What is PTSD?

Post Traumatic Stress Disorder (PTSD) is often associated with those who’ve seen active combat in the military.  One of the first things to know about PTSD:  it’s not just for combat veterans.  While it’s incredibly prevalent in combat veterans – up to 75% of veterans who were injured during combat reported PTSD symptoms – you’ll also find it in a large number of other professions ranging from police officers to medical professionals, along with the potential for PTSD to be an issue for anyone who’s suffered extreme trauma.  PTSD is also probably a lot more common that you think; around 3 million cases in the US per year, and around 50% of rape victims experience PTSD.

At one time, PTSD went by other names:  shell shock or combat neurosis.  PTSD as a term began use in the 1970’s with the US military, and came into wider use in the 1980’s with the American Psychiatric Association.  Generally speaking, it’s been around for as long as humanity has existed, we’ve just finally got a fitting name for it – one that helps show that the problem affects more than just those who’ve seen combat.

We’ve mentioned PTSD in two other articles already – anxiety disorders and depression. While PTSD does share some things in common with these other disorders, it is dealt with as it’s own unique health problem, and PTSD it’s self can lead to depression and anxiety disorders.

Causes of PTSD

The source can be summed in one word:  trauma.  It can be a single traumatic event, or a series of them.  Just a quick idea of things that may cause PTSD:

  • Active Combat Situations
  • Physically or Mentally abusive relationships
  • Rape
  • Car Accidents
  • Explosions
  • Witnessing the loss of a friend or loved one
  • Natural Disaster

Additionally, certain occupations run higher risks of putting people into situations where PTSD may be a result:

  • Military Service (including non-active combat positions)
  • Law Enforcement
  • Firefighters
  • EMS
  • Emergency Room Personnel

What actually happens to the brain to cause the long term side effect of these events?  The mechanism isn’t fully know yet, and may actually represent multiple things going wrong at once.  The hippocampus, the part of the brain that handles memory, often shows a loss of mass in those who are suffering from PTSD.  The hypothalamic-pituitary-adrenal (HPA) system also goes out of whack – it’s part of the system that regulates stress.  Research for the full effects and physiological changes that go with PTSD is ongoing.

Symptoms of PTSD

Unlike Anxiety or Depression, each of which is often a chemical imbalance issue, PTSD is most directly associated with a traumatic event or events in life, and the symptoms very much reflect that:

  • Flashbacks:  when triggered, the PTSD sufferer goes back to the moment in time where the original trauma (or traumas) occurred.  This isn’t just a simple memory – this can be a full sensory experience where they may be feeling, mentally seeing, and hearing the event, and possibly even feel displaced in time to that moment.
  • Dwelling:  the PTSD suffer may spend quite a bit of their time thinking back on the moment of trauma.
  • Survivors Guilt:  Often, if the trauma included loss of life, the PTSD suffer dwells on the impossible question – why did they survive, and not the other person or people involved.
  • Insomnia
  • Nightmares
  • Emotional Detachment
  • Fear
  • Suspicion
  • Hypervigilance
  • self-destructive behaviors
  • Social Isolation
  • Guilt
  • Loneliness
  • Alcoholism and Drug Abuse

PTSD Triggers

These signs are free to all veterans – click on the image to visit the site and order one for yourself or loved one if you have a need for one.

If you have a loved one or friend who’s dealing with PTSD, or even if you just have a neighbor who has PTSD,  it’s good to understand the concept of “triggers”.   When talking about the symptoms, we mentioned flashbacks to unpleasant memories.  Often these (and other symptoms) are “triggered” by things occurring in the immediate vicinity of the person suffering from PTSD, and one of the most common ones happens around the 4th of July:  fireworks.

From time to time, you’ll see signs indicating that a veteran lives in the neighborhood, and to avoid using fireworks.  It’s not that someone is old, crotchety, and doesn’t want you to have fun:  they’re dealing with a serious issue.  As mentioned in the symptoms, for some people PTSD includes full bore flashbacks, taking the suffer back to the moment the trauma occurred.  In the case of veterans fireworks (gunshots, explosions, or other potentially loud noises) may send them mentally back in time to the field.  It’s not just a minor thing, either – imagine what it takes to be in active combat, to be shot at and have explosions going on in your area.  Now, remove yourself from that sort of element for years, then suddenly be thrust back into that frame of mind in your own home, with lived ones around.  Or, imagine having to re-experience the moment when an improvised bomb blew up the truck you were riding in.  Respect those signs.  It’s more than just being polite, it’s helping someone maintain the best mental health possible.

But, it also goes further than that.  If you have a friend or loved one who is suffering from PTSD, if they’ll talk about it, find out what the triggers are for them to help avoid those situations.  There are more triggers than just fireworks or loud noises.  For those who have experienced abuse or rape, they most likely have a very different set of triggers.

Treatment

PTSD treatment is a long ways from being a one-size fits all situation.  In our first articles on cannabinoids, we mentioned that there has been some promise in the idea of treating PTSD with marijuana, though most of the data is “self reported” rather than full medical studies due to the legal status of marijuana.  That’s far from the only promising treatment, though.

Anti-anxiety medications, such as Selective Serotonin Reuptake inhibitors (SSRIs) show promise in many cases, though they may take up to two months to begin showing results.   Psychotherapy (such as group talk therapy) often helps considerably.  There’s also entirely new classes of experimental treatments on the way, such as VR (virtual reality) based exposure therapy that could become more widespread in the future.

Where To Start

For veterans and their families, there are a ton of places to start.  A good is one we linked for the fireworks sign, MilitaryWithPTSD.org, which provides information on resources for both the PTSD sufferer their family.

For those who aren’t military, if you feel that you (or a loved one) is suffering from PTSD, talk to your healthcare professional.  They can help direct you to the best possible resources in your area.

Header image by Sgt. Denoh Grear via Flickr.

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