Can Long-Term Bullying Lead To Post-Traumatic Stress Disorder (PTSD)?

Bullying, and especially long-term bullying, can have far-reaching mental and physical consequences.

Children who become victims of bullying have a higher risk of depression, anxiety, self-harm, and suicidal feelings or attempts as well being more prone to physical ailments like common colds, headaches, stomach aches, and poor sleep.

As they grow up, people who were bullied in childhood are still more likely to be depressed, anxious, suicidal and to have psychotic experiences — but what's more, they earn less than their peers, take longer to recover from illness, and tend to have less robust social support networks. Research has even found that former victims of bullying have higher levels of inflammation in their bodies, chronically. 

Bullying is all sorts of bad news — but can it cause post-traumatic stress disorder?

What is bullying, and what qualifies as a trauma?

Bullies can use direct tools like punching, kicking, blackmailing, threatening, and stealing their victims' belongings, or constantly ridiculing and name-calling. They can also turn to less direct methods like ignoring or socially excluding the person or group of people they're picking on. 

Victims are often powerless to escape the bullying on their own because, as one paper points out, "bullying occurs in settings where individuals do not have a say concerning the group they want to be in", like schools and even workplaces. 

The first diagnostic criterion someone has to meet to be able to get a diagnosis of post-traumatic stress disorder is exposure to trauma. The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) defines trauma as "actual or threatened death, serious injury, or sexual violence". While it's true that bullying sometimes involves all of those things, it doesn't always. Prolonged social isolation and emotional rather than physical abuse have also been shown to leave a deeply detrimental psychological mark, but the DSM-5 doesn't account for this. 

One study defined trauma differently — as an "an inescapably stressful event that overwhelms people's existing coping mechanisms". That, I think we can all agree, describes the experience of chronic bullying very well. 

Can bullying cause PTSD?

In short, yes. Quite a few studies into the topic have found that bullying can cause PTSD symptoms. 

One study found that nearly 28 percent of eighth- and ninth-grade boys who were bullied at school met the diagnostic criteria for post-traumatic stress disorder — or rather would, if bullying were to be considered a traumatic stressor — along with around 40 percent of girls. What's more, another study that looked into PTSD symptoms among adults who were victims of workplace bullying found that 44 percent had high levels of symptoms also seen in post-traumatic stress disorder. 

A meta-analysis of studies examining whether bullying can lead to PTSD, meanwhile, found that 57 percent of victims had above-threshold symptoms — a rather high percentage when you consider that a relatively low 7.8 percent of the general US population develops post-traumatic stress disorder at any point during their lives. 

We know that being "different" in some way makes people more likely to become a target for bullies. That would include physical characteristics like being overweight or wearing glasses, ethnic or racial differences, being depressed or anxious, or having an intellectual or neurological disability. This, unfortunately, means that it's very possible for a person to be bullied in more than one setting simultaneously — and not having a safe place to escape to might contribute to a high risk of PTSD. 

What's more, research has found that children who are abused or neglected within their families are more likely to become victims of bullying, too. In those circumstances, a child would be exposed to multiple sources of trauma at the same time, in turn contributing to their odds of developing post-traumatic stress disorder. 

Healing from bullying: What help is available?

People who suffer from post-traumatic stress disorder will experience symptoms like:

• Intrusive and distressing memories of the trauma, flashbacks, or physical and emotional distress when reminded of a traumatic experience. 
• Doing their best to avoid any reminders of the trauma, whether by staying away from people, places, or circumstances somehow connected to it, or by trying to avoid thinking about it. 
• Cognitive changes such as memory gaps relating to the trauma, persistent negative feelings about self or others, chronic anger or fear, unrealistic self-blame and guilt, feeling detached from other people, and being unable to experience positive emotions. 
• Changes in the way they react to the environment, like always being on the alert for danger, an exaggerated startle response, poor sleep, and angry or irritable outbursts. 

If you have been bullied, you may recognize a lot of these symptoms in yourself — and if you're the parent of a bullying victim, your child may be plagued by PTSD symptoms. Know that, whether or not bullying leads to a formal diagnosis of post-traumatic stress disorder, help is available. The same therapeutic approaches that help people who are diagnosed with post-traumatic stress disorder, including cognitive behavioral therapy and psychodynamic therapy, can help those who lived through a traumatic event that isn't currently recognized as such.