Post Traumatic Stress Disorder, Part 1: What Does It Really Mean?
Post Traumatic Stress Disorder has been in the news with great frequency as of late. We're told that up to 30% of the soldiers who return from Iraq and Afghanistan experience it. We're also told that the recent mass murders by a psychiatrist at a Fort Hood military base may have been in part due to his repeated exposure to the stories recounted to him by soldiers and that he may have suffered from vicarious trauma. There has been a great deal written and said about PTSD. However, at the end of the day, is it simply an unusually stressful experience that makes you very upset for a long while? Although there is some truth to this, what the stressful situation is and what being "very upset" looks like is much more specific and requires the experience of a qualified professional to recognize.
There are many stressful situations in the course of a day that we all deal with in various ways. These experiences are a normal part of living. The stressors that result in a Post Traumatic Stress Disorder are unusual because of their intensity and the fact that the person affected typically fears for their life. Experiences that qualify as extremely stressful could include witnessing a killing, being raped, badly beaten or mugged, or being in a potentially deadly car or plane accident. These experiences are clearly not the same as losing your job or being late to a meeting because your car will not start.
There are also many different ways that people handle their daily stressors. Some deal with them through physical activity, others by talking to a trusted person and still others by smoking cigarettes, or taking drugs and alcohol. The intensity and fear associated with a traumatic stressor means that the affected person finds themselves taking extraordinary measures, both physically and psychologically, to help them deal with their experience. Traumatic experiences are too difficult to absorb in the same way we process our daily stress. People with PTSD find that In order to absorb these more problematic experiences, a combination of both re-experiencing the traumatic event and avoiding it ensues. For example, a child that was sexually molested may have undesired dreams or mental flashbacks about the events and, at the same time, actively avoid going back to the scene where the events transpired and forget some of the more difficult aspects of the experience.
Therefore, following a traumatic experience, many people begin a cycle of re-experiencing and avoiding the details of what they went through. In addition, people with PTSD tend to become more highly agitated or aroused so that they may have difficulty sleeping, and are more easily angered, or distractible. They may also be on the look out for danger, and be hypervigilant, and easily startled.
The simplified definition detailed above, while containing a kernel of truth, does not truly describe this complex phenomenon. PTSD involves a fearful, life-threatening experience that is so difficult to absorb that the body and mind need to take it in gradually over time in a dual process that involves both re-experiencing and avoidance. Agitation, sleeplessness, anger, distractibility and heightened arousal may also be involved.
Visit Family Anatomy tomorrow as Dr. Brian and I interview William Krill, author of Gentling: A Practical Guide to Treating PTSD in Abused Children.
Note: Posts on Family Anatomy are for education only. If you need to talk to someone about family or mental health issues, you can get a referral from your family doctor.