Post-traumatic stress disorder (PTSD) is still often mistaken for a mental health condition that only affects military veterans or people who have lived in war zones. There is also a growing understanding that sexual and physical abuse can lead to PTSD. When that abuse is in childhood, victims can bury it deep within, and it can manifest as complex PTSD.
Often overlooked, it is all the other causes of PTSD can lead to many thousands of cases going undiagnosed and untreated. That means countless people suffer in silence without knowing why they struggle in their relationships, careers, and daily lives.
PTSD comes from trauma, but what is trauma?
The word trauma can cover a wide range of events and experiences, including single or sustained occurrences. It is a situation in which we feel frightened, stressed, or shocked, often related to feeling that you or someone else is in danger.
That is more common than you may realize. Experts believe that 60-70% of people experience a significant trauma in their lives.
Your likelihood increases according to your job role. Some careers will be more likely to put you in contact with traumatic situations, such as police officers and frontline healthcare staff. However, there are less apparent careers that leave you vulnerable to PTSD, too. The perfect example is train drivers. Statistically, they are likely to see at least one suicide during their career.
Whatever your job role, age, or social circumstances, you could one day face a traumatic situation. For example, being in or witnessing a road accident, witnessing a suicide (whether that is someone you know or not), sudden death, being in a fire or explosion, seeing or being the victim of a violent crime, and being bullied, harassed, or stalked.
Trauma response varies
The above is not a complete list, as one of the most problematic things about diagnosing PTSD is defining what constitutes a trauma with the potential to leave a lasting impression.
Much depends on what each person finds most unsettling and frightening!
For example, two people can see the same violent and distressing event, and only one of them could go on to develop serious mental health issues. That does not invalidate that person's PTSD and is not a sign they are the weaker of the two. Solid and resilient people can and do develop post-traumatic stress disorder.
PTSD and the human brain
Another of the abiding myths about PTSD is that it is something you can 'throw off' or move away from if you focus on positive things and don't dwell on the trauma you experienced. You can ignore it if you want to, but in many cases, sustainable recovery comes from tackling the changes that happened to your brain.
PTDS is not a superficial set of emotions and behaviors. It is a form of 'damage' that trauma can do to brain chemistry.
The part of the brain that deals with something frightening, shocking, and distressing is called the hippocampus, which is at the base of your brain and plays a crucial role in storing and retrieving memories.
Sometimes, a memory gets attached to feelings of intense fear or anger. When this is powerful or stressful enough, it can alter the hippocampus in some people, making it less active and less effective at sorting memories according to logical principles.
Imagine if this happens to you. Your emotions and responses are tangled and hard to process, and as a result, you misbehave or are out of proportion to the situation. You can't switch that off because someone told you to or you want to return to normal. You need help to 'rewire' and strengthen your memory associations and responses.
Global research is underway to understand this process better. If medical science were able to scan and measure hippocampus activity, it would be possible to predict PTSD and measure recovery.
That's not the only way PTSD can change your brain chemistry, either.
Our bodies have automatic responses to traumatic situations. We go into 'alarm mode,' producing hormones that trigger physical activities designed to protect us, like moving away from danger.
You may know the instincts known as "fight, flight, or freeze ." They don't need explanations of how they help us cope with perceived dangers. There is another one, too, which is 'fawn'. That is when you plead or bargain with someone or behave submissively and use flattery to alleviate them and diffuse the risk.
This instant alarm and response system saves our lives in some instances. Then, new hormones automatically switch us back to our usual composure and rational thinking.
However, trauma can trigger such an excessive 'alarm' response that switching it back off becomes a challenge. The person feels constantly alert and hypervigilant to risk and responds to even the mildest situations with an urge to run, hit out, shut down, or bargain.
When you consider the way trauma can alter brain chemistry, it is easy to see the root of many PTSD symptoms. For instance, people with post-traumatic stress disorder can become emotionally withdrawn as part of their 'freeze' instinct. They can also be quick to anger and 'lash out' as their 'fight' instinct switches on inappropriately.
Other ways PTSD manifests include poor sleep due to hypervigilance and a brain that's hard to 'switch off,' as well as flashbacks and nightmares as the hippocampus struggles to rationalize a trauma memory.
Other symptoms of PTSD include constantly feeling anxious, poor concentration, irritability, and a heightened sense of guilt.
Your behavior may seem illogical, too, as you avoid any triggers that remind you of the emotional impact of the trauma. That can mean even intense, joyous, pleasurable experiences may be too overwhelming, and avoiding social contact as much as possible becomes easier.
Is PTSD curable?
Though trauma affects different people in different ways, and individual experiences of PTSD can differ considerably, help is available to achieve sustainable recovery. What that help 'looks like' can also vary. Some people only need short-term therapy, while others require a package of help using a blend of treatments.
The most important thing is to accept that no one case of PTSD is more valid than another. If trauma has changed you, then please seek help as you deserve it.