Not Just Shell-Shock


Post-traumatic stress disorder, or PTSD, is diagnosed from symptoms occuring after a traumatic event. Those symptoms generally relate to the event—recurring memories and flashbacks, avoiding discussing the event, or people and places assoiated with it, upsetting dreams. Other symptoms include irritability, despair, trouble sleeping, and emotional withdrawal. Symptoms usually start within a few months of the initial trauma, but sometimes can come years later. These symptoms can have repercussions; PTSD sufferers have substantially higher rates of divorce, unemployment, homelessness, and subtance abuse, and the substance abuse—occurring in more than a quarter of women and more than half of men with PTSD—exacerbates the other problems still further.

The condition is common among war veterans, but there are a lot of other traumas that can lead to PTSD. More than 12 percent of residents of lower Manhattan were found to have PTSD in the wake of 9/11, for example, in line with statistics showing as many as one-seventh of people who’ve been through some sort of trauma will deveop it. According to the Department of Veterans Affairs, people are more likely to develop PTSD if they were seriously hurt during a truamtic event, were directly in danger, felt helpless during the event, or had a severe reaction during the event, such as crying, shaking, vomiting, or dissociating from their surroundings. Long-lasting trauma, such as bullying (including on-line bullying), is also more likely to lead to the disorder.

Since so much of PTSD is tied to the memory of the event, one treatment technique that has been suggested is to diminish that memory. A drug has been found that, in combination with behavioral therapy, may be able to weaken memories of traumatic events if used shortly after the trauma occurs. Cognitive-brhavioral therapy is effective as a preventative measure, as well as in treatment, on its own. Exposure therapy, in which patients are deliberately triggered in a safe, supportive, and controlled environment can help in some cases when administered with professional guidance, though deliberately triggering PTSD without the patient agreeing in advance is likely to do more harm than good. Debriefing, allowing someone who has been part of a traumatic event to discuss and confront their response to it, was thought to be helpful in preventing its development, but research suggests it is not.

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