Revisiting PTSD

Post traumatic stress disorder (PTSD) is back in the headlines in a big way, making it well worth reviewing this anxiety disorder.  As with all such conditions, this is a complex and debilitating illness, with a wide range of triggers, symptoms, problems and treatments.  It is not easy to diagnose or solve, and it certainly is not the explanation behind everything that goes wrong in combat or other extreme settings.  But it is very real and those suffering its effects need patience, compassion and timely, effective medical treatment.

The US Department of Veterans Affairs has published a report that defines and outlines PTSDs, which we summarize here:

What exactly is PTSD?  It’s an anxiety disorder that sometimes occurs after a person has been through a traumatic event, something deeply troubling or frightening (or just plain horrific).  It can be something they’ve seen, or heard, or had happen to them personally.  Their life was in danger, or the lives of others were at risk, or lost.  The patient feels he or she has no control over what’s going on.  And this can happen to anyone going through a life-endangering event, such as:

These events invariably leave their victims feeling scared, angry and confused.  The trouble starts when these feelings don’t go away or even get worse, eventually disrupting the lives of their sufferers.  This ongoing interference is an unmistakable sign of PTSD.

How does PTSD progress?  Someone with PTSD has endured a major traumatic event that made them fear for their lives, witness atrocities or horrible things, and feel utterly helpless.  These powerful emotions actually cause changes in the brain that may lead to PTSD.  Remember that nearly all of us who go through traumas experience these strong emotions at the beginning, but they fade with time.  There is no such fading in those who go on to develop PTSD.  No one knows for sure why most of us recover, while others do not.

How likely someone is to develop PTSD appears to depend on a variety of factors:

  • The intensity of the trauma, or how long it lasted
  • If the trauma sufferer lost someone close, or was injured
  • How close to the event the person was
  • How strong the reaction was to the original trauma
  • How much control over events the person undergoing the trauma felt
  • How much help and support was available after the event

While most people who do develop PTSD after an event eventually get better, about 1 in 3 PTSD victims continue to have symptoms for some time.  Treatment works, though, and will at the very least help those with lingering effects maintain their normal routines.  With good care and support, they can often return to work and enjoy family, friends and healthy relationships.

Tomorrow, we will review the major symptoms of PTSD and go over the resources available for help.  Along with traumatic brain injury, PTSDs will no doubt continue to dominate headlines and talk shows over the coming weeks as we all come to grips with the recent shootings in Afghanistan.  Nearly every one of us has – or knows someone with –  a son or daughter or husband or cousin or old school buddy in military service.  We owe it to all of them to understand some of what they go  through.  At the same time, while we offer our unlimited support and understanding, we must be clear about what really happened last week, and why.  Again, not everything that goes wrong in a combat setting is attributable simply to stress or other neat and simple answers.  Most of our soldiers are stressed, really, really stressed.  But most of our soldiers – stressed, exhausted, frightened, whatever – would never shoot sleeping civilian children.


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