PTSD or posttraumatic stress disorder can be a lifelong problem, especially if the sufferer is not receiving appropriate intervention. The disorder was first identified in soldiers, but it does not only affect veterans and combat troops. It takes hold of anyone who either experienced or witnessed a traumatic, shocking, or horrifying event. For instance, repeated night time bombing raids against London during World War II produced PTSD symptoms in many British civilians.
The traumatic event does not need to be a life-threatening nor a one-off experience, cumulative stress or continuous exposure to stressful situations can also lead to a severe form of PTSD called Complex PTSD. Medical professionals now recognize the importance of envisioning the heterogeneous nature of PTSD, not limited by the DSM-5 criteria or subjectively reported symptoms. The following experiences (ongoing stress) can cause PTSD symptoms:
- Repeated exposure to verbal, emotional, or physical abuse
- Experiencing childhood neglect or abandonment
- Long term exposure to bullying
- Repeated exposure to violence
- Living in war-torn regions
- Experiencing slavery or human trafficking
- Repeated exposure to calamities, accidents, deaths, or other violent acts (first responders, paramedic, firefighters)
When old wounds don’t heal
The length of time a person can experience PTSD symptoms varies. Researchers and experts in the field are still not certain why some people can easily move on from a traumatic experience while others are haunted by it for months, years, and even decades.
To receive a PTSD diagnosis, a person must have symptoms for at least one month following a traumatic event. PTSD usually begins within three months of the trauma, but it can also occur years after a traumatic event. The so-called delayed PTSD is rare but it deserves attention. It sometimes occurs if the person develops symptoms that do not meet the criteria for a PTSD diagnosis; if the symptoms are not addressed adequately, the individual may develop late-onset PTSD.
There are many factors that affect the development of PTSD. These include individual differences (personality), early childhood experiences, family characteristics, and the availability of emotional support from family and friends.
The consequences of untreated PTSD
Most patients with PTSD experience hyperarousal. The nervous system has been sensitized by extreme trauma, thus general arousal becomes elevated and the brain overreacts to even smaller stressors. Heightened arousal and reactivity are dangerous because they trigger destructive behavior. The person also develops a fear-or-flight response to virtually anything—even to objects or events that couldn’t cause any harm. While they feel ashamed of their response and exaggerated fear, often thinking that they are “going crazy,” they can also be irritable and angry. Here’s an example to help us better understand this phenomenon:
A young teen was bullied and physically harassed by a group of male teenagers in his class. He subsequently developed hyperarousal when going to school or campuses. He’s not particularly keen on accompanying his siblings to school. This is not surprising since the traumatic event happened inside the school campus. But isn’t it unusual for him to be hyper aroused whenever he sees a baseball cap? Only after therapy and careful prodding does he finally recall that one of the perpetrators (the leader of the group) was always wearing a baseball cap every time they beat him. His brain has made a connection unconsciously. He has even forgotten about the existence of the baseball cap and unable to recall most of the details of the events. The trigger object also continues to create a widening network of associations. Baseball caps may associate to beanies, helmets, or doctor’s surgical caps.
The sufferer may reach the point where leaving the house becomes a problem because he is easily triggered by various stimuli he can’t identify (since his brain made the connections without his conscious knowledge) and control. The same teenager will then utilize whatever is available to calm him down, relieve the pain, and regain lost control:
- Misuse of alcohol and other substances such as marijuana, cocaine, methamphetamine, and prescription drugs.
- Impulsive and risky behaviors: sudden trips abroad, compulsive gambling, compulsive shopping, or eating disorders.
- Deliberate self-injury (cutting, hair pulling, excessive scratching of the skin, extreme body modification, or refusing needed surgery/treatment.
- Prostitution, sex addiction, casual sexual encounters
- Revictimization: staying in an abusive relationship, seeking a powerful figure to rescue him or her
- Suicidal thoughts and behaviors
Recovery from PTSD
About one-third of those who develop PTSD will have chronic symptoms that will not go away. In some cases, the traumatic experience can cause long-term personality alterations and an impaired functioning that diminishes their capability to live a normal life. However, with proper treatment, the remaining two-thirds will recover from the disorder either partially or completely. There is still hope for the majority of trauma survivors and their families. But healing doesn’t happen overnight. The path to recovery is long and often arduous. Sometimes the memories of trauma remain throughout one’s lifetime. Despite the devastating effects of PTSD, there are many treatment options available to reduce your symptoms and take your life back.
“Sixty percent of those who develop PTSD will recover, whether or not they’ve ever received treatment.”
—Laurie B. Slone and Matthew J. Friedman