PTSD — Am I at Risk?

Post-traumatic stress disorder (PTSD) results from experiencing or witnessing a terrifying event. Symptoms may include flashbacks, nightmares, anxiety attacks, and uncontrollable thoughts about the event. Depending on the severity of the event – falling off your bicycle and spraining your wrist would be less traumatic than being robbed at gunpoint – most people who experience trauma have only temporary difficulty; with time and good coping strategies, they usually get through it OK. Psychologists estimate that less than 10% of the population develops severe PTSD symptoms following even a harsh traumatic experience. In other words, most people handle the stress pretty well. But what about that 10%?

People who have a history of psychiatric disorders are more prone to PTSD. Also, experiencing childhood trauma leaves one vulnerable to PTSD following adult trauma, especially when the two traumas are similar – such as, being bitten by a dog as a child, and then again as an adult. Just as physical injuries leave the body vulnerable to later injury, so, too, do early psychological scars leave one vulnerable to later stress.

Some people have oversensitive nervous systems. They respond more intensely to loud noises, pain, and unexpected events, and are more prone to uneasiness and discomfort in new and strange environments. This biological make-up makes them more vulnerable to PTSD.

PTSD is also more likely among those who have lived a relatively sheltered, stress-free life, and who believe adversity and danger primarily affects others, not them. They have been indulged, and are ill-prepared for effective cognitive processing of trauma. If a trauma occurs, they react with denial – “This is not happening!” – or catastrophic thinking – “My world has ended!” Parents who go out of their way to indulge their kids and protect them from hardship and disappointment are actually engaging in a subtle form of emotional child abuse, and making their kids more vulnerable to PTSD.

Not surprisingly, people who feel isolated and lonely are more vulnerable to PTSD than those who have an extensive and supportive social network. When people are supported and helped by friends and family, they are better able to process trauma and avoid PTSD.

Those who have training about what to do when faced with trauma fare better after experiencing trauma. Soldiers undergo extensive training before they are sent into combat; school children have evacuation drills in case of fire or other emergency; some women take courses in self-defense to prepare themselves in case of personal attack. Such preparation can provide a sense of control over the unexpected, and equip people to deal with trauma more effectively.

The bottom line? PTSD is not inevitable following a frightening experience. That’s important to remember because being anxious over the possibility of developing PTSD can add to stress levels and complicate even mild symptoms after trauma. Talk about a self-fulling prophecy! “What’s the matter, Ann?” She replies, “Serving on that jury was really stressful. I’m scared to death I’m going to develop PTSD!” Ann is vulnerable to PTSD because she’s afraid she will develop PTSD!

Some other useful things to consider: When dealing with PTSD, remember that what works for someone else may not work for you – and that’s OK. Give yourself some time to process a traumatic event. You may need several days – or even a week or two – to adapt psychologically to what has occurred, and that’s OK. Premature discussions with counselors during that processing time might be ineffective, and may even worsen the impact of the original trauma.

In a supportive context with open sharing of thoughts and feelings, it’s usually helpful to talk with others who have experienced the same or similar traumas. Talking to yourself, writing about the experience, or recording yourself talking about the event may also be beneficial. Many victims find that privately expressing their deepest thoughts and feelings about what happened can help get emotions out so they can re-evaluate and process them. Finally, if appropriate, it may help to return to the place where the event took place. For many victims this step comes only after much preparation and support. The “visit” can be symbolic, as is the case when Vietnam veterans visit memorials like The Wall, or real as when veterans return to Normandy on the anniversary of D-Day.

Note that all these recovery techniques have two things in common: Neither denial nor self-blame are part of the coping process, and the process takes place in a context of what victims can control. One way or another, and at the appropriate time, victims accept the reality of the event, they take responsibility to face that reality head-on, and they take action to empower themselves for the future.

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