Learn About Post-Traumatic Stress Disorder
When you are facing a dangerous situation, it is a natural response to be afraid. Situations in which an individual feels threatened causes split-second changes in the body, referred to the “fight-or-flight” response, in which the body prepares to either defend itself or avoid the danger. Some individuals who have experienced or witnessed a traumatic event may develop Post-Traumatic Stress Disorder (PTSD).
A trauma is an event that is perceived by the individual to be threatening and can have long-term negative effects on a person’s ability to function in many different aspects of their life. The after-effects of experiencing a trauma can impact an individual’s social, emotional, and physical well-being. Traumatic events can occur on one occasion or can repeatedly occur over a period of time. What is considered to be traumatic is based on how the events are perceived and experienced by that individual, which means an event that is traumatic for one individual may not be for another.
Some types of traumas that may result in PTSD include:
- Sexual or physical abuse
- Terrorist attacks
- Serious accidents like a plane crash or car crash
- Ongoing domestic violence
- Natural disasters
- Being held up or threatened with a weapon
- Childhood abuse
In the U.S. the yearly incidence rates of PTSD have been estimated at about 3.5%. Of these cases, 36.6% (1.3% of U.S. adults) are rated as severe. Lifetime prevalence rates have been estimated at about 8.7%. There are differences in rates across age groups, with estimates for those ages 18-29 being 6.3%, 8.2% in those ages 30-44, and 9.2% in those ages 45-59, while rates for those over the age of 59 is estimated at 2.5%. For those who have lived through active military combat, captivity (e.g. POW’s), rape, and ethnic or political genocide, the prevalence rates of PTSD when taken together have been estimated at 50%.
PTSD and Co-Occurring Disorders
Most people who have PTSD suffer from another psychiatric or substance-related disorder. Common co-occurring disorders include:
- Bipolar disorder
- Substance abuse
- Conduct disorder in childhood or adolescence (seen more frequently in males than females)
Causes and Risk Factors for PTSD
While there is no definitive answer to the question of what causes PTSD, there is some evidence indicating that certain factors play a significant role in the development of the disorder. These include a variety of genetic, physiological, and environmental elements.
Genetic: Currently a lot of focus is placed on genes that play a role in creating fear memories. PTSD researchers have pinpointed certain genes that may play a role in the development of this disorder after a traumatic event.
Brain chemistry: A signaling chemical in the brain, gastrin-releasing peptide (GRP) is released during emotional events. GRP may help control the fear response and a lack of GRP may lead to the creation of greater and longer lasting memories of fear, which could lead to the development of PTSD.
Stress Hormones: Evidence indicates that individuals who develop PTSD display decreased levels of cortisol and increased levels of epinephrine and norepinephrine. These three chemicals are linked to the fight-or-flight response which occurs in response to fear. This leads to the person remaining in fight-or-flight mode, which in turn appears to lead to the symptoms observed in PTSD.
Effects in the Brain: It has been shown that many people with PTSD have an overactive amygdala, a structure of the brain that is one of the primary areas related to the experience of fear. When hyper-reactive, the amygdala pairs the exceedingly fearful memories of the trauma with numerous neutral factors, leading to the development of a multitude of triggers related to factors that may have nothing to do with the trauma. It has also been discovered that in some individuals with PTSD, the hippocampus is smaller than in others. This is important as the hippocampus is related to the encoding and processing of memories.
Previous Trauma History: Previous life experience appears to be a factor in the development of PTSD. Those who have a long-term history of significant stress and previous trauma are more likely to develop PTSD after the experience of a major trauma than those without a similar history.
Temperament: Certain inborn temperamental qualities appear to be associated with the development of PTSD. Individuals have varying levels of optimism and tendencies to view challenges in a positive or negative way. Additional temperamental qualities include behavioral inhibition, neuroticism, emotional reactivity, and introversion.
Signs and Symptoms of PTSD
While it is normal to experience distress after a traumatic event, for some individuals this distress persists for a prolonged period of time. If the symptoms last for more than three months the individual may be experiencing PTSD and seeking assistance would be the best option. Common symptoms of the disorder can be grouped into three different categories:
Re-experiencing Symptoms: These symptoms can cause problems with everyday routine. They can start with the person’s own thoughts and feelings. Other things such as words, objects, or situations that remind a person of the event can also trigger these symptoms.
- Flashbacks (reliving trauma over and over)
- Bad dreams
- Frightening thoughts
Avoidance Symptoms: Anything that reminds the individual of the traumatic experience can cause the development of avoidance symptoms. Any of these symptoms can cause an individual to make changes to their normal routine.
- Staying away from places, events, or other objects that are reminders of traumatic experience
- Feelings of guilt
- Emotionally numb
- Loss of pleasure in activities once enjoyed
- Trouble remembering the event
Hyperarousal Symptoms: These symptoms are usually constant instead of being triggered by things that remind one of the event. They can make a person feel stressed, angry, and may cause problems with sleeping, eating, or concentrating.
- Easily startled
- Angry outbursts
- Feeling tense
- Difficulty sleeping
Effects of PTSD
There are numerous consequences associated with untreated PTSD, including:
- Substance abuse
- Eating disorders
- Survivor guilt
- Domestic violence
- Loss of financial security
- Emotional numbing
- Sleep problems
- Difficulty concentrating
- A sense of hopelessness over the future
- Feeling helpless in terms of affecting positive change in life
- Anger outbursts, aggression, and violence (may be the result of flashbacks)
- Avoidance of social situations for fear of losing control
- Problematic family relationships
- Marital discord or divorce
- Decreased productivity at school or work
- Suicidal thoughts and behaviors
- Cardiovascular disease
- Chronic pain
- Depressed immune system, resulting in the development of subsequent medical problems