Understanding, Supporting, and Advocating for Mental Health
Overview
Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are highly debilitating conditions that affect millions of people across the world. PTSD is a condition that is developed following a traumatic event, in which the experience is never fully processed by the victim. They continue to re-experience sensations and thoughts related to the event long after it ends, creating a cycle of stress and torment. On the other hand, CPTSD is a post-traumatic condition that results from prolonged or repeated exposure to trauma. Those with each condition have their relationships, work, and daily function hindered by intrusive symptoms. A few symptoms of PTSD include hypervigilance, intrusive thoughts, flashbacks, nightmares, and executive dysfunction. Without proper treatment, PTSD and CPTSD can quickly derail one's life. PTSD and CPTSD are often misunderstood, with many people unaware of the debilitating effects that trauma can have on a person's life. Raising awareness about the importance of seeking help, early intervention, and providing support systems is essential in managing each condition and improving outcomes.
Risk Factors
Gender: Women are significantly more likely to develop PTSD because they are larger targets for sexual assault. A study from Humboldt State University found that an estimated 91% of rape victims are female, meaning they are overrepresented in cases of rape and sexual assault compared to men. Another study from the National Criminal Justice Reference Service (NCJRS) found that 94% of women exhibited PTSD symptoms within two weeks of an assault. Because there is such a strong correlation between PTSD and Sexual Assault, and women make up a disproportionate number of Sexual Assault victims, it follows that women are far more likely to develop PTSD.
Childhood Trauma: Children are highly vulnerable to traumatic experiences because they lack the cognitive development and life experience to process their trauma. Children have a far greater propensity to internalize their negative experiences, therefore, making the shame, fear, and guilt associated with a traumatic experience much more acute. Children are also learning to understand the world around them, and when a traumatic experience occurs early in their childhood, it can skew their worldview and self-concept for years to come. Relationships are also a very fundamental part of children's lives. If the relationship models they see and dynamics they experience with others are negative, it can leave a damaging imprint on their view of relationships and how they relate to the world around them.
Genetics: There is research that indicates genetics play a role in PTSD susceptibility. Genes related to serotonin regulation have an especially strong impact on PTSD predisposition. The 5-HTT allele has been linked to increased vulnerability to stress and cortisol, which are often linked to traumatic events. Furthermore, people with a family history of mental illness are more likely to develop PTSD. Understanding the role someone's genetics play in their mental health is crucial for early intervention which could potentially decrease the likelihood of PTSD development later in life.
Symptoms
PTSD and CPTSD symptoms manifest in diverse and often debilitating ways:
Intrusive Thoughts: Intrusive thoughts are a hallmark symptom of PTSD and CPTSD. Environmental triggers can cause intrusive thoughts which lead to distress in victims. The emotional associations and traumatic history associated with intrusive thoughts is what makes them particularly distressing without proper understanding and processing. Intrusive thoughts can colonize one's life, making them afraid of engaging in social interactions and daily life out of fear that intrusive thoughts could arise at any moment. Furthermore, flashbacks, nightmares, and emotional dysregulation can create a cycle of torment that feels inescapable. To avoid situations that trigger these thoughts, victims may find themselves avoiding any environments that trigger these reactions, leading to isolation and social withdrawal.
Hypervigilance: Hypervigilance is a state of being on constant alert. It is a survival response to PTSD and happens because victims feel as if they are in a perpetual state of danger. Hypervigilance can become incredibly stressful and exhausting when one fails to regulate it, especially if they fail to discern between real and false danger. Hypervigilance is accompanied by heightened levels of stress and cortisol which kick in as a warning signal to the victim. This is however a destructive cycle that can hinder one's work and relationships if it manages to arise in those moments.
Emotional Dysregulation: PTSD is linked to worsened mood and difficult controlling one's emotions. Often times, the stressful symptoms associated with PTSD and feelings of loss of control can become incredibly disheartening and troubling to those suffering. As a byproduct of feelings of shame and hyperarousal, it is common that one may desire to withdraw from family and friends out of fear their symptoms might be triggered. PTSD can also be very overwhelming and difficult to control, the unpredictability of it can make inexperienced individuals prone to spiraling. Thus, to avoid that happening they begin to avoid others which can lead to feelings of loneliness and sadness. Feeling disconnected from others can cause lowered self-image which may also result in a worsened baseline mood.
All of these symptoms can be very overwhelming. It can impact one's ability to feel secure within themselves and feel stable. To cope with this loss of control, people often self-medicate with alcohol and other substances, digging the hole of suffering even deeper. It is important to remedy PTSD and CPTSD as quickly as possible to avoid worsening the symptoms.
Treatment Options
Effective treatment for PTSD and CPTSD often requires a combination of approaches:
Prolonged Exposure (PE): Is the most popular form of PTSD therapy. It entails exposing a patient to their trauma in a controlled environment over several sessions. Patients begin with imaginal exposures, which entail closing their eyes while the therapist helps them relive the traumatic experience with full awareness. The goal of imaginal exposure is to eventually desensitize patients to the memory so it begins to cause less distress in them over time. Eventually, patients move to in-vivo exposures which require exposure to stimuli in real life that trigger those same memories and sensations. Despite being the most charged form of PTSD therapy, it is considered the gold standard.
Cognitive Processing Therapy (CPT): CPT focuses on changing a patient's relationship with their trauma. They are challenged to re-examine the assumptions they've made about themselves being weak or helpless in the face of a traumatic experience. Therapists in CPT help patients develop a new identity and improve their self-esteem to free them from the shackles of PTSD and CPTSD. Rather than internalizing feelings of guilt and blame for a traumatic experience, patients can learn to take a more detached and balanced perspective of the events that transpired. This cognitive reframing of traumatic experiences is incredibly powerful and effective in overcoming trauma.
Eye Movement Desensitization and Reprocessing (EMDR): Is a form of therapy that entails rapid eye movements while recalling traumatic experiences. Therapists will often have patients focus their attention on a particular object while they walk them through the accounts of a traumatic experience. EMDR activates the brain regions that are mobilized during REM sleep. Those regions of the brain are responsible for information processing and integration. This is why EMDR is such an effective form of therapy.