The word is literally part of the disorder’s name—post-traumatic stress disorder—so obviously, undergoing a traumatic experience plays a major role in PTSD. Understanding that role is often not as simple as it sounds. Developing PTSD may occur when one goes through or witnesses or learns about a disturbing, stressful, or frightening event (typically more intense than, say, a divorce or job loss). Some of the many examples include violent criminal assault, natural disasters, life-threatening condition, extreme neglect, time spent in a combat zone, sexual assault/violence, and prolonged sexual abuse.
Unfortunately, many of us endure such a traumatic experience. While not everyone develops PTSD, a staggering 1 in 3 do. What accounts for this ratio? Why are some people seemingly more susceptible to PTSD? Answering questions like this requires us to go to the heart of understanding many mental health issues. There’s a very complex mix at work and it involves a wide range of genetic and experiential of factors, e.g.
- Inherited mental health risks
- Inherited personality traits
- Your brain chemistry and its regulation of stress chemicals and hormones
- Past mental health history
- Lack of support after undergoing a traumatic experience
- Family history and current level of social connection
These factors touch on some of the reasons behind the 1-in-3 statistic but don’t explain why one’s brain and body would choose the cluster of traumatic symptoms that present with PTSD. Researchers have proposed three broad, intertwined suggestions in addressing this paradox: it’s a survival mechanism, it impacts adrenaline levels, and it alters how the brain processes such real and perceived threats. Let’s explore each of these rationales.
Survival. The thesis here is that our brain so wishes to prepare us to survive a traumatic experience in the future that it keeps us in a constant state of hyperarousal. The ensuing flashbacks are designed to remind us to stay vigilant and prepared. In reality, they prevent us from processing and moving beyond the trauma.
Adrenaline. In studies, people with PTSD present with high amounts of stress hormones. Of course, this “fight or flight” reaction is essential when we’re in danger. However, when such hormones are elevated without the presence of a threat, it can result in either dulled emotions or the aforementioned hyperarousal (or swings between the two).
Chemistry. PTSD-related brain scans have shown important changes in the hippocampus, the part of the brain responsible for emotions and memory and it appears smaller in people with PTSD. As a result, it’s been theorized that flashbacks and nightmares are prevented from being properly processed and thus, the anxiety generated by such trauma remains undiminished over time.
If any or all of this sounds familiar, you may wish to participate in a PTSD screening and, if necessary, consider treatment options:
Dialectical Behavioral Therapy (DBT). Your therapist will help you discover coping mechanisms for the strong feelings and thoughts you experience with a longer term goal of replacing them with more adaptive reactions and skills.
Trauma Reprocessing. This modality may find you discussing traumatic memories with your therapist while you make new meaning, understanding, and emotional connections with the goal of changing how you react to painful memories.
Mindfulness. This ancient practice teaches us how to return to the safe present moment while radically accepting the uncomfortable feelings, thoughts, and sensations that may be part of the traumatic memory.
Whichever route you take with your therapist, the goals will be to reduce symptoms and find a way to move forward after trauma.