different symptoms of PTSD.

As explained above, children who experience trauma can be at high risk of developing PTSD. Sometimes, however, their symptoms may not manifest in the same way that adult symptoms do. As a result, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires different symptom criteria for diagnosing PTSD in children younger than 6 years old.

First of all, young children can develop PTSD not only through actually experiencing violence or another life-threatening event, but also by receiving threats of violence or harm to the self or others to whom the child is close, such as a caregiver or sibling.

In addition, young children do not require as many symptoms to potentially be diagnosed with PTSD. Diagnosis for children 6 or younger is made if the child demonstrates, either for more than one month or in ways that causes extreme upset within the child’s relationships:

• One or more re-experiencing symptoms
• At least one of either the avoidance or cognition behavior issues
• Two or more hyperarousal symptoms

Children with PTSD are often unable to articulate why they behave the way they do. They may not correlate their feelings with their experiences of abuse, neglect, or other traumatic experiences. For this reason, it is important for parents or other caregivers to be aware if a young child in displaying these types of symptoms and to get help from a professional regarding diagnosis.

5. PTSD can contribute to high levels of substance abuse.

People with PTSD often struggle with more than one mental health disorder. In many cases, this co-occurring condition may be some form of substance abuse, which may arise if the individual tries to manage the symptoms through drugs or alcohol. Often called self-medication, this way of coping with the feelings that result from PTSD can easily lead to substance abuse or addiction.

As an example, a study from the Journal of Dual Diagnosis states that, compared to women without PTSD, women with the diagnosis are seven times more likely to also engage in daily drug use, and 15 times more likely to engage in both drug and alcohol abuse.

Substance abuse can even occur with certain medications prescribed by a doctor to ease PTSD symptoms. Anti-anxiety drugs like benzodiazepines may be used more often than they should be in order to cope with what seem to be increasing symptoms. This can occur when the person becomes tolerant of the drug – that is, the person needs to take more and more of the medication as time goes on to achieve the same result. If the person then goes against the prescription and takes higher or more frequent doses, the body can develop a dependence on the drug, which, if continued, can lead to addiction and its severe consequences, such as:

• Missed work, school, or responsibilities due to the use or effects of the drug
• Relationship problems
• Loss of interest in favorite activities
• Increased mood problems or health issues

The combination of substance abuse and PTSD can be a difficult one to deal with. However, with the right treatment by experienced professionals, it is possible to manage PTSD and substance abuse together.

6. Stigma often prevents people with PTSD from getting help.

Many organizations, including the military, are concerned about the public stigma around disorders like PTSD – some to the degree that they want the word disorder dropped from the name because they feel it makes people more hesitant to get treatment.

This is understandable – a study from the Psychiatric Rehabilitation Journal shows that people with symptoms of PTSD hesitate to get help because they don’t want to be labeled as having “mental illness.” People with the disorder are also often shunned as being unstable, violent or dangerous, or even crazy. As discussed above, many people who don’t understand mental illness blame the person who suffers from the disorder as being weak or cowardly, or even having some level of personal responsibility for developing the condition.

These stigmas are damaging and dangerous, because they can make it harder for people with PTSD to get the help they need to get the condition under control. PTSD is not the fault of the individual who has it; it also doesn’t mean that the individual is faulty or less of a complete person. PTSD can happen to anyone, and treatment can help get it under control.

It is possible to treat and manage PTSD.

There are a number of types of treatment for PTSD, including therapy, medication, or a combination of the two. According to the Anxiety and Depression Association of America, some types of psychotherapy that are commonly used include:

• Cognitive Behavioral Therapy to help recognize triggers or symptoms and initiate specific behaviors to counter them
• Exposure therapy or virtual reality to create a safe way of the person confronting the fears and anxieties that arise from the trauma
• Stress inoculation that helps the person through activities and behaviors that reduce anxiety
• Cognitive restructuring to help the person work through, understand, and create more realistic perceptions of the event

When it comes to supplementary medications, it is important to follow the doctor’s or therapist’s prescription instructions precisely to avoid the problems of substance abuse. For those who struggle with substance abuse, medication may be risky as a PTSD treatment. However, by working closely with the treatment specialists, the individual can learn to manage PTSD and move forward into recovery.

Recognizing the challenges that lead to PTSD and understanding the truths about how PTSD occurs and affects people from all walks of life can make it easier for these people to feel comfortable getting treatment. For anyone struggling with this condition, the knowledge that it is treatable can create a sense of hope for the future.

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