PTSD has likely existed as long as humanity itself, but our words and treatments for this medical disorder have varied tremendously over time. At no other time have psychologists and researchers understood the psychological and physiological effects of truama, and have developed evidence-based treatments to help you resolve this difficult and wrenching condition.
A (very) Brief History of PTSD and Trauma
French psychology pioneer Pierre Janet, who coined the words dissociation and subconscious was the first researcher to see a connection between events in a subject’s past life and his or her present-day trauma back at the turn of the last century. Sigmund Freud, who often worked with young women who were likely victims of incest and rape, and were called “hysteric”, developed treatments that involved the patient delving in to their primary relationships and combing their memories for traumatic events to uncover the connection between the current “hysteria” and the past. After WWI returning soldiers were said to have shell shock or hysterical trauma. Terms shifted after WW2 and later 20th century conflicts: “battle fatigue” or having “soldier’s heart”. Later, when rape was again recognized as a deeply traumatizing event, it was called “rape trauma syndrome”. Earlier, not very effective treatments for PTSD have included: exposure therapy, sodium pentathol, hypnosis, massage and “fresh air”, and psychoanalysis. Some of these treatments were marginally effective to ineffective, and with the case of treatments that required the patient to talk about their experience, further traumatizing.
According to the US Department of Veteran Affairs, PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. Physiologically speaking, your autonomic nervous system (which encompasses your sympathetic (fight/flight/freeze) and parasympathetic (rest/digest) nervous system responses and includes the vagus nerve complex) is stuck in the “on” position – in a heightened state of arousal. Not only is this a difficult and unpleasant state to live in, there are serious health implications from being in a heightened state. Conditions like diabetes, heart disease, arthritis and chronic pain in addition to substance abuse can all be triggered when PTSD is left untreated.
Pioneers in the field of Trauma have helped us understand that Trauma is an Injury and PTSD is a medical condition Read more about these pioneers: Sandra Bloom, MD - Sanctuary Model Bessel van der Kolk, MD - Neurobiology of Trauma Peter A. Levine, MD - Somatic Experiencing Stephen Porges - Polyvagal Theory
Traumatic Events don’t always result in PTSD
In the wake of an upsetting event, it’s totally normal to have disrupted sleep, to feel on edge, and to shy away from normal activities. But if it persists, you may have developed PTSD. If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time. What makes one person develop PTSD and another not? There is some indication that previous exposure to trauma predisposes you to developing PTSD. It is thought that if you experience traumatic stress as a child, you may be more prone to PTSD. The ACES (Adverse Childhood Events Study), a landmark study that identifies health risks associated with exposure to traumatic stress in childhood.
10 Signs that you may have PTSD
- You witnessed or experienced a traumatic event (like a shooting, car accident, sexual assault, violent assault)
- You experience flashbacks – reliving the event, or having intrusive unwanted memories of the event suddenly enter your awareness. These flashbacks are usually triggered by something in your current environment that reminds you of the trauma.
- You have nightmares about the traumatic event. Sometimes the nightmares are vivid re-experiencing of the horror you witnessed or experienced, sometimes they are highly abstracted, but carry the emotional weight and charge of the traumatic event.
- Avoiding people, places or things that remind you or trigger your flashbacks. Not going to a grocery store because you were robbed there, avoiding an intersection because you were t-boned there years before, dropping out of college following a sexual assault on campus would all be examples.
- Being hypervigilant, or on high alert for dangers. Scanning your environment for possible danger is another sign that your autonomic nervous system is in overdrive, searching constantly for new potential threats.
- Getting startled easily, or hyperarousal, is another sign you may have PTSD. Images of soldiers sent into a flashback when hearing fireworks is a classic illustration of hyperarousal, but it can be more subtle, like jumping when someone accidentally touches your arm. Panicky feelings may also be present.
- Depression or irritability is often a sign of PTSD. For too long, doctors have looked at depression as a stand alone issue. More and more physicians are beginning to understand that depression often results from a traumatic event. It is very hard to adjust to life after these events, and especially in the case of sexual assault, you may feel isolated and very alone.
- Chronic pain. Neck pain, headaches, recurrent muscle pulls, or more serious conditions like fybromyalgia and chronic fatigue. After the injuries heal, pain may yet persist. Researchers don’t know exactly why, but they think that pain and trauma signals may share the same neural pathways.
- Emotional detachment or isolation is also a feature of PTSD. Pushing loved ones away, perhaps thinking you are protecting them, or just feeling a sense of alienation is common. Or seeking out social groups with those who get your experience and distancing from other communities.
- Experiencing some or all of these feelings for more than a month after a traumatic experience? First let me say that there is no shame in that. It is only information. You may have PTSD and do not hesitate to seek out medical treatment.