What is Post Traumatic Stress Disorder (PTSD)?
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CONTENT WARNING: I would like to mention that I am not a medical doctor, psychologist, psychiatrist, or therapist and I am sharing this content for educational purposes only. Social media should never be used as substitute for mental nor medical health care. If you suspect that you or any loved ones are experiencing mental health concerns, it is okay to get help, and I highly recommend seeking help from a medical doctor, psychologist, psychiatrist, and/or therapist who is qualified to do so.
Post-Traumatic Stress Disorder (PTSD) is a mental illness that can develop in individuals after they have experienced an upsetting, "shocking, scary, or dangerous event" (NIMH 2023). While many traumatic experiences are life-threatening, trauma is not always life-threatening; trauma is any negative event that causes a person to experience emotional distress. According to the National Center for PTSD, "about six out of every 100 people will experience PTSD at some point in their lives" (NIMH 2023). Everyone experiences at least one type of trauma in their lifetime and not everyone who experiences trauma will develop PTSD.
Some types of traumas that commonly result in PTSD include:
- Child abuse/neglect
- Sexual assault
- Domestic abuse (also known as intimate partner violence and family abuse)
- Bullying
- Stalking
- School shootings
- War
- Military service
- Terrorism
- Refugee trauma
- Automobile accidents
- Natural disasters, such as hurricanes, tsunamis, earthquakes, tornadoes, etc.
- Fires
- Drug/alcohol/smoking addiction
- Medical trauma, such as diagnoses of life-threatening illnesses and/or misdiagnoses
- Having a loved one with an anxiety disorder, behavioral disorder, and/or addiction
- Death of loved ones
- Any experience that causes a person to fear that one's own life or a loved one(s)' life is in danger
- Witnessing any type of trauma
- Other shocking, unexpected, or terrifying experiences that cause emotional distress
Each individual experiences trauma and PTSD differently. Each individual's severity of symptoms and overall development of PTSD depends on the details of their traumatic experience and quality of each trauma survivor/warrior's social-emotional support system. To elaborate more, if a survivor/warrior does not have an effective support system at home in the aftermath of trauma, they are more at risk for developing PTSD and this lack of support can worsen their symptoms. As for survivors/warriors who have a positive support system at home and elsewhere such as in their school life, workplace life, community, and/or therapy, they are most likely to be resilient and come a long way in their healing journeys while they can still develop PTSD of all ranges.
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Symptoms:
Individuals with PTSD tend to experience their symptoms immediately during the aftermath of their traumatic experience. Some individuals also do not start experiencing their symptoms until one or many years later. PTSD can affect people's learning and lives in numerous ways.
Many of the symptoms of people with PTSD include but are not limited to:
- General anxiety symptoms
- Depression
- Severe feelings of sadness, fear, shame, and/or embarrassment about discussing their traumatic experience(s)
- Feeling grouchy or easily angered
- Feelings of loneliness
- Panic attacks
- Difficulty with self-regulation skills
- Constant bad flashbacks
- Nightmares about the traumatic experience(s)
- Avoiding talking, thinking, and having feelings about what happened
- Avoiding people, places, and things that cause them to remember what happened
- Hypervigilance
- Attentional difficulties
- Disassociation
- Short-term memory (STM) loss, especially being unable to remember "important aspects of the trauma" (pg. 3, Cohen 2010)
- Repetitive intrusive thoughts
- Suicidal thoughts
- Feelings of self-blame also known as survivor's guilt
- Lack of self-expression about emotions
- Socially isolating oneself
- Difficulty with social skills
- Loss of interest in activities and anything that they enjoyed before what happened
- Lack of motivation
- Fight, flight, freeze, or fawn trauma responses
- Fatigue
- Regression in skills, especially "toileting and speech" (pg. 3, Cohen 2010)
- Difficulty with functional life skills
- Thoughts of denial about experiencing trauma (Note: This is also common in parents of trauma survivors/warriors due to lack of awareness of their child's trauma and PTSD along with sometimes being the narcissistic perpetrator.)
- Challenging behaviors, especially oppositional defiance and hyperactivity
- Lack of mental and physical self-care
Diagnosis Criteria:
Just like any other diagnosis, individuals are required to share honest experiences of a certain number of specific symptoms in order to meet the criteria to be diagnosed with PTSD. PTSD is one of the few psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition Text Revision (DSM-V-TR) that "requires the presence of a known" cause that led to the development of that disability with that being "a traumatic event that precedes the development of the disorder" (pg. 2, Cohen 2010). While avoidance of describing one's traumatic experiences due to triggers is a symptom of PTSD, the survivor/warrior with signs of PTSD describing their trauma is always required as part of the diagnosis process. Diagnoses of PTSD cannot be made otherwise even if there are present alternative symptoms associated with PTSD. Survivors/warriors must report or have strong evidence of a traumatic experience and specific symptoms of traumatization from their trauma in order to receive an official diagnosis of PTSD. For example, some individuals may be able to provide a forensic evaluation or police report confirming that they experienced their trauma. They may be able to provide a doctor's note stating their diagnosis of a life-threatening illness, such as cancer, that traumatized them.
PTSD cannot be diagnosed in individuals until after they have continued to experience symptoms for over one month. Alternative diagnoses during this time period may include Acute Stress Disorder, Adjustment Disorder, or confirmation of experiencing symptoms that overlap in PTSD and other disabilities that the individual may have received previous official diagnoses of. Acute PTSD is diagnosed in individuals whose symptoms are present during the first month and less than three months in the aftermath of their trauma. PTSD tends to be misdiagnosed as ADHD, Autism/Autism Spectrum Disorder (ASD), and Bipolar Disorder due to their strong overlap of symptoms. This is especially due to the similarity between PTSD flashbacks and ADHD, Autism/ASD, and Bipolar Disorder rumination also known as fixation. Besides PTSD, there is also Complex Post-Traumatic Stress Disorder (C-PTSD), which is "disorders of extreme stress not otherwise specified or developmental trauma disorder" (pg. 2, Cohen 2010). To elaborate more, C-PTSD develops due to prolonged trauma (such as many years of child abuse) or multiple traumatic experiences in one's lifetime. There are many controversial opinions about the overall existence of C-PTSD or whether it is the equivalent of chronic PTSD. While people with ADHD, Autism/ASD, Bipolar Disorder, and many other disabilities tend to be at risk for experiencing trauma and PTSD, they can also experience mental health struggles unrelated to their traumatization. In addition, there are many people who struggle with symptoms associated with PTSD without having PTSD.
There are many different types of assessment tools that psychologists use to diagnose PTSD. The selected assessment tools vary based on the age of the individual being evaluated. This is especially true when it comes to diagnosing children versus adults with PTSD. Psychologists will use many different types of official questionnaires for the individual and a certain number of loved ones to fill out. Child behavior checklists, trauma symptom checklists, and observation records may also be filled out along with conducting interviews and school-based screenings. Psychologists may also assign children to use a fear-thermometer to self-express their emotions about their trauma. Fear-thermometers are "developmentally appropriate visual analogs such as gradated depictions of fearful to happy faces to rate symptom severity and interference with functioning" (pg. 6 Cohen 2010). Developmentally appropriate language based off of the DSM-V-TR criteria must be used in assessment questions of children with PTSD.
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New modern-day trauma-informed care practices recommend that psychologists and healthcare professionals ask all clients about exposure to trauma even if their referral is made for another diagnosis. Clients and patients should be screened for PTSD symptoms if any exposure to trauma is confirmed. Once psychologists and healthcare professionals are made aware that the client has experienced trauma, it is important for them to "ask them to provide adequate details about the start of, frequency, and duration" of symptoms to be convincing (pg. 6, Cohen 2010).
It is important for psychologists to diagnose PTSD and individuals with PTSD to get help as early as possible due to how severe this mental health condition is.
Risks:
Childhood PTSD commonly results in various major health and wellness concerns in the adulthood of individuals diagnosed with the disability. Experiencing trauma at any age can cause several major mental and physical health concerns in survivors/warriors as well.
People in the PTSD community are at risk for the following:
- Diagnoses of additional disabilities especially conduct disorder, depression, and/or anxiety disorders
- Developing autoimmune diseases
- Difficulty falling or staying asleep also known as insomnia
- Drug/alcohol/smoking addiction
- Self-harm
- Psychiatric hospitalizations
- Suicide
- Difficulty with building and maintaining relationships
- "Lower academic achievement" (Note: This is most common in childhood PTSD and students with PTSD are at-risk for dropping out of school.) (pg. 3, Cohen 2010)
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Treatment:
While people with PTSD have their struggles, there is always hope for healing as long as they try. It is okay to get help and there are many different evidence-based interventions for providing treatment to the PTSD community.
Trauma-informed care and education practices should be used by teachers at all times regardless of whether they know for sure if any of their students have PTSD and/or have experienced trauma. It is important for teachers and everyone to avoid biased assumptions about who has and has not experienced trauma. Mental health struggles are not always visible and not everyone feels comfortable opening up about their negative experiences. Some people may also not be aware that they and/or their child has PTSD and/or have experienced trauma due to an innocent lack of education about the topic and/or their child being too insecure to self-advocate. As the saying goes, "Everyone is going through a rough battle that you know nothing about. So always be kind." For that matter, it is important for teachers and mental health professionals to educate families about trauma as much as possible. It is also important for families to consult with the child's educators for support as much as they can. In order to support children in the aftermath of trauma, educators and families can provide as much positive attention, continuous praise, and reassurance as possible. They should also utilize Social-Emotional Learning (SEL) lessons and have a routine in order to provide predictability along with avoiding using time out as a consequence for negative behaviors. Emotional Support classrooms are also a common educational placement for students with social-emotional needs. Students may benefit from attending Emotional Support classrooms in addition to their General Education classes during their school days.
Many people with PTSD tend to attend many different types of therapies to receive support during their healing journeys. The most common therapies used by the PTSD community include but are not limited to Cognitive-Behavioral Therapy (CBT), Eye Movement Desensitization Therapy (EMDR), Dialectical Behavioral Therapy (DBT), family therapy, and group therapy sessions in and outside of schools. Therapists usually encourage their clients to use deep breathing techniques and mindfulness meditation to decrease their "physiological" struggles of "traumatic stress" (pg. 9, Cohen 2010). In addition, therapists and clients will work on positive self-talk, thought interruption, and positive imagery along with potentially improving safety, problem-solving, and social skills. They can recommend self-care strategies as well.
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Besides trauma-informed care and education practices and therapies, people with PTSD tend to seek treatment from psychiatrists, other medical and mental health professionals, and primary care physicians. It is common for clients with PTSD to be prescribed to taking antidepressant medications called "selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI)" (National Center for PTSD 2023). According to the National Center for PTSD, the four most common SSRI medications recommended to treat PTSD include Zoloft (aka Sertraline), Prozac (aka Fluoxetine), Paxil (Paroxetine), and Effexor (Venlafaxine). Overall, no matter what interventions people with PTSD seek for help, it is important for them to focus on their symptom improvement in order to gain resiliency and continue to function and make progress in life.
Celebrities with PTSD:
- Oprah Winfrey (former talk show host on The Oprah Winfrey Show, television producer, author)
- Brittany Sinitch (teacher social media influencer aka Five Foot One Teacher, survivor of the Marjory Stoneman Douglas High School shooting)
- Whoopi Goldberg (American actress, talk show host on The View)
- Ariana Grande (pop singer, songwriter)
- Shia LeBeouf (American actor)
- Lady Gaga (pop singer)
- Abraham Lincoln (sixteen United States President)
- Kelsea Ballerina (country singer)
- Mick Jagger (lead singer of the rock band called The Rolling Stones)
If you are interested in learning more about how trauma affects the mind, brain, and body, here is a book recommendation below:
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma written by Bessel van der Kolk
[Image Description: "Always remember that if you have been diagnosed with PTSD, it is not a sign of weakness; rather it is proof of your strength because you have survived." in left-aligned white marker font. My "FIRST FORMER BUDDY CLUB PRESIDENT" logo is in the bottom right corner of the image. The background of the image has a light, medium, and dark gray smoky appearance.]
If you are affected by Post Traumatic Stress Disorder (PTSD), remember that you are not alone and there is hope. If you or someone you know needs support right now, call the National Suicide Prevention Lifeline at 988 or text "HOME" to the Crisis Text Line at 741741. If deaf and hard of hearing, call 988 Videophone [for American Sign Language (ASL) users], dial 711 then 988, or send any message to 988. All of these hotlines are available 24/7 in the United States and Canada.
You can also visit The Mighty's suicide prevention resources page by clicking on this link: https://themighty.com/suicide-prevention-resources/.
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Citations
1. Avila, R. (16 March 2016). PTSD Quotes, HealthyPlace. Retrieved on 2023, July 30 from https://www.healthyplace.com/insight/quotes/ptsd-quotes2. Cohen, J.A., Issues, T. W. G. O. Q., & AACAP Work Group on Quality Issues. (2010). Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49(4), 414-430. https://www.jaacap.org/article/S0890-8567(10)00082-1/pdf
3. National Institute of Mental Health. (May 2023). Post-Traumatic Stress Disorder. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
(N.d.). PTSD TREATMENT DECISION AID: THE CHOICE IS YOURS: SSRI/SNRI. https://www.ptsd.va.gov/apps/decisionaid/resources/PTSDDecisionAidSSRI.pdf
(N.d.). PTSD TREATMENT DECISION AID: THE CHOICE IS YOURS: SSRI/SNRI. https://www.ptsd.va.gov/apps/decisionaid/resources/PTSDDecisionAidSSRI.pdf
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