As our nation simultaneously fights a healthcare pandemic and an economic crisis, while grappling with the impacts of significant social justice issues, heightened levels of anxiety and stress have become the norm. That’s why now is a critical time to gain a better understanding of post-traumatic stress disorder (PTSD)—and how to recognize its symptoms in ourselves and those around us.
Just like many emotional and mental disorders, PTSD comes with a set of damaging stigmas that can themselves be deadly, as they cause those living with PTSD to keep quiet and avoid getting help. These stigmas are fueled by misinformation in American discourse, and it’s high time we debunk some of the most common among them.
Myth 1: PTSD is an invisible disease that is all in someone’s head.
False. The absence of visible symptoms makes PTSD hard to “see” by the naked eye. This “invisible wound” can make it hard for family and friends to believe it’s real, especially if the person hasn’t personally experienced a violent or traumatic event. While it’s true you can’t tell if someone has PTSD just by looking at them, the past decade has ushered in frequent use of brain imaging to assess the effects of traumatic stress on the brain. Using MRI technology, researchers can now identify changes in the neurochemical systems and specific brain regions, or “circuits,” involved in the stress response. This transforms our understanding of PTSD as more than just psychological, but as a biological injury that can be seen—and treated.
Myth 2: Most people who are exposed to trauma will develop PTSD.
False. The length of time that symptoms persist is key for diagnosing PTSD. The diagnostic definition of PTSD requires that symptoms persist longer than 30 days. Yet for the majority of people who experience “PTSD-like” symptoms following a trauma, those symptoms usually resolve within a month, especially with proper emotional support.
A more common cause of those symptoms is likely acute stress disorder. Acute stress disorder is a brief period of psychological stress following a life-altering or traumatic event. While common symptoms such as anxiety, insomnia and heightened reactivity make it easy to confuse the two disorders, acute stress disorder does not persist for longer than 30 days. Both acute stress disorder and PTSD, however, are worthy of attention and the right care.
Myth 3: Only veterans who see combat can develop PTSD.
False. Most people still associate PTSD with soldiers returning from combat (think Forrest Gump’s Lieutenant Dan.) While it’s true that many vets who see combat struggle with PTSD, they are not the military population with the highest incidence of the disease. Military sexual trauma (MST) comprises the highest rate of PTSD in veterans amongst both men and women.
Military sexual trauma refers to an experience with sexual assault or sexual harassment occurring at any point during military service. Examples include forced sexual encounters, repeated advances and quid pro quo scenarios from upper ranks.
According to the VA Healthcare system, an estimated one in four female veterans and one in 100 male veterans report experiencing MST. By percentage women are at greater risk of MST, but nearly 40 percent of veterans who disclose MST to VA are men.
Sexual trauma adds a complex layer of shame with its survivors in both the military and civilian populations struggling with a higher lifetime rate of PTSD for both men 65 percent and women 49.5 percent.
Myth 4: You have to experience extreme violence to get PTSD.
False. According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), PTSD can occur if a person experiences, witnesses or is confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others. In addition, PTSD can occur when the person’s response involves intense fear, helplessness, or horror. While it might make sense that 49 percent of rape victims develop PTSD, a less obvious example is breast cancer. Nearly 25 percent of women diagnosed with breast cancer develop PTSD. They experience a potential life threat from cancer, with the additional anxiety over a change in body image.
Under this definition of PTSD, it’s hardly shocking that COVID-19‘s frontline workers will face the very real risk of developing PTSD in the months ahead. Recent headlines around frontline caregiver suicides are a harbinger of a scary truth: stressed frontline caregivers risked their own lives every day as they helplessly watched their patients die in record numbers. Even setting the turmoil of 2020 aside, many U.S. adults already struggle with PTSD at some point in their lives. COVID-19 is just gas on the fire, and the latest example that PTSD can emerge from a wide array of life’s circumstances.
Myth 5: PTSD is a life sentence.
False. The majority of patients who struggle with PTSD can find effective relief. Successful treatments for PTSD exist and are evolving every day. Traditional treatments include a combined approach of patient education, cognitive behavior therapy and psychopharmacology. While using traditional therapies can achieve an estimated 60 percent success rate, they require more healthcare resources and a time commitment from the patient and their support system to “put in the mental work” of recovery. Now, with increasing recognition of PTSD’s biological nature, breakthrough treatments such as the stellate ganglion block (SGB) are showing promising results as high as a 70-80 percent success rate with just a short three minute procedure, and the positive effects can be felt almost immediately.
As we collectively shift into recovery mode from the pandemic, the economy and the social unrest we are witnessing daily, we have a responsibility to help each other heal. That starts by breaking down stigmas of yet another “invisible enemy” and actively recognizing the signs of trauma in ourselves and those around us.
Getty image by Lyubov Ivanova
Dr. Springer is one of the nation’s leading experts on PTSD and trauma, and Chief Psychologist at Stella Center, a new treatment center for the relief of mental trauma-related conditions. Based on her extensive work with veterans and trauma sufferers, she can explain the deeper psychology of why COVID-19 is impacting all of us so heavily, and how we can form an action plan that will help us all to adapt in this time. Recently, she was featured in a piece for CNN Health about how to know when your anxiety has turned dark, she wrote a piece for Military Times about how civilians are experiencing crisis stress well known to military veterans, and provided a list of coping methods. Soon after, Congressman Scott Perry shared that article with his 21,000+ followers. Additionally, Psychology Today featured an article Dr. Springer wrote on "America's coping muscle" as part of their #1 "Essential Read" series. Dr. Springer’s work has been featured on NPR, NBC and Forbes.
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