Five Fundamental Truths about PTSD

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Guest post by Harry Croft M.D., and Rev. Dr. Chrys Parker

As American servicemen and women return home from war, it’s estimated that one out of five will suffer from Post-Traumatic Stress Disorder (PTSD). As these war heroes integrate back into civilian life, it becomes likely that virtually everyone in our society will have dealings, or a relationship, with someone who has PTSD. It is therefore more important than ever that our society understand PTSD, free of myths and misconceptions about this condition.

Here are five truths that EVERYONE should be aware of when it comes to PTSD:

Truth #1:  PTSD, like diabetes, cancer and heart disease, affects millions of people

PTSD is often perceived as a condition experienced by male combat soldiers. In truth, it is not confined to males, to the combat experience or even to soldiers. Some research indicates that up to 50% of the American population has sustained at least one traumatic experience in their life, and up to 20% of the population at large may experience symptoms of traumatic stress and/or PTSD. Of these, the single largest affected population is female – predominantly victims of rape and sexual assault (which affects approximately one out of every 2.5 females in this country). Other sufferers include victims of crime, natural disasters, domestic violence, physical and verbal abuse, traumatic accidents, vehicle crashes, burns and a host of other life-threatening incidents.

Truth #2: PTSD does not make you crazy

PTSD is a disorder of anxiety. It is NOT a personality disorder, or a psychotic disorder. Not only does PTSD not make you crazy, it does not make you “irrational” nor does it destroy your underlying competence as a human being. Something that often makes people feel “crazy” occurs when their PTSD-related symptoms appear to come out of “nowhere.” This “coming out of nowhere” may be the way the illness feels, but it is not actually the way the illness works.

PTSD always comes from somewhere. In fact, PTSD symptoms are produced by intense, unregulated stress reactions that originate deep in the unconscious center of our brain. A traumatic event may originate or occur at one point in time, which may be months or years before the stress reaction to that event is later “re-triggered” at an unanticipated time or place.

The “not knowing” when the old stress reaction will be re-triggered leaves people feeling out of control. This “out of control” feeling is really what makes people feel crazy, when they are really not. The fact that PTSD symptoms may arise long after a traumatic event is also something that does not make sense to people, and therefore makes them wonder if they are “crazy.”  But these delayed reactions do not make a person crazy.  It is not true that PTSD must develop within 3 months of an event. That is a serious misunderstanding that many people hear and mistakenly believe. Many people suffer from what is known as “late onset PTSD”.

Truth #3:  PTSD is a real medical disorder that has a biological basis

It is true that, to some extent, our society has gone too far in its efforts to assign a biological cause for everything that ails mankind. In the case of PTSD, however, exactly the opposite happened. The biological was ignored. As a result, millions of PTSD sufferers have had to live with shame about their “bad behavior” and never knew that, in fact, they actually have a bona fide medical illness. PTSD is not just “in their heads.” PTSD has a primary biological root, which leads to secondary behavioral side effects.  Most people are only familiar with PTSD “behaviors”, and are not familiar with the absolutely real medical processes that cause these behaviors in the first place.

Truth #4:  There are three major symptom categories in PTSD

1.  Re-experiencing of traumatic episodes:  Traumatic episodes are life threatening, and therefore take precedence over almost everything else in order of importance. Your brain watches and replays the event over, and over, and over, trying to “figure it all out,” so as to protect you better the next time.

2.   Avoidance of feelings, people and situations:   PTSD sufferers tend to avoid situations that could bring on their symptoms. If a father avoids his son’s little league game, for example, it’s not that he doesn’t want to be involved in his son’s life, but perhaps a helicopter could fly over that could create feelings of terror or endangerment. In other words, the father is avoiding triggers that are present in the child’s vicinity.  Being closely involved with friends, loved ones, and spouses can sometimes bring on PTSD symptoms.  For this reasons, many PTSD sufferers “disengage” with people and avoid them by hiding out.

3.    Symptoms of increased arousal:  This may involve sleeplessness or sleep disorder;   razor-sharp awareness of sights, sounds and smells; ultra-fast reactions including super-startle response and reflex-responses which occur before the person can actually stop and think about them. Anger, irritability and an explosive temper that flares for little or no apparent reason is also symptoms of increased arousal.

Truth #5:  PTSD Symptoms Can Usually Be Managed

The belief that all PTSD sufferers are stuck with their symptoms for life is false. Most can be managed with proper care and case planning. How easy or difficult this process is will be affected by several factors, including the life circumstances of the patient, their personal commitment to managing the illness and whether they suffer from another co-occurring illness which complicates their condition (alcohol or drug dependency, bipolar disorder, major depressive disorder, etc.). Generally speaking, however, there are a number of ways that symptoms can be managed or, over time, eliminated.

Although psychiatry is one type of care for PTSD, there are in fact many types of care that can contribute to effective PTSD management, including management of some physical symptoms by primary care providers.

Harry Croft M.D. is a former Army doctor and a psychiatrist who has evaluated more than 7,000 veterans diagnosed with PTSD.  Rev. Dr. Chrys Parker is a clinical chaplain and psychotherapist specializing in trauma, and is a consultant and advanced instructor for the military. Croft and Parker are co-authors of the book I Always Sit With My Back To The Wall:  Managing Traumatic Stress and Combat PTSD Through The R-E-C-O-V-E-R Approach for Warriors and Families.


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