According to the National Center for PTSD, about 7% of us will experience PTSD at some point in our lives, following a traumatic event such as a car crash, surgery, unexpected death of a loved one, gender or sexual orientation-based harrassment, sexual assault, race-based hate crime, or other experience of violence.
In his book “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” (Penguin, 2015), psychiatrist Dr. Bessel van der Kolk pays homage to the brave Vietnam War veterans who successfully lobbied the American Psychiatric Association in the 1980s. Since then the medical profession has accepted the diagnosis of PTSD in wider populations, bringing in funding to support different treatment modalities (see below) and provide help.
Is everyone at risk regarding PTSD?
No, they’re not, and that’s a really interesting field of neuroscientific research.
Many of us face traumatic events in our lives, but don’t necessarily go on to develop PTSD. We may be temporarily thrown by awful experiences, and require help, and perhaps treatment. But most people can recover and thrive, in time, often with a greater understanding of the fragility of life, and develop a deeper empathy for fellow human beings as a result.
In a study, scientists at the The Peninsula College of Medicine and Dentistry found that most human brains have a “trauma switch” as part of the plasticity of our mental wiring. This enables us to “block out” and/or release mental anguish that is (literally) too much to bear. In technical terms, the protease-activated receptor 1 or PAR1 receptors in the amygdala (the emotional center of the brain), can “reprogram” themselves, either wiping or “rewriting” the traumatic memories, to protect us from overwhelming fear.
But if the trauma is persistent as in prolonged exposure to war, or the atrocities viewed are just too much to take, PTSD develops as a “shutdown” mechanism in the body and brain.
The diagnosis is now fully-recognized by the National Center for PTSD (part of the Veteran’s Administration), which states that: “PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. [But] if symptoms last more than a few months, it may be PTSD.”
How is PTSD diagnosed?
According to the National Institutes of Health (NIH), to be diagnosed with PTSD, an adult must have all of the following for at least 30 days:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
During this time they may report re-experiencing symptoms including:
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Frightening thoughts
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping
- Having angry outbursts
As a result, people suffering with PTSD may display the following cognition and mood symptoms:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities
How is PTSD treated?
There are several schools of research on addressing PTSD. These include trauma-focused psychotherapies (“prolonged exposure” and/or “cognitive behavioral therapy”) which focus directly on the event, but in a safe environment, to process it through visualization, talking, writing, or thinking-through the experience.
Another modality used for people who have trouble with focus and tend towards dissociation, is “Eye Movement Desensitization and Reprocessing” (EMDR). This involves trauma recall, while also paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone). This helps the brain reintegrate the trauma experience by re-experiencing it, but also re-framing it (in the past).
Sometimes medication is used, as part of the treatment.
Removing the stigma of PTSD
It is worth saying the true numbers of people suffering from PTSD are still unknown because the stigma of self-reporting is still fraught with complexity for many, particularly in the armed forces. It is hoped that by talking about it openly, others will be able to come forward and get help.
It is worth acknowledging that research around PTSD has also been expanded in recent years to examine the effects of growing up as a marginalized member of society. This includes trauma exposure from race, gender and sexuality-based assaults.
Places to get help
Have you been the victim of a race-related hate crime, including prolonged workplace racism? The actor Taraji P. Henson set up the Boris Lawrence Henson Foundation, in memory of her father, an African-American Vietnam war veteran.
Are you a member of the armed forces and experiencing PTSD symptoms following deployment in Afghanistan, Iraq or other places of conflict? The Veteran’s Association is here to help.
Did you experience trauma as a child? It’s never too late to address this, and find recovery – contact the National Child Traumatic Stress Network.
You are not alone. If you are suffering from PTSD, please seek help. It is possible to recover – but we all need help from time to time. There’s no shame in reaching out.