Information on PTSD is endless. Entire books are written about it. But without first-hand experience, most people know little about it and may not recognize symptoms in others. Some suffering is visible, but sometimes it hides behind a facade to hide feelings of guilt, shame, and weakness. And people may suffer alone rather than seek help.
Causes: PTSD can result from a single life-threatening event, such as a car or plane crash, robbery, fire, physical attack, rape, etc, OR long lasting trauma, such as physical, mental, or sexual abuse, trauma during childhood, traumatic jobs, etc. Risk factors may involve a person's stress tolerance, biochemical changes in the brain and body, and a person having little or no support after the event.
Symptoms: Symptoms can run the gamut from mild to severe. NIMH suggests 3 types of symptoms: Re-experiencing in which the victim re-lives the trauma over and over through nightmares, flashbacks, and thoughts; Avoiding reminders of the event, feeling guilt, depression, numbness, losing interest in activities, not remembering some parts of the event, anything to avoid thinking about it; Hyper-arousal, feeling on edge, on guard, angry outbursts, fear, self-destructive thoughts. They want to run away, but there's nowhere to run. And with some, it can be torture.
PTSD from military combat can be particularly debilitating and even dangerous. When I worked with a Mental Health Team in the jail, I counseled a young Navy man who suffered severe PTSD symptoms. He had been on the ship's bridge in the Persian Gulf when he saw 2 missiles headed for his ship, but the alert was too late to save the ship, and many Navy men were killed. He began having PTSD symptoms and was assigned to help clean up the section where he and his buddies were housed, and he had to pick up their dead bodies from the flooded water. His symptoms increased, and on the way to the ship's U.S. home port city, he experienced severe trauma with frightening flashbacks, hyper-vigilance, nightmares, and hearing voices. He called his family in another state and told them not to meet his ship, because the city was teeming with dangerous terrorists. After reaching port, he had a psychotic break with voices telling him terrorists were near, and he was arrested for murder. While in jail awaiting trial, he saw a Psychiatrist multiple times, was in the state mental hospital twice, and attempted suicide 3 times, feeling he didn't deserve to live. He was discharged from the Navy, and in civil court was given life in prison without parole. A tragic story for all concerned, and this is not an isolated case. Too many similar situations do happen.
Treatment: Everyone is different, and a treatment that works for one may not work for another. But early intervention and support with psychotherapy, medication, or both are important for any good outcome. The U.S. Department of Defense and NIMH prefer Cognitive Behavioral Therapy involving safe Exposure to events, places, etc with tools such as mental imagery and writing; Cognitive Restructuring in a realistic way dealing with guilt, shame, etc; and Stress Inoculation Training to replace fearful, upsetting thoughts with positive, less distressing ones. But with all the intervention, some of the most important ingredients for healing are love, understanding, and compassion from family, friends, and even from people we don't know.
After my car wreck (Part 1) I was fortunate in the nursing home for 2 months of rehab where medication kept my anxiety in check, and a Psychologist helped relieve my fear. I also used coping skills I knew as a Psychotherapist myself. I'm a careful driver, but since that time 10 years ago, I've not driven at night, and at intersections where someone out of my view may be waiting to turn in front of me, my stress rises
. But that soon abates with self-talk and my angels on the hood of my car.
If you have PTSD, get help. If you know someone who has it, give love, understanding, and
compassion. And be happy.