What is PTSD
- Post-traumatic stress disorder (PTSD) is a severe form of anxiety disorder that binds psychological and physical symptoms from the experience or witnessing of a traumatic event. PTSD can permanently change the individual’s perception of the world and affect their day-to-day and social life. A person can be in a continual state of alertness, fear, and anxiety or sudden symptoms can be triggered even if there is no sign of danger. PTSD can occur in people exposed to a traumatic event such as a natural disaster, a serious accident, a terrorist act, war, rape, and those who have been threatened with death, sexual violence, or serious injury.
- PTSD is complicated and individualistic. Two people can go through the same traumatic event but only one might develop PTSD1. Some may develop PTSD from a highly intense event, while others can develop equally serious PTSD from less stressful situations. PTSD reflects the very sophisticated nature of human emotional and psychological makeup – cultural background, childhood, gender, genetic predisposition, personal experience, etc. affect an individual’s perception of any event, and consequently, if and how they develop PTSD symptoms2.
Symptoms of PTSD
- Most PTSD symptoms significantly change an individual’s life and day-to-day routine, but symptoms can fluctuate. Long periods of low-level symptoms can be followed by periods of intense symptoms. Others may have constantly high-level symptoms. Symptoms may develop shortly after a traumatic event, after several months or several years3.
- Intrusion Symptoms: The memory of a traumatic event can remain permanently embedded. External stimuli can trigger uncontrolled re-appearance of the memory as reality (intrusion). The individual becomes panicked, with a strong desire to escape the stimuli. Nightmares and flashbacks (dissociative reactions) can resemble the traumatic event. Flashbacks are unintentional, involuntary, may be very intense, and usually relive the worst moment of the trauma (known as “hotspots”). If aware of certain triggers (for example sounds or images), a person may try to continually avoid them, which affects the quality of their daily life4.
- Avoidance Behavior. An individual will avoid places, areas, items, and even sounds that remind them of their past trauma5. It can become hard to participate in social events, make new friends, and sustain old relationships. Living a normal social life can become impossible6. The subconscious tends to build “a wall” of behavioral patterns to avoid the frightening re-experience of trauma. A person may become abnormally suspicious, irritable, or angry towards other people5.
- Hyperarousal Symptoms. These include anger and angry outbursts, anxiety, hypervigilance, problems concentrating, difficulty falling asleep, careless and irresponsible behavior, and exaggerated responses to unexpected stimuli. The individual is always on high alert and the world and people appear as harmful and dangerous. The person can have decreased interest in participating in activities, feel separated from others, and lose the ability to feel positive emotions7.
- Physical Symptoms: Many patients tend to report physical health problems more often than mental health issues. Poor physical health might be related to PTSD causing abnormal biochemical and neurohormonal changes which change the brain’s structure and can reduce resistance to cardiovascular and other diseases. This can also produce immunologic disorders and cause chronic pain8. Misdiagnosed and untreated PTSD consequently can lead to significant health complications.
PTSD, Depression and Suicide
- Studies show 80% of PTSD victims have some kind of substance use disorder and over 90% have some level of depression and/or anxiety9. About half of those diagnosed with PTSD are also diagnosed with major depressive disorder. PTSD is linked with a higher-than-average incidence of suicide attempts. When accompanied by other mental ailments, like depression, the risk of suicidal behavior increases10. The rate of actual suicide is associated with easier access to weapons, such as guns and knives.
Peacekeepers, Veterans and Their Loved Ones
- A study of PTSD and depression in US soldiers deployed into Iraq and Afghanistan found 44% had significant levels of PTSD and/or depression. The study also found that being divorced or separated was a risk factor for these soldiers to develop PTSD whereas being single lessened that risk11.
- A Dutch study found a strong connection between peacekeepers who have PTSD and their loved ones developing secondary symptoms of PTSD. The most common secondary symptoms were sleep disturbances and somatic symptoms (where excessive concern about physical symptoms causes anxiety, distress, and disruption in daily life). The study concluded this is mainly due to how tiring and over-taxing it is to care for loved ones with PTSD, as well as how detrimental PTSD symptoms are to daily life. All peacekeepers in this study were male, however, the link appears regardless of gender and all those suffering from either primary or secondary PTSD should be given proper support12.
Consequences of Untreated PTSD
- The causes, symptoms, and stigma of PTSD are complex and individualized thus many patients remain undiagnosed and untreated. When untreated there is an increased risk of symptoms regularly reappearing and worsening, with an individual’s life severely affected for years, or a lifetime. Isolation from society is extremely common leading to an inability to continue at work or school, self-harming behavior, and suicide. Untreated PTSD has also been linked with unrest in families, relationships, marital and sexual problems, and divorce13. Prolonged and untreated PTSD often results in substance abuse problems with individuals attempting to self-medicate their symptoms and recovery can prove extremely difficult when PTSD symptoms are left untreated.
- Since untreated PTSD is so widespread and causes such debilitating problems, it is important to understand the symptoms, the risks of leaving it untreated and to identify reasons why an individual’s PTSD is left untreated, whether due to feelings of guilt, fear of stigma, lack of knowledge, lack of resources, inadequate treatment or other causes.
There is Hope, There Is Help
Based on randomized controlled trials, and case reports, ketamine has shown a near-complete resolution of PTSD symptoms over the short term. These clinical improvements are immediate and typically last a minimum of 1–2 weeks after a single treatment.
References: 1The National Institute of Mental Health 2016. 2Psychology Today 2015. 3National Health Service 2015. 4Hirsch et al 2007. 5NATAL 2017. 6Levin et al. 2014. 7DSM-V 2013. 8 U.S. Department of Veterans Affairs 2016. 9Karni, Tsachi, & Zahava 2010. 10Panagioti & Gooding 2009. 11Lapierre, Schwegler, & LaBauve 2007. 12Dirkzwager, Bramsen, Ader, & van der Ploeg 2005. 13Vitzthum, Mache, Joachim, Quarcoo, & Groneberg 2009.