PTSD can develop at any age, and is more likely to affect women than men. According to the National Center for PTSD:
- 7.7 million Americans age 18 and older have PTSD.
- 67 percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.
- People who have experienced previous traumatic events run a higher risk of developing PTSD from the next traumatic event.
- 7 or 8 out of every 100 people will experience PTSD at some point in their lives.
Individuals who have served or are serving in the military have a higher risk of developing PTSD because of the greater chance they will witness traumatic events in combat:
- Operations Iraqi Freedom and Enduring Freedom: About 11-20 out of every 100 Veterans (or between 11-20%) who served suffer from PTSD in a given year.
- Gulf War (Desert Storm): About 12 out of every 100 Gulf War Veterans (or 12%) struggle with PTSD in a given year.
- Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were currently diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study. It is estimated that about 30 out of every 100 (or 30%) of Vietnam Veterans have struggled with PTSD in their lifetime.
PTSD is linked to suicide:
- In 2012 over 5,000 suicides in the United States alone occurred as a result of combat-based PTSD.
- PTSD related suicide is the 10th leading cause of death in the United States.
As its name implies, Post Traumatic Stress Disorder is a prolonged and ongoing stress disorder triggered by a traumatic event. PTSD is most often associated with violent and dangerous events such as sexual abuse, physical endangerment or attack, military combat, natural disaster, or violent accidents. But some people develop PTSD after less personally violent but still traumatic situations like when a close loved one or friend dies, someone close to them experiences harm or danger, or they witness a dangerous event occurring live on television.
The age a person witnesses a traumatic event is very important, as children aren’t as equipped with skills, understanding, and experience as adults are to process and manage traumatic situations. Examples include parent’s divorce, seeing pornographic or violent pictures/movies, getting lost in a mall, being rejected or embarrassed by peers, or failing in prominent or important activities.
Thankfully, not everyone who experiences even the worst traumatic event will develop PTSD. Some risk factors for PTSD include not talking about and processing the event quickly after it occurs, having little or no social support after the traumatic event, experiencing several stressful events at the same time, having a history of mental illness or substance abuse, having experienced past trauma, or being a younger age. Most importantly, those who do not manage stress effectively are at higher risk for developing PTSD.
Criteria for PTSD Diagnosis
PTSD is complicated with dangerous physical and psychological consequences if not treated properly. A behavioral health specialist, either a psychiatrist or psychologist, with expertise and experience assessing and treating PTSD, is the most qualified professional to diagnose PTSD. According to the Behavioral Health Diagnosis Manual, DSM 5, criteria for diagnosing PTSD are the following:
- Criterion A (one required): The person was exposed to a traumatic event: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, to themselves or a loved one. (Benzio note: Serious injury is determined by the victim when the incident happens)
- Criterion B (one required): The traumatic event is persistently re-experienced, through intrusive thoughts, nightmares, flashbacks, emotions, or physical reactivity.
- Criterion C (one required): The person exhibits avoidance of trauma-related stimuli, situations, thoughts, feelings, or reminders (could be people or characteristics of people) of the traumatic situation.
- Criterion D (two required): Negative thoughts or feelings that began or worsened after the trauma. There are many possibilities such as memory loss of the trauma, negative thoughts about oneself, exaggerated blame of self for trauma, negative mood or feelings, decreased interest in activities, or feelings of isolation.
- Criterion E (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the form of irritability, risky behavior, hypervigilance, heightened startle reaction, difficulty concentrating, and trouble sleeping.
- In addition, the following criterion are required:
- Criterion B, C, D, E symptoms last more than 1 month.
- Criterion B, C, D, E symptoms create distress or functional impairment (e.g., social, occupational, relational, life management, financial).
- Criterion B, C, D, E symptoms are not due to medication, substance use, or other medical or psychiatric illnesses.
- Dissociative Specifiers or Subtypes: Some people, but not all, have some dissociative symptoms after experiencing trauma as a way to cope with, escape from, or avoid the distressing thoughts, feelings, or symptoms listed in Criteria B, C, D, or E. The following 2 Dissociative Subtypes are for someone who meets the above PTSD criteria:
- Depersonalization:frequent experience of being an outside observer of one’s life or feeling detached from oneself (e.g., feeling as if “this is not happening to me” or one were in a dream).
- Derealization:frequent experience of unreality, distance, or distortion (e.g., “things are not real”)
- Delayed Specification or Subtype:Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of some of the symptoms may occur immediately.
Symptoms of PTSD
When experiencing a trauma, we are shocked, hurt, and never want to experience that again. So our mind responds in a defensive way to protect us by either blocking out any reminders of the past trauma or putting all our systems on hyper alert so we can avoid any future events that might harm us. PTSD symptoms grow out of our mind’s reflexive attempts and immature strategies to deal with the shock of the traumatic event, disrupted thinking or feelings caused by the event, or being on a heightened sense of alert to protect us from future potential traumas.
The most well-known symptom of PTSD is the presence of flashbacks or nightmares. This results from the person not adequately processing the event so the event keeps pushing up into their mind and re-experiencing to try to make sense of it, master it, or overcome the fear it caused. The mind is wrestling with it to work through the event and conquer it once and for all. But because the person isn’t prepared and consciously working on it, this rudimentary re-experiencing does not help, in fact, it only causes more distress to the person as they feel like the trauma is happening again, increasing their anxiety and fear.
Symptoms of PTSD are grouped into four clusters as follows:
Re-experiencing symptoms: these are often triggered by words, objects, feelings, people, or events that remind them of the traumatic experience.
- Flashbacks – hearing, seeing, or physically feeling the events as if it is actually occurring again
- Nightmares – flashback while asleep
- Frightening thoughts – images or thoughts as a result of the event
- Emotions similar to those felt around or during the event
- Purposely avoiding places, events, or things that remind the person of the trauma
- Avoiding thoughts or feelings connected with the trauma
- Detachment from life
- Decreased motivation
- Relational distance or isolation
Arousal and reactivity symptoms
- Easily startled
- Tense feeling
- Easily agitated, angered, frustrated
- Physically restless, edgy, pacing, tapping, hard to sit still
- Muscle tension, tremor, twitching
- Heartburn, diarrhea, stomach cramping
Cognition and Mood Symptoms
- Memory issues
- Concentration or attention struggles
- Occasional confusion or feeling overwhelmed
- Negative self-defeating thoughts
- Distorted views about themselves, others, God, or various life activities
- Distorted feelings of guilt or self-blame
- Loss of interest in past hobbies or activities
- Lack of enjoyment
- Anxiety, depression, anger
Symptoms of PTSD usually begin shortly after the traumatic event, but may sometimes take years to develop or are triggered by a stressor or similar event in their own life, a person close to them, or something they are exposed to in the media.
Treatment and Prevention of PTSD
It is imperative to help people process troubling events as soon as possible so the ripples of these distressing and damaging symptoms can be avoided or minimized. We should never assume that because a person seems fine after a traumatic experience that they will not struggle with PTSD. Talking about it and processing the event several times after it occurs allows the event to be dealt with and understood so it doesn’t disrupt the victim’s normal thinking, feeling, and overall functioning.
If we think someone is having an exaggerated response to a mild event, we should also not belittle or minimize their reaction, even if we don’t think the event was stressful or traumatic. Each person has their unique background of experiences, skills, and lenses through which they see life, so what is traumatic for one might not be for someone else. If an individual is traumatized by an event, they should get help to process their distress.
Treatment for PTSD brings a lot of emotional relief, freedom from negative thoughts, and restores normal living. Treatments include psychotherapy (talk therapy), medications, and infusing spiritual truths, principles, and skills. Prognosis for recovery is very good, especially when treatment begins as closely after the trauma as possible. To learn more about the treatment of PTSD, see page 3.