Table of Contents
Hundreds of millions of people around the world suffer from post-traumatic stress syndrome (PTSD) after they have been exposed to death or the threat of death. In the States and in many other countries, PTSD is most commonly associated with war, but it also can occur in someone who survived an armed robbery, in someone who has been raped, in the survivors of an industrial accident or a car crash, or in the survivors of a devastating earthquake, or in someone who went into remission after being told to expect death from cancer, among many other scenarios.
There are a variety of ways PTSD can come about:
- Directly experiencing a traumatic event, being the person who was threatened.
- Being present in person as other people are threatened.
- Learning that the traumatic event occurred to a family member or friend.
- Repeated first-hand exposure to the details of the traumatic event.
People with PTSD re-experience the event in flashbacks, in dreams, in obsessive thoughts, in dreams, illusions, delusions, hallucinations, or in intense reactions to things that remind them of the event. They then "deal with" their trauma by at least two of the following:
- Inability to remember the traumatic event.
- Persistent and exaggerated negative beliefs about themselves, others, or the world.
- Persistently negative emotions.
- Feelings of isolation or estrangement from others.
- Persistent inability to express positive emotions.
- Loss of interest in or failure to participate in important activities.
These ongoing negative feelings are accompanied by at least two changes in behavior:
- Angry outbursts.
- Hypervigilance, being always on the alert for a new traumatic event.
- Problems concentrating.
- Easily startled.
- Reckless behavior.
These behaviors last more than a month, cause their own distress, and are not due to a medical condition.
Although Americans tend to think of PTSD as something that occurs to soldiers who participated in wars, whole populations can experience PTSD where wars have been fought. About 18.5 percent of soldiers who served in Iraq or Afghanistan have PTSD (which means about 81.5 percent do not), but about 10 percent of the population who have not been in war suffer the condition. About 4 percent of boys and 6 percent of girls have experienced personal traumas that cause lasting psychological symptoms by the age of 18 in the United States. Many countries have higher rates of PTSD.
Some people are at higher risk for PTSD than others. Soldiers have an unusually high rate of the disease not just because of the horrors of war, but also because of the frequent concurrence of brain injuries. The war-related traumatic spectrum disorders encompass both emotional and physical causes of PTSD. The condition is also more common in people who have problems with opioid medications and in people who have insomnia even before the traumatic event. PTSD not caused by war is about twice as common in women as in men.
PTSD is persistent. About 1/3 of people who have it never recover. Without treatment, it takes on average 64 months, a little over 5 years, to regain normal emotional functioning. With treatment, it still takes about 3 years. Fortunately there are many medical and non-medical treatments for PTSD that help. None of these methods is completely curative all by itself, but each can help, sometimes substantially.