In our society today, there are many factors that attribute to our mental health and how we cope with our day to day afflictions. For many, the simple task of coping can be extremely difficult because of past traumas and unfortunate experiences. The effects of these experiences can intensify and turn into something more serious that has a lasting influence. Post traumatic stress disorder or PTSD is one disorder that can be attained immediately, months, or even years later following a traumatic event. What are the causes and symptoms of PTSD? How can we prove the disorder really exists? And how do we treat it?
Symptoms of posttraumatic stress disorder overlap between those who have experienced military combat trauma and those who have experienced another sort of trauma. Other traumas could be rape, car accidents, or natural disasters, to name a few of the common ones. The main symptom is that the PTSD sufferer may have recurring memories or nightmares that feel life-like to them. If flashbacks occur regularly, it can affect the sufferer’s ability to function in society. Because of the problem’s flashbacks can bring in the moment, sufferers will begin to avoid situations that remind them of the event. The sufferer may also begin to have changes in beliefs and feelings. Their feelings and beliefs may become more negative. They may begin to distance themselves in relationships, and they may become less social.
Lastly, they may suffer from hyper arousal. They will constantly be stressed, tense up, or jittery. They may end up always looking for danger(ptsd.va.gov). While these symptoms hold true for all PTSD sufferers, how these symptoms manifest themselves can differ from case to case, especially between traumas. What are triggers for a rape victim are very different than the triggers for a military veteran. PTSD symptoms can also be shared with other disorders, such as sleep disorders.
One study directly compared the ability of veterans suffering from PTSD to individuals suffering with primary insomnia to see which group lacked the most sleep. According to that study, published in the Journal of Traumatic Stress (February 2015), “Comparing the two clinical groups, PTSD patients reported worse global sleep quality than PI patients on the PSQI.” The study implied that generally PTSD sufferers would most likely have worse sleep issues than those who suffered from primary insomnia. However, with certain comparisons in the sleep cycle the difference was insignificant. This possibly shows how the cause of an issue, changes the symptoms and their effects on the body. The causes for PTSD are obviously different from primary insomnia.
The causes of PTSD certainly are common between military and nonmilitary sufferers. However, the triggers will be different. According to Psychguides.com, Post-traumatic stress disorder is a mental health condition that is triggered when a person witnesses a psychologically traumatic event, such as war, a natural disaster, or any situation that invokes feelings of helplessness or intense fear. While most people eventually adjust to the after effects of these events, some people find their symptoms getting worse with time. These worsening symptoms are the product of PTSD.
It is important to note that most people experiencing these events will eventually cope and get better on their own, and it is rare that a person will get worse over time. There is uncertainty as to why one person begins to suffer from PTSD while another person does not. Doctors currently believe there are multiple factors at work. The list believed to be the most encompassing produced by the Mayo Clinic includes; inherited mental health risks, such as an increased risk of anxiety and depression; life experiences, including the amount and severity of trauma you’ve gone through since early childhood; inherited aspects of your personality, often called your temperament; and the way your brain regulates the chemicals and hormones your body releases in response to stress.
These risks are believed to be the difference between the individuals who experience the same or similar events and develop PTSD and those who do not. In relation to these causes there are different types of triggers. What are the different traumatic events that can cause PTSD to manifest itself in an individual?
Non-military triggers include: rape, natural disasters, car accidents, etc. These events can happen to thousands of individuals, but only a select few will suffer from long lasting nightmares and flashbacks.
Military triggers come from: being in battle, losing a close friend, almost dying, sustaining lasting injury, etc. While these events are more traumatic than what the average individual goes through, there has traditionally not been more Veterans suffering from PTSD than those who do not. However, PTSD can be faked. This has led to some questioning the legitimacy of PTSD. The rise in recent years among veterans has also led to more questioning.
As legitimacy is called into question, it is worthwhile to establish that military combat can most certainly lead to PTSD. Psychologists are unified in its existence, but there are some in the general population who have questioned it. When comparing two different triggers for PTSD side-by-side, it is likely that military-triggered PTSD is the harder one to recover from. In an interview with Sebastian Junger, Dr. Yehuda explains how a soldier is likely to have a harder time recovering than a rape victim.
Treating combat veterans is different from treating rape victims, because rape victims don’t have this idea that some aspects of their experience are worth retaining. For soldiers, it is the most important thing someone has ever done. Especially since these people are so young when they enlist, and it’s probably the first time they’re ever completely free of their societal constraints. They’re going to miss being established in this very important and defining world.
The similar symptoms between these two groups and the recovery rate shows us that PTSD is real. The problem that had arisen is the boost in soldiers claiming to have PTSD. As stated by Junger, “Part of the problem is bureaucratic: in an effort to speed up access to benefits, in 2010 the Veterans Administration declared that soldiers no longer have to cite a specific incident…in order to be eligible for disability compensation.” This has caused a rise in disability claims that have led to issues among veterans who truly need help seeking treatment. One question now is, is there a way to solve this issue?
One study that may give legitimacy to sufferers is a study led by Yuan Zhong that compared the resting state FMRI in PTSD sufferers who could cite a specific incident to non-PTSD sufferers. The study found that, “Compared with the controls, PTSD patients showed increased local coherence in bilateral amygdala, bilateral hippocampus, bilateral thalamus, and right putamen. Significantly decreased local coherence were shown in medial prefrontal cortex (mPFC) and left dorsolateral prefrontal cortex (dlPFC).” This shows that perhaps a gauge for treatment, and a way to know if an individual is suffering, is to see if they have any of these differences in the brain. This may even be a tool to demonstrate to an insurance company that a patient needs further treatment.
There are varying types of treatment that exist for those who suffer from PTSD. There are many types of therapies and some medication. Treatments range from medications, to cognitive behavioral therapy (CBT), to group therapy, to art therapy, to music therapy, etc. There are even more types of therapies, but for interest and clarity there are some highlights to be aware of. Each type of therapy has strengths and weaknesses. There are three basic types of treatment: medication based, interaction based, and creative based. Medications in PTSD treatments are generally not a long-term solution, but can help individuals in coping and dealing with immediate situations. Interaction based therapies include CBT, group therapy, and family therapy. Creative therapies include music, art, writing, and sometimes dramatizing. There is some overlap between interaction type therapy and creative therapy, but also some very distinguishing factors.
Medication is often prescribed for mental disorders even when effectiveness is low, or few studies have been done on the effects. This has to do with the desire for a quick remedy to problems. In a study conducted by Psychiatric Services (February 2013) they listed several medications that have been prescribed to PTSD patients that did not match the guidelines for PTSD treatment. They stated in 2009, among all veterans with PTSD who had continuous VA medication use, 65.7% were prescribed SSRI/SNRIs, and 70.2% of this prescribing was attributed to mental health care providers. Second-generation antipsychotics were prescribed for 25.6% of these veterans, and 80.2% of the prescribing was attributed to mental health care providers. Benzodiazepines were prescribed for 37.0% of the sample, and 68.8% of the prescribing was attributed to mental health care providers. While these medications are prescribed for PTSD sufferers, it is not the most effective for long lasting treatment. Medications should be used as a way of initially coping and helping the sufferers go through therapy that will lead to long-term results.
Interaction type therapies have very promising results when it comes to coping and recovery. However, if they are done incorrectly they can be detrimental. Under the category of interaction type therapies, it seems best to include: cognitive behavioral therapy, group therapy and family therapy. While there are other types of interaction therapy, these are the most prominent. CBT has been shown to be effective in the past. One study published by Applied Psychophysiology and Biofeedback (2015) tested CBT with added in breathing biofeedback. The hope was that through this feedback the patients, their stress might be reduced when reliving trauma and that they might be able to engage with the therapist more easily. The results in the previous study showed that the biofeedback set up was not distracting to the patient.
Also, the patients in the biofeedback were better at attending and following through on assignments than the control group. For comparison, the control group that was going through traditional CBT only had one patient not attend one session. This shows that CBT can still be effective without the feedback, just perhaps not as effective.
Creative therapies have been used in treatment of PTSD for a many years now. Creative therapies include art, music, drama, poetry, and dance. The focus this section will take will be on music therapy, but it is important to know about the other options. Different patients with different backgrounds and skills may feel more comfortable or more able to communicate using other means. In a chapter on creative therapies written by Johnson PhD., Lahad MD., and Gray PhD., they spoke of the struggle with traumatized people being able to express themselves. They stated, “The inability to put feelings into words appears to be relatively common in patients with PTSD. Presumably, … nonverbal/behavioral forms of the creative arts are a more welcoming means of expression.” The problem with creative therapies, which they would later address, is the lack of experimental research in relation to PTSD. All creative therapies are under researched and therefore are not established.
PTSD is filled with issues. The high comorbidity rates can make it difficult to treat. The fact that it can be faked and the strong suspicions that it has been faked has only led to further issues for those who truly suffer. Treatment options are available and those who suffer can achieve a level of normalcy, if not achieve complete recovery, but more research is needed. Research into alternative types of therapies are needed so that more people will be able to recover from these unfortunate events using a wider variety of beneficial and effective treatment options.
