Post Traumatic Stress Disorder (PTSD) is a much mentioned and talked about diagnosis that is not always understood by the public. It is often seen as something that happens to people in the military or in paramilitary organization, such as the police. In fact, PTSD is something that can strike anyone. It does not always require the horrors and brutality of combat.
Like all mental health diagnoses, PTSD is diagnosed based on a review of symptoms. These symptoms must be present for more than one month and they have to be severe enough that they interfere with the domains of daily life, including relationships, work, education, and integration into community. Note that this means people can have some of the symptoms of PTSD without meeting the full diagnostic criteria. Just because there is not a diagnosis does not mean the person is not experiencing some level of distress.
The root cause of PTSD is the experience of a situation that violates a person’s core sense of safety and integrity. While the common image of this is combat, it can be any event that meets these criteria. Being in a car crash, suffering abuse as a child, witnessing the loss of a loved one and other events can result in PTSD for anyone. Even vicarious trauma from helping others with trauma can trigger PTSD. While most people respond to traumatic events with a decrease in functioning, those who develop PTSD experience a lasting impact. This often seems to be a direct result of the individual being unable to integrate the experience. In fact, neurological studies show that some people with PTSD have a brain state that is persistently akin to the Fight, Flight, or Freeze response, literally meaning parts of their brains are not communicating effectively to process the event.
Symptoms often begin within a few months of the event, but they can emerge much later. These fall into re-experiencing, avoidance, arousal, and cognition.
Re-experiencing symptoms include things such as flashbacks, intrusive thoughts or memories, dreams, and physical symptoms that match time incident.
Avoidance includes staying away from events, places or objects that can be reminders. Often, this results in restriction of activities than can worsen over time.
Arousal symptoms include things like easily being startled, hypervigilance, agitation, short temper, loss of sleep, and poor concentration.
Cognition can range from gaps in memory of the event, loss in sense of safety, increased blame on self or others, and depression. All of these things can be triggered though apparently unconnected events.
The triggers for each person are based on his or her experience. Often, for people who have been in combat, loud noises can be that trigger. Riding in a car may be the trigger for someone who has had a car accident. A survivor of sexual abuse may be triggered with proximity of certain touches. It is important to observe individuals and watch for repeated responses around a certain behavior, activity, and/or person. This can be a clue that an assessment for trauma and PTSD is in order. What is critical to remember is that any event, even if it does not seem traumatic to others, can be a source of PTSD or PTSD like symptoms. What is important is how the individual experienced the event and how that is playing out now.
Caring for someone with PTSD therefore requires patience, understanding, and grace. It requires knowing the individual and understanding the individual expression that PTSD has in his or her life.
Source: National Institute of Mental Health
