What You Need to Know About PTSD

Posttraumatic stress disorder (PTSD) has been part of our vernacular since 1980, when it was added to the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme.[1] Now, more than 40 years later, the incidence of PTSD continues to grow, resulting in some sobering statistics:

• Seven to eight percent of all Americans will have PTSD at some point.
• In a given year, some 8 million U.S. adults have PTSD.
• PTSD affects women more often than men, with 10 percent of American women diagnosed sometime during their lives, versus 4 percent of men [2].
• With higher PTSD rates for particular types of trauma experienced by children and teens, 3 to 15 percent of girls and 1 to 6 percent of boys develop PTSD.
• The incidence of PTSD is 11 to 20 percent in veterans who served in Operations Iraqi Freedom and Enduring Freedom, 12 percent in Gulf War (Desert Storm) veterans, and an estimated 30 percent in Vietnam veterans.[3]

Before looking at the ways in which PTSD is being better understood and treated, it is important to know the science behind the diagnosis and the best ways to identify it quickly.

Trauma Biologically Changes the Brain

The brain and body change when exposed to any kind of trauma, such as combat, accidents, natural disasters, domestic violence, sexual assault, child abuse, and even global pandemics. Neuroscientist and physician Paul MacLean described our brain in a three-part model:

• Reptilian (brain stem): Survival instincts and autonomic body processes occur in this innermost part of the brain.
• Mammalian (midbrain): Emotions are processed and sensory relays are conveyed here.
• Neomammalian (forebrain): Cognitive processing, decision-making, learning, memory, and inhibitory functions are controlled in this highest evolved area.

When we experience trauma, the reptilian part of our brain kicks in, making the body react. The hormones produced cause us to fight, run away or stop dead in our tracks. Normally, when the threat is gone, the brain returns to its restorative mode. It becomes responsive and in control. But one-fifth of trauma survivors develop PTSD symptoms because their brains never leave the reactive mode.[4]

Recognize PTSD Symptoms, in Yourself or Others

During World War I, PTSD was known as “shell shock,” and was called “combat fatigue” after World War II. But as we know now, combat veterans are not the only people who develop PTSD. It is found in people of any age or race, in any country or culture.[5] Celebrities such as Ariana Grande, Lady Gaga, Whoopi Goldberg, Monica Lewinsky, Shia LaBeouf, Charlize Theron, Gabrielle Union, and Reese Witherspoon have discussed the traumas they have experienced and how they live with and treat their PTSD.[6]

Many people undergo trauma and never develop PTSD; others who do have it do not need psychiatric treatment, as their symptoms ease and eventually disappear. What are the primary symptoms of PTSD? The American Psychiatric Association places them into four categories:

• Intrusion which includes repeated flashbacks, upsetting dreams, and involuntary memories.
• Avoidance of triggers to painful memories of certain people, places, activities, objects and situations, or discussions of the traumatic event.
• Alterations in cognition and mood such as negative thoughts and feelings, and distorted perceptions about what caused the event, along with fear, horror, anger, guilt, or shame.
• Alterations in arousal and reactivity like irritability, reckless or self-destructive behavior, angry outbursts, suspiciousness, and sleep or concentration problems.

Disruptive indicators must last at least a month to become a PTSD diagnosis. Many people do not develop symptoms right away, and some can experience them for months or even years.[7] This is why it is essential for anyone who has experienced trauma to self-monitor and share any signs of illness with healthcare providers, family, and friends.

Treatment Is Making a Difference, but Each Patient Is Unique

Professional treatment is the first step towards successfully coping with diagnosed posttraumatic stress disorder. Find someone who is experienced in helping people who have faced trauma. Talk therapy and cognitive behavioral therapy are often cited as options, as are certain medications. Alcohol and drug misuse are not appropriate in coping with the often overwhelming feelings generated by PTSD. There are much healthier alternatives to lessen the intensity or frequency of anxiety:

Post-Traumatic Stress Disorder Essential Reads

Taming the Amygdala in PTSD

What Happens In the Brain During PTSD?

• Deep breathing
• Progressive muscle relaxation
• Mindfulness
• Self-monitoring
• Social support
• Self-soothing
• Expressive writing
• Distraction
• Behavioral activation [8]

The ways in which PTSD alters the brain can be reversed by reprogramming the mind and body. Those treatments include hypnosis, neuro-linguistic programming, somatic experiencing, tension, and trauma releasing exercises, and other body-centric techniques. People diagnosed with PTSD may reduce the effects of the disorder and even eliminate the symptoms when they seek treatment and stick to what works for them.[9]

One form of PTSD treatment showing great promise is MDMA-assisted therapy. Also called Molly or ecstasy, MDMA is a psychoactive drug that stimulates energizing brain chemicals. The hormones released as a result of the MDMA can increase empathy, self-awareness, sensory pleasure, energy, the ability to open up about emotions, and the perceptions of spatial and temporal differences. During two or three MDMA-assisted therapy sessions within 12 weeks, psychotherapists help patients recall and resolve painful events. In one study, 67 percent of those reporting no longer met the criteria for PTSD one year after completing MDMA-assisted therapy.[10]

Somatic therapist Peter A. Levine, Ph.D., said, “Trauma is a fact of life. It does not, however, have to be a life sentence.” May we commit to communicating that message of hope to all who are touched by PTSD.

To find a therapist, please visit the Psychology Today Therapy Directory.