Post-Traumatic Stress Disorder (PTSD), I suspect most of us have heard about this condition but I’m less sure how many people have a solid understanding of what it is, and how a person could develop it. PTSD is often associated with trauma experienced in combat, although this is by no means the only trauma that can lead to PTSD. When we understand what PTSD is and how it is caused, we can see how both military personnel and civilians can be affected.
PTSD falls into the family of anxiety disorders. There are several criterion that are considered in making a diagnosis of PTSD, the first requirement is a stressor. The stressor must be severe, it can be actual or threatened and includes such events as serious injury, death or sexual violence. It does not need to be directly experienced by the individual, although it can be, it can also be witnessed, experienced indirectly (for instance a traumatic event that occurred to a loved one). Finally, the trauma can be caused by repeated indirect exposure, for instance first responders repeatedly witnessing violence. Intrusive symptoms are another requirement of the disorder, for instance, intrusive nightmares, flashbacks or recurrent memories of the event. A person with PTSD actively avoids anything that may remind them of the trauma and cause them distress. Mood and vigilance level are also negatively affected.
Not everyone who experiences a traumatic event will develop PTSD, in fact most people who experience a stressful event do not develop PTSD. There are some factors according to the National Institute for Mental Health, that are considered protective and decrease the likelihood of a person developing PTSD. These include having adequate social support after a traumatic event, feeling positive about the way the traumatic situation was handled, and having good coping skills. There are also some risk factors which may increase the risk for developing PTSD, for instance seeing people hurt or killed, suffering a loss such as losing a loved one, or a home, getting hurt in the course of the traumatic event, and having limited social support after the event.
As a young undergrad student of psychology I was taught about how an organism reacts to a stressor by learning about the 3 F’s – fight, flight or freeze. When a person is exposed to a dangerous situation, it’s normal for them to feel afraid, upset, stressed out! Some people react to the stress by fighting, others by fleeing and others by freezing. And your reaction in one situation may be different than your reaction in the next. For that matter, your reaction to the same situation may be different upon repeated exposure. What happens to people who are affected by PTSD is that the way they react to stress is damaged. They begin to experience those extreme reactions of fear and seek to fight, flight or freezing when they are no longer in danger.
Now that I’ve presented all this background information, I think my next point will logically follow from the information above. People who suffer serious injuries leading them to become disabled are at risk to develop PTSD. One of the risk factors for developing PTSD noted by the NIMH is becoming injured in the course of the trauma. So the risk is increased simply by the situation of having become suddenly disabled through a traumatic event. If you or a loved one is in the position of having become suddenly disabled, we know from our list of protective and risk factors there are some things we can do to decrease the likelihood of developing PTSD.
First and foremost, social support is key. When a person suddenly becomes disabled, there is a myriad of ways they might deal with this. They may become avoidant of old friends and family, mobility challenges may lead them to see less of friends and family, they may suffer from depression and avoid people in general, family and friends may avoid their loved one who has become disabled because they are struggling to handle the situation. All of these scenarios are likely to lead to reduced social support for a person who is already at risk for PTSD. Now that you are armed with this information, you can actively work to increase social support if you, or someone you know is in this situation.
Find a support group, either in person or online, talk to loved ones on the phone if mobility issues keep you from getting together, seek counseling if your mood is affecting your desire to be social. Outside of social support, what else can you do? Work hard to use positive self-talk. Despite the challenges of the situation, try not to let yourself get bogged down by the negative things you say to yourself. If you have a difficult time fighting against those negative thoughts, it’s probably time to see a therapist. Learn coping strategies that work for you, maybe meditation or relaxation audio scripts help you relax, maybe its deep breathing. There is no right or wrong way for a person to handle trauma, there is no right or wrong way to cope with such an event. What matters is what works for you, and if what you’re doing is not working, that you try something else, or seek the help of a professional.
There are several effective techniques for the treatment of PTSD. If you believe you may be experiencing symptoms of PTSD I would strongly encourage you to find a counselor who specializes in the treatment of anxiety and PTSD.