

Emotional Health: PTSD affects more than just victims of war

By Anna Zernone Giorgi/HealthyLife

Illustration: CSA- Archive/GettyImages.

Illustration: CSA- Archive/GettyImages.

Imagine experiencing a traumatic event so disturbing that it alters the way you think, the way you relate to others, and the way you live. Imagine that, as you’re trying to find peace somewhere in this new reality, you’re debilitated by recurring thoughts and reminders of the horrific event that you’re trying to forget. And, imagine that those memories are so constant that they invade your dreams, so even sleep isn’t an escape. If you can picture yourself there, then you can try to imagine the struggle of coping with post-traumatic stress disorder (PTSD).

PTSD is an anxiety disorder that can occur in some people after they experience or witness a traumatic event, which typically involved physical harm or the threat of it. While many associate PTSD with war, anyone who has been a victim of a traumatic event, or has witnessed a traumatic event as it happened to a loved one or even strangers. Its victims are people of all ages, even children.

“Trauma can take a variety of forms. It can be combat exposure, but it also can be a terrorist attack, a physical or sexual assault, a serious accident, a natural disaster, or childhood sexual or physical abuse,” says Amanda Kras, Ph.D., a clinical psychologist at the PTSD clinic at the Albany Stratton VA Medical Center.

It’s likely that more than half the U.S. population will experience a traumatic event at some time. The National Center for PTSD, U.S. Department of Veterans Affairs, which works to promote research and education on the disorder, reports that approximately 60 percent of men and 50 percent of women in the general population will experience at least one trauma in their lifetimes.

Not everyone who experiences a trauma, however, will develop PTSD. Between 7 and 8 percent of U.S. adults are likely to develop PTSD at least once in their lifetimes, according to the National Comorbidity Survey, a groundbreaking nationally representative mental health survey completed in 1992. The risk is about twice as high for women compared to men. About 10 percent of women are likely to develop PTSD at least once, compared to a 5 percent risk of PTSD for men. The subsequent 2005 National Comorbidity Survey-Replication study estimated that PTSD affects about 7.7 million U.S. adults annually.

Getting Lost

The reasons that some people develop PTSD while others do not aren’t easy to predict, since every individual experiences events uniquely. “It’s based on how that person perceived the event, how the person felt in the environment, and whether their internal state of safety was at risk,”says Lauren Fury, a clinical social worker and therapist in Albany.

While it’s difficult to predict who will develop PTSD, certain risk factors can make you more prone to the disorder if you have a traumatic experience. “If an individual has already experienced a [previous] traumatic event, it can make them more susceptible to getting a PTSD diagnosis. Other risk factors are: if they had prolonged exposure to violence and to a threat of their own safety in their environment in general, whether that be at home or in a community; or if they already have a mental illness such as depression, low self-esteem, or anxiety,” Fury says. “Other considerations are whether internally, they have the ability to cope; and externally, do they have family support or do they have friends who are supportive? What other community networks do they have? Do they have a group as a social support?”

Whether or not a traumatic experience leads to a PTSD response isn’t always immediately apparent. “It’s really common for folks to have stress reactions immediately after going through a traumatic experience. Most people do. You might notice things like anxiety or trouble sleeping, feelings of anger or sadness, bad memories or dreams of the traumatic events that took place — all of those would be very common for most people right after they experienced something traumatic. Oftentimes, those kinds of symptoms will diminish over time for people,” Kras says. “It’s really when those persist and, or if they’re interfering significantly with someone’s life, that he or she may have PTSD and might benefit from more evaluation and potential treatment.”

While the specific symptoms of PTSD can differ from one individual to another, certain types of behaviors typically occur in adults. “T.R.A.P. is a useful acronym to describe the symptoms of PTSD,” says Gretchen Wilber, Psy.D., a clinical psychologist at the PTSD clinic at the Albany Stratton VA Medical Center.

T stands for the traumatic event that occurred. R is for re-experiencing symptoms, which are bad memories, traumatic dreams, or flashbacks. The A stands for avoidance, which can include avoidance of other people, avoidance of their emotions, avoidance of stimuli connected to trauma. P stands for physiological arousal or hyperarousal. “Many people will experience an exaggerated internal response, an increase in things like heart rate and blood pressure when they are exposed to trauma cues,” she says. “There is also a general sense of hypervigilance or being on guard. These symptoms need to occur for 30 days or more before an individual can be diagnosed with PTSD.”

The difference between a typical reaction to a traumatic event and a diagnosis of PTSD is in the duration of the symptoms and their impact on your daily life. “In order to meet the criteria for most psychiatric conditions, including PTSD, it has to have interfered with an individual’s ability to take part in meaningful activities in their life, which could be school, work, or social relationships. Many people might exhibit some of the symptoms, but it may or may not necessarily interfere with their life,” Wilber says.

As the symptoms persist, people with PTSD can experience more anxiety as they struggle to cope with maintaining a normal life. “At first, most people will usually have what’s called, ‘a normal reaction to an abnormal situation.’ However, ongoing hyperarousal, hypervigilance, and flashbacks can make you unable to do your day-to-day activities. Having obtrusive thoughts or memories of the event can result in poor concentration and an inability to focus. You keep going back to the event in your mind, which is what makes it difficult to concentrate,” Fury says.

The symptoms of PTSD in children can differ depending on the type of event that occurred and the age of the child. “For children, when it comes to sexual abuse and maltreatment, domestic violence, and things of that nature, they tend to sometimes withdraw from their normal personalities. Maybe they were more extroverted and become more introverted. When it comes to something like molestation, maybe they don’t want to be with a particular person, and they throw up a fight every time they see a person when before, it wasn’t a problem,” Fury says. “Children also may act it out in their play. They may be more sexualized or have more sexual knowledge than their age, or what’s appropriate for their age, or what they’ve been taught or learned. They also may act it out in other ways such as angry outbursts or sudden bedwetting or defecating in their pants.”

Finding A Way Out

Photo:Carmen MartA-nez BanAs/GettyImages.

Photo:Carmen MartA-nez BanAs/GettyImages.

If you suspect you may have symptoms of PTSD, it’s important to consult with a mental health professional to confirm a diagnosis so that you can pursue effective treatment. “Healing from trauma is different for different people, but it is something that’s very possible. The distress that accompanies PTSD and the ways that PTSD can limit and restrict a person’s life, they don’t have to go on indefinitely; there really is help,” Kras says.

Treatment for PTSD often involves psychotherapy or counseling. It also may include medication in conjunction with counseling. The medications often prescribed to treat PTSD are a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which include sertraline (Zoloft) and paroxetine (Paxil). For some patients, medication can be an effective way to control symptoms such as anger, worry, and sadness, allowing them to fully participate in psychotherapy.

Treatment can vary depending on the symptoms present and individual needs. Psychotherapy or “talk” therapy can be an effective option. “Cognitive processing therapy and prolonged exposure therapy are both examples of cognitive behavioral therapies that have a lot of research supporting their effectiveness in reducing the symptoms and the distress of PTSD,” Kras says. “These therapies, broadly speaking, help individuals with PTSD learn about PTSD and begin to address the factors that maintain some of the problems that they’re having. Those with PTSD are able to learn new ways of dealing with their symptoms and they have an opportunity to emotionally process and work on making meaning of their experiences. All of that promotes healing.”

Eye movement desensitization and reprocessing (EMDR) is another type of therapy that can be effective for treating PTSD, according to the National Center for PTSD. Like cognitive processing therapy and prolonged exposure therapy, EMDR can help people change how they think about memories of the traumatic experience. As they think or talk about their experience, a therapist helps them focus on other stimuli such as eye movements or sounds.

The length of prescribed treatment also is an individual issue. PTSD may be accompanied by diagnoses such as depression, other anxiety disorders, or other mental health issues. “There is likely to be some variation regarding what treatment looks like from person to person. Cognitive processing therapy and prolonged exposure therapy are both designed to be time-limited treatment options. Both of those are designed to be about three to four months of intensive work on the PTSD, but it’s not uncommon for individuals to come in and also have other things that they may need to address in treatment as well, so the overall treatment package might look somewhat different from person to person,” Kras says.

Treatment for substance abuse also may be necessary. “After a long period of time, they start to isolate because they don’t feel that the outside world is a safe place for them; that’s when depression really sets in and then it becomes anxiety and depression. After that is when you see people really start to self-medicate, especially to lessen the anxiety so that they can try to feel somewhat normal. Or, sometimes they use it as a way to escape,” Fury says.

Sharing thoughts and feelings about PTSD with others who have similar experiences also can be therapeutic. “Groups are really important for trauma survivors. It’s really an amazing thing because you get to express yourself openly in safe place and with people who have experienced things similar to you. You get to share, but you also get a social support that sometimes people don’t come home to,” says Fury, who facilitates a women’s trauma support group and a support group for non-offending parents of children who have been physically or sexually abused.

Having the support of spouses, family and friends also can be critical to the healing process of PTSD. The National Center for PTSD at is an excellent resource for family, friends, employers who want to learn about the disorder.

“It can be very helpful for those people to learn as much as they can about the disorder so that they can understand better what the individual with PTSD is going through. Other things they can do are: go to doctors’ visits, help them to keep track of medication and therapy appointments, and just generally be there and be supportive, telling a loved one that you want to listen and that you understand if he or she doesn’t feel like talking about it,” Wilber says.

By becoming involved in the treatment process and understanding how the individual is affected, spouses and family members can avoid blaming the victim for the situation. “Offer them validation for their feelings. A lot of times, people do not validate their feelings and unintentionally blame the victim, but you don’t want to blame. It’s not the victim’s fault. They’re dealing with a normal reaction to an abnormal situation, where their faculties were not able to respond in a way that maybe they felt they should have. But, they need to remember that they did what they needed to do to survive,” Fury says. “Just giving people time to really heal is important. It takes time; it’s not something that happens overnight. They can get back to a normal life, but they need the support.”

Could You Have PTSD?
If you’ve experienced or witnessed a traumatic event, you may have PTSD. If you think you or a loved one may be dealing with PTSD, compare your symptoms against the behaviors that The National Center for PTSD says are the most common. A Trauma Symptom Checklist is available at
Consult your healthcare or mental health provider if you’re experiencing any of the following symptoms:

  • re-experiencing or reliving the event
  • avoiding thoughts, feelings, or other reminders of the event
  • feeling detached or disinterested in others after the event
  • physical symptoms, such as headaches or gastrointestinal problems, or emotional symptoms, such as anxiety or depression, that began after the event
Tony Pallone