De-stigmatizing Post-Traumatic Stress
by Annette Hill
That the prevalence of Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) have finally become openly acknowledged in our culture, and are the topic of great discussion, is a terrific thing. However, more work and progress to de-stigmatize those who suffer from the symptoms of these diagnoses has to be done. This will allow PTSD therapy to be offered to those in need and allow for help to be provided where needed.
“The following information is offered in an effort to demystify, de-stigmatize, normalize, identify, and finally give hope for relief and recovery.”
The “D” in the PTSD diagnosis stands for “disorder,” and it is that word that makes so many people uncomfortable and avoidant to seek treatment. It maybe more helpful to see the “D” as a matter of “duration” that the symptoms are present, as the diagnosis comes from the persistence of symptoms over time. It must be noted that after a traumatic event many people will initially present with some, if not all, post traumatic stress symptoms. Thus the term “PTS” will be used here forward.
The intention of this article is to give general information and is not intended to be a diagnostic tool. Rather, if you feel you, or someone you care about, may have these symptoms, please call (844) 448-2567. Help to learn more and begin the healing is just a call away.
It is important to understand that although much media attention about these issues have, understandably, been focused on our veterans coming home with one or both diagnoses, understand that anyone, at any age, may suffer with symptoms and could benefit from PTSD counseling. These two diagnoses may occur separately or together as result of traumatic events experienced in everyday life and are more common than people realize.
We’re Here to Help
The following information is offered in an effort to demystify, de-stigmatize, normalize, identify, and finally give hope for relief and recovery. The Clinical Criteria and symptoms of PTS are enumerated below. Symptoms of TBI, however, depend on the region(s) of the brain the physical trauma is stained, type of trauma, duration (meaning singular incident to chronic events), medical interventions, etc.
Common events where one could experience both one or both diagnoses range from an automobile accident, physical altercation, sexual assault, combat experiences, or a head injury in any contact sport, just to name a few. Sorting out symptoms due to PTS versus TBI is important and will require assessment by a trained professional through PTSD counseling or PTSD therapy.
What they have in common is that the symptoms are the body’s normal reaction to an abnormal situation. Please read that last sentence again!
Seeking Help is Not a Weakness
One of the biggest issues faced is the perceived stigma one may feel when presenting with symptoms of either diagnoses and thus remain unwilling to seek treatment. Unfortunately, in certain groups of individuals, where either diagnosis is more common, the stigma can be even greater. For example, the military and first responder populations are extremely skilled in remaining calm and focused, while maintaining a high level of functioning, a necessity in performing their duties during a critical event in an attempt to keep themselves and others safe. With military service members and police officers, there is the added layer of trying to determine who is the enemy and who is not, quickly and decisively. There is also the possibility of being “shamed” by peers or supervisors perceiving symptoms of PTS as a sign of weakness.
All of this requires highly concentrated training in how to “override” natural, emotional impulses to extreme, adverse stimuli. The problem is that often these populations are not given clear instruction about what to do after the critical event is over, when the natural and normal emotions do come to the surface and need to be felt and processed in order to remain healthy, fit, and functioning. That sentence also merits a re-read!
What Causes Post-Traumatic Stress?
So why does PTS form? To put this in the simplest of terms, the primary function and purpose of our brain is to keep us physically and emotionally safe. When we experience events that threaten our physical or emotional safety, a counter reaction and coping behavior is normal and necessary. To ensure our physical and emotional survival, humans make meaning about that traumatic event(s), about others, the world, and about themselves. This meaning creates a type of “efficient prediction” about what to do should we be faced with anything related to the original event again. Aspects of this “meaning” sit at the subconscious level and become reactive in nature going forward. Sometimes people will turn to substances in an attempt to calm down or numb out and thus giving birth to an addiction. The goal of therapeutic treatment is to assist the individual to normalize the reactions, reorganize the physical, emotional and cognitive repercussions to achieve new learning and mastery … to live a calm, happy and present focused life. The symptoms of PTS need not be permanent and, with time and skilled attention, can abate through the use of PTSD therapy or other methods such as PTSD counseling.
A synopsis of the clinical criteria for PTSD is as follows. Please read below about each of the DSM-5 Criteria for PTSD in detail:
DSM-5 Criteria for Diagnosis of PTSD
The American Psychological Association has set the following criteria for PTSD:
Criterion A: Stressor
The individual experienced a threatening event, actual or perceived. This includes witnessing death, death threats, injuries or sexual violence. It can also include learning of a close relative or friend’s threatening or traumatic event. It can can also include being constantly exposed to details of trauma in the course of professional duties. This does not include indirect exposure, such as through electronic media, pictures, or videos.
Criterion B: Intrusive Symptoms
Details or symptoms of the traumatic experience is re-experienced, involuntarily, in a various way.
These ways can include any or all of the following:
- recurrent, involuntary, and intrusive memories
- traumatic nightmares
- intense distress after being reminded of the traumatic experience
- physiological reactivity when exposed to trauma-related stimuli
Criterion C: Avoidance
Constantly trying to avoid stimuli related to the traumatic experience. Stimuli could include traumatic thoughts or feelings, or external reminders such as people, places, activities, items, or situations.
Criterion D: Negative Changes in Cognitions and Mood
Thoughts and moods get worse after the traumatic experience. This can include any or all of the following:
- Inability to remember key features of the traumatic event
- persistent negative ideas or expectations about oneself or the world
- constantly blaming oneself or others for the traumatic experience
- persistent traumatic emotions, decreased interest in pre-trauma hobbies or activities
- feelings of alienation
- inability to experience positive emotions
Criterion E: Alterations in Arousal and Reactivity
Arousal and reactions feel out of one’s control, in sleeping and/or waking states. This can include irritable, hostile, aggressive, self-destructive and/or reckless behavior. It can also include hypervigilance, exaggerated startle responsiveness, problems concentrating, and sleep disturbance.
Criterion F: Duration
The symptoms explained in Criterion B, C, D and E occur for more than one month.
Criterion H: Exclusion
Symptoms are not occurring due to reactions from medication, substance abuse, or illness.
This must be specified with dissociative symptoms, such as experiencing depersonalization and/or derealization.
Full diagnosis of Post Traumatic Stress is not met until six months after the trauma occurs, even though symptoms may start immediately.