How does PTSD develop?
Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.
The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events).
How common is PTSD?
An estimated 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.
About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high as 8 percent.
Who is most likely to develop PTSD?
1. Those who experience greater stressor magnitude and intensity, unpredictability, uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and betrayal
2. Those with prior vulnerability factors such as genetics, early age of onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events
3. Those who report greater perceived threat or danger, suffering, upset, terror, and horror or fear
4. Those with a social environment that produces shame, guilt, stigmatization, or self-hatred
What Causes PTSD?
As the name implies, PTSD is caused by trauma. During war, taking part in and/or witnessing the brutal and violent acts of battle. However, PTSD can also be brought on by non-combat acts of brutality or violence toward combatants or civilians. There are many PTSD vets who have never been aggressive towards others, but who may suffer feelings of profound guilt by mere association with such acts of violence. In any case, PTSD is clearly triggered by violence in warfare.
What are the Signs and Symptoms of PTSD?
Re-experiencing traumatic events (obsessive recollections, flashbacks or intrusive thoughts, nightmares), avoidant symptoms (fear of being with people), signs of hyper arousal (easily startled, irritable), avoiding experiences or people that trigger memories of such event(s), increased arousal, to include nervousness, over-reaction to sudden noises, difficulty sleeping (night sweats), and nightmares, bouts of rage and/or depression, difficulty relating emotionally to others, feelings of extreme alienation and meaninglessness, isolation from others, in extreme cases, persistent thoughts of murder and-or suicide. Symptoms can take months or even years to develop.
What Do I Do If I Think I Have PTSD?
PTSD is difficult to recognize, because soldiers are socialized to believe that admitting to feeling bad is weak and that seeking professional help is often viewed negatively and discouraged by the Chain of Command. The best thing you can do is get yourself the care you deserve and improve your quality of life even if there is “peer pressure” not to. Seek out help from a trained mental health professional. You can do this on your installation or through the VA if you are not on active duty. If you are diagnosed, you should immediately call 1-800-827-1000, and ask to be connected to the Veterans Administration Regional Office. Once connected, ask for instructions on how to apply for services related to PTSD. Do NOT take no for an answer. Depending on the VA facility, or individual VA employee, you may be discouraged from filing a claim. Even if they tell you that you are not entitled, demand the application paperwork and file it.
How is PTSD treated?
PTSD is treated by a variety of forms of psychotherapy (talk therapy) and drug therapy. There is no definitive treatment, but some treatments appear to be quite promising, especially cognitive-behavioral therapy, group therapy, and exposure therapy. Exposure therapy involves having the patient repeatedly relive the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Prozac and Zoloft. At present, cognitive-behavioral therapy appears to be somewhat more effective than drug therapy. However, it would be premature to conclude that drug therapy is less effective overall since drug trials for PTSD are at a very early stage. Drug therapy appears to be highly effective for some individuals and is helpful for many more. In addition, the recent findings on the biological changes associated with PTSD have spurred new research into drugs that target these biological changes.