Trauma Disorders & PTSD

Throughout life, extremely stressful and frightening experiences happen to us all. If we are taught to respond to anxiety, fear, and stress with compassion and an educated mindset, and if those around us react in healthy ways, we are more likely to retain our own helpful coping mechanisms later in life.

There are extreme instances, however, when stress and anxiety happen so rapidly and violently that we may become vulnerable to traumatic anxiety symptoms. In this section, we'll learn how to define trauma and look at its effect on anxiety through the lens of PTSD.

Definition/Exploration
Post-Traumatic Stress Disorder (PTSD) is an anxiety condition defined by "severe, persistent emotional reaction[s] to a traumatic event that severely impairs one's life." The major example most people think of is a soldier returning from war who experiences combat flashbacks. He or she reacts with extreme horror or fear to memories of their experience or to triggering sensory cues. Active experiences during combat certainly have affected, and will continue to affect veterans. But PTSD is an anxiety disorder with a larger canvas of influence.

Before continuing, it's helpful to define exactly what trauma is and how it is related to anxiety. Trauma is any strong negative emotional response to tragic, scary, or violent events. These events can be performed directly to a person, happening to someone else the person cares about, or could arise after witnessing a tragic/violent event happen to total strangers. Any number of life experiences are capable of producing trauma, including:

• Life-threatening events
• Violence, lived or witnessed
• Natural disasters
• Sexual abuse
• Accidents/Unexpected deaths

Vitally, not everyone who experiences a traumatic event develops some form of PTSD. Equally vital is to be aware that traumatic events, whether on a large or personal scale, can happen to anyone at any age. 60% of women and 50% of men will experience at least 1 traumatic life event, though 20% of women develop PTSD symptoms overall. 5% of adolescents meet PTSD diagnosis criteria, and a staggering 60% of children in foster care suffer PTSD as a result of sexual mistreatment or abuse. It's estimated that 20% of soldiers who have served in Iraq experience PTSD. Domestically (U.S.), nearly 20% of women report a traumatic sexual experience, and 50% of all rape victims, male or female, are at serious risk for developing PTSD. Worldwide, nearly 260 million people have experienced PTSD in the previous year.

Clearly, trauma and PTSD are global conditions. But why is PTSD an anxiety disorder?

Symptoms
People living with PTSD have not only experienced highly stress- and anxiety-inducing scenarios, but they continually re-experience these feelings in multiple ways. To be diagnosed with PTSD, a person has to meet certain criteria for 3 months or longer:

1. A person has to have personally experienced or witnessed a traumatic event

2. A person's reaction to the event is either with horror or intense fear, although children may act "disorganized"

3. The traumatic event serves as a triggering event. Unlike GAD or many instances of Panic Disorder, PTSD is directly related to a specific traumatic event. These events are generally outside everyday stress and anxiety typically experiences. They can be instantaneous (an accident) or prolonged (war, sexual abuse)

From this point in symptomatology, without intervention or healthy coping, a person's thoughts and behaviors significantly alter. The three main symptoms of PTSD are:

• Re-experiencing – A person relives their traumatic experience through thoughts, feeling, dreams, images, flashbacks, or, in the case of many children, continually reenacting the event through play
• Avoidance – A person may seek to completely avoid people, places, or sensory details that remind them (trigger them) of the event. Many may seem dazed or distant and often actively suppress details of their trauma
• Increased Arousal - PTSD sufferers become "jumpy" or "edgy," vigilant about their surroundings, and may experience insomnia and changes in mood (anger, irritability, or depression). Like many other anxiety disorders, experiencing PTSD also increases the risk of developing other anxiety disorders or negative coping habits such as drug or substance abuse.

At this time, the causes of PTSD are thought to be very dynamic. There are of course the triggering events themselves and genetic predispositions toward anxiety to consider, but researchers have also made exciting headway in uncovering the brain structures and genes responsible for creating fear memories. These advances, coupled with advances in behavioral extinction research, are paving the way for potential drug treatments to relieve PTSD sufferers of their condition.

For now, the best interventions for helping PTSD patients are Psychotherapy (discussed here) and medication (here). Preventive and resilience factors, as well as healthy coping habits, are also encouraged.

Case Study
Here is a very personal example of how PTSD has affected someone's life--a prison security guard who was beaten by several inmates:

"Over the next few months he experienced a significant number of flashbacks to the incident, feeling the force of the blows to him and experiencing the fear of dying. Many occurred at night, while in bed. Every flashback was terrifying, and in the hour following them he had to get out of bed and try and watch television or read a book to help him calm down. He regularly had two or more flashbacks per night. As a consequence he became increasingly exhausted. In addition, he spent much of the day mulling over the causes and consequence of the attack. He would spend many hours ('A day may disappear') looking out of a house window dwelling on the attack..."