PTSD Awareness Month: What is PTSD? What help is available?
June is PTSD Awareness month. The term “PTSD” often gets used in casual conversation, like this:
· “I have PTSD from taking my toddlers to the grocery store!”
· “I have PTSD from that work project!”
· “Driving in Birmingham traffic gives me PTSD!”
· “Watching that stressful Alabama-Auburn game gave me PTSD!”
But what does PTSD really mean? To break it down, PTSD stands for Post-Traumatic Stress Disorder. This diagnosis only occurs after someone has been exposed to a traumatic experience, such as threatened death, serious injury, or sexual assault. Witnessing someone’s else’s actual or threatened death can also result in PTSD, as can repeated exposure to trauma details (such as a journalist reporting on war or a social worker hearing details of child abuse). Some examples of traumatic events include combat, natural disasters like tornadoes or hurricanes, man-made disasters like bombings, childhood abuse, intimate partner violence, and serious accidents. Estimates indicate that about 70% of American adults have experienced some type of traumatic event at least once in their lives.
Humans have noted PTSD symptoms for centuries–you may have heard of veterans of previous generations having “shell shock” or “battle fatigue.” My grandmother shared that her cousin was never the same after his return to Lineville, Alabama from World War II. She didn’t see him that much, as he often would not come to family gatherings, but his parents reported that he would fight and scream in his sleep, saying things like “They are coming for us!” Treatment wasn’t widely available or well-understood at that time, and he turned to alcohol to numb his symptoms. Sadly, he fell into a creek while drunk and drowned about 8 years after his return home to Alabama from war.
Post-Traumatic Stress Disorder was initially named as a diagnosis by the American Psychiatric Association in 1980, and our understanding of both the pattern of symptoms and the most effective methods of treatment has grown exponentially since then.
Most Americans will experience at least one traumatic event during their lives, but thankfully, the majority will not go on to develop PTSD. About 6 percent of Americans will suffer from PTSD at some point in their lives.
If someone has been exposed to a traumatic event, they may then be diagnosed with PTSD if they have symptoms in the following clusters:
· Re-experiencing symptoms
· Avoidance symptoms
· Arousal and Reactivity symptoms
· Cognition and Mood symptoms
Let’s work through these symptom clusters with a trauma event that is all-too-common in Alabama–a severe tornado. It is normal and appropriate to be terrified and deeply affected immediately after a traumatic experience, and it is normal to retain some longer-term caution after surviving an event such as a deadly tornado. My husband and I definitely re-thought our safety plan after living through the April 27, 2011 tornado in Birmingham, although our experience was much less severe than that people in other parts of Alabama: Tuscaloosa, Hackleberg, Phil Campbell, Rainesville, and other parts of Birmingham such as Pratt City and McDonald Chapel. However, perhaps your fear goes beyond simple preparations for future storms. Maybe you can’t enjoy activities with your family because memories of the storm keep intruding. Your sleep might be disrupted by nightmares of the storm. You may avoid activities that remind you of the storm, such as things you were doing that day. Maybe you start having some wine every night to dull frightening memories. Maybe it’s not even obvious that you are trying to avoid memories–maybe you work nonstop and are more productive than ever! You may be unable to sleep because you are staying up to monitor the weather every night. Understandably you probably find yourself feeling a little more irritable and angry given that you are on edge and on alert for bad weather all the time. Other people may comment on how jumpy you are when you hear a siren. You may believe the world is no longer a safe place or that you can’t trust yourself to keep your family safe. Maybe being in crowded or closed-in spaces, like Walmart or a church service, is now intolerable for you and you find yourself avoiding these spaces. You may feel sad and overwhelmed.
Most people will experience at least some of these symptoms soon after a trauma, but many will improve on their own in those early weeks. There are some factors that make you more likely to develop PTSD, such as past trauma, lack of social support, and being injured during the event. However, if your symptoms have lasted at least a month and are causing distress and impairment in your daily life, it’s time to seek an appropriate diagnosis and treatment from an experienced clinician.
The most helpful treatments for PTSD involve working on the trauma memories directly. This is challenging, and we consider it an honor to sit with clients through these difficult moments. It’s certainly tempting to push those trauma memories away instead. But consider this example. I recently told my children to go clean their rooms. After 5 minutes their rooms appeared clean, but I was suspicious. It turns out they had simply shoved dirty clothes, toys, and empty candy wrappers under their beds and into their closets. This clean-up strategy worked temporarily, but a toy fell on my foot when I opened a closet, smells from dirty clothes wafted into the bedroom, and candy wrappers would eventually attract bugs. It might be harder at first, but actually taking the time to put toys in their proper place, throw away trash, and wash dirty laundry is worth it in the long run. Treating PTSD is the same way.
Thankfully, in the decades since PTSD was identified as a diagnosis, we have a growing body of research on how to help people recover. Upward therapists are trained in the gold-standard treatments for PTSD–Cognitive Processing Therapy and Prolonged Exposure Therapy. If the symptoms in this post are resonating with you, we would consider it a privilege to discuss the best plan of care to help you embrace your life again.