Post-traumatic stress disorder is among the most well-known mental health conditions in modern society. Our collective understanding of PTSD and its treatment has developed since the post-WWI era when military veterans returned home suffering from ‘shell shock’ and the enlightened public of today has achieved at least a certain awareness of the toll that the trauma of warfare can have on physiological wellness. The debilitating effects of warfare-induced PTSD are numerous and serious. As such, support and awareness for military veterans are increasing, as they should. What is often lost in the modern conception of PTSD is that the effects or symptoms of the illness are far more widespread than often portrayed in cinema and the media, and many, many sufferers live undiagnosed and perhaps unaware that the non-combat related trauma they have experienced is causing them suffering.
Non-Military Can Suffer from PTSD Too
Combat-related PTSD is so correlated with the illness that a quick google search of ‘NON-combat PTSD’ will return a list of resources for military veterans to prove that their trauma unrelated to warfare should qualify for VA disability status. I do not make this point as any statement about the VA and what should and should not be covered, but to say that non-military folks suffering from PTSD are far from the forefront of public awareness on mental health (even the APA website barely makes page 3 of a google search on the topic).
Understanding Symptoms and Treatments of PTSD
It is important that we understand the causes and symptoms of PTSD for all sufferers. The truth behind mental health usually requires some investment to understand, and PTSD is no exception. A formal PTSD diagnosis usually requires extended and severe symptoms (not everyone who experiences trauma will experience PTSD), though experiencing some degree of the disease is not a pass/fail test, it is a spectrum that can be caused by an event, series of events, relationship, situation, or any other stimulus that results in any degree of trauma. It is also closely related to other anxiety disorders such as acute stress disorder, adjustment disorder, disinhibited social engagement disorder, and reactive attachment disorder. The effects of PTSD vary from mild annoyance to crippling debilitation.
- Intrusion: Have you ever been lying in bed becoming sleepy when all of a sudden, once again, your brain involuntarily recalls to your mind a very specific, very embarrassing moment from junior high school? That is a symptom of PTSD called intrusion. For those of us who have not experienced serious trauma these may be easily dismissed, fleeting thoughts. However, for individuals who have experienced serious or repeated trauma, these thoughts are not simple to disregard and can even result in waking visions of past scenes of intense pain.
- Avoidance: Have you ever skipped past a song on the radio because of its association with a former partner, or because it was played on repeat at the fry shack where you worked 3 summers ago? This is another symptom of PTSD called avoidance. More serious examples include refusing to go to certain places, see certain people, or participate in certain activities because of their association with traumatic events. When I was young I had a teacher in a middle-aged man, a genius whom I respected very much. Years later I learned that this man had not driven on the interstate for the last 20 years to avoid driving on the road where his spouse had been killed in an auto accident. The possibilities for avoidance following trauma are endless.
- Changes in Mood and Cognition: Most of us have, at one time or another, snapped undeservedly at a friend or family member after a long day. That’s because stress affects our mood. For those of us with a normal amount of stress and a lack of trauma, a few moments of relaxation or a good meal is enough to restore our usual temperament to equilibrium and we move on. For those still suffering from past trauma, that relief does not come. After an extended period without relief, the mood change seems permanent. This another symptom of PTSD. The inability to remove the stress from past trauma removes the joy from activities the sufferer once enjoyed.
- Sensitivity to Environment or Surroundings: Have you ever been driving to a place you’ve never been, and as you struggle to concentrate on navigating, you find yourself turning down your radio? This is an example of how stress reduces cognition. Turning down your radio will not allow you to see the road better, but sound can be a form of stress, and by removing the stimulus of your radio, you can think better and your cognition improves. Now imagine that same scenario, except your radio is at full volume as you search for a location in your car, and you are not capable of turning the music down. This is similar to the loss of cognition a PTSD victim can experience as they are engulfed by the aftershocks of their traumatic experiences.
- Changes in Arousal and Reactivity: One of the most severe symptoms of PTSD, angry outbursts, and extreme irritability with seeming little provocation can occur. These episodes are the result of a PTSD sufferer running out of options. To continue our car radio example: If you were driving to an unfamiliar place and couldn’t turn your radio down to help focus, one option, an extreme option, might be to destroy the radio. Without any other option, this decision could seem rational. However, a passenger in the same car who was not feeling the stress would view the action of destroying the radio as completely rash and totally irrational. This is the same reaction many people in our society, without the context of a PTSD diagnosis, view mental health episodes associated with PTSD.
“Time heals” is an adage that can be true for PTSD treatment. It is not uncommon for the lasting effects of trauma to fade with time and without the help of other treatments. A support structure can also be helpful. When the sufferer has a network of family and friends willing to provide latitude for recovery the odds of said recovery are increased.
In some cases though, further treatment is necessary for PTSD recovery. As a result, several types of therapy, researched and proven, have been developed:
- Cognitive processing therapy: This form of therapy helps sufferers work through mood and cognition changes by addressing negative emotions and beliefs stemming from the trauma. For example, the victim of a crime suffering PTSD may develop the belief: “a person hurt me, so all people might hurt me.” As a treatment of PTSD, Cognitive processing therapy helps to walk that belief back, and thus undo the psychological damage caused by the trauma.
- Prolonged Exposure Therapy: This commonsense form of therapy helps victims directly address the trauma causing their symptoms. To reference my friend who would not drive on the freeway after he lost his wife to an auto accident: Under prolonged exposure therapy he may have utilized a driving simulator for longer and longer durations until the act of driving on the freeway in a controlled and safe environment removed the stress from the activity.
- Stress Inoculation: This form of therapy focuses on coping mechanisms. Earlier, I mentioned skipping a song that reminds me of an unpleasant time of my life. Stress inoculation teaches ways to avoid many more types of stress triggers.
- Medication: For those suffering from the most serious symptoms of PTSD, medication may be necessary to allow the sufferer to heal and return to a normal condition. Some antidepressants such as SSRIs and SNRIs (selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors) are commonly used as a treatment for the core symptoms of PTSD. They are used either alone or in combination with psychotherapy or other treatments. These decisions should always be made by professional and licensed mental health professionals.
Overcoming the Effects of PTSD
If any of the symptoms mentioned in this article resonate with you, consider taking steps to fortify your mental health. If you see these symptoms in others, I recommend advocating for anyone who may be suffering in the shadow of the trauma they have endured. Whether Henry David Thoreau’s statement “The mass of men lead lives of quiet desperation” is true or not, I have found that treating everyone you meet as if they are in need of help is the best practice.
Curtis grew up in Texas and graduated from Southern Utah University with a master’s degree in Public Administration. He has spent the majority of his career working in field operations and currently works as a talent acquisition manager. His passion for mental health comes from personally witnessing the struggles of individuals experiencing mental health challenges and their suffering from the social stigma with which such illnesses are often met.