The causes, treatments of PTSD

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumping anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience.

According to the U.S. National Library of Medicine, PTSD can occur at any age. It can follow a natural disaster such as a flood or fire, or events such as assault, domestic abuse, a prison stay, rape, terrorism or war. For example, the terrorist attacks of Sept. 11, 2001, may have caused PTSD in some people who were involved, in people who saw the disaster, and in people who lost relatives and friends. Veterans returning home from a war often have PTSD. It can also develop in one who has lost their ability to feel safe.

The cause of PTSD is unknown but psychological, genetic, physical and social factors are involved. PTSD changes the body's response to stress and affects the stress hormones and chemicals that carry information between the nerves. It is not known why traumatic events cause PTSD in some people but not others. Having a history of trauma may increase one's risk for getting PTSD after a recent traumatic event.

One of my readers offers this experience. "I was thinking of the latest robberies in the area and the PTSD that it creates within a family. One family whose home was robbed now feels unsafe in their home. Their children struggle to sleep wondering if someone is going to sneak into their bedroom and take them. The robbery has changed the family's lives. Their 12-year-old was just starting to come home and feeling OK about it ... not now.

"The 10-year-old has her own bedroom and now is frightened to sleep alone. The family is now afraid to leave their home for even a short period of time ... even running to the store. Seems like our society thinks of PTSD as something very drastic, but as you know, it can be any event that personally affects the person. Children are not resilient like some parents think and don't take it seriously when children have fears."

Some psychologists believe PTSD has been overdiagnosed, due partly to a broadened definition of trauma (originally meant direct exposure to threatened death or serious injury such as rape or combat). Well-intentioned attempts to have people relive the trauma may actually exacerbate their emotions and pathologize normal stress reactions. Debriefing survivors right after a trauma by getting them to revisit the experience and vent emotions has actually proven generally ineffective and sometimes harmful (Devilly, 2006).

In opposition to PTSD is Post-Traumatic Growth. Psychologists Richard Tedeschi and Lawrence Calhoun discovered that suffering can lead to "benefit finding." The struggle with challenging crises, such as cancer, often leads people later to report an increased appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life ... suffering has transformative power. Out of even our worst experiences some good can come. Like the body, the mind has great recuperative powers.

Does trauma, loss of safety, feeling helpless or seeing an unbelievable atrocity cause anxiety? Absolutely but each person deals with anxiety differently. One might show little psychological effect, while another develops PTSD or grows spiritually in the trauma. The reason one person is resilient and less affected with anxiety than another is unknown. What is known is reliving the experience exacerbates the anxiety, reinforcing the possibility of the anxiety becoming a diagnosable psychological disorder.

Last week I told the story of a bike wreck my wife and I experienced three years ago. I offer a brief synopsis of the event.

Three years ago, my wife and I are riding our mountain bikes on the Trail of the Coeur d'Alenes from the Snake Pit to the Cataldo Mission. It is a beautifully warm April morning and the first opportunity of the year to stretch our legs and breathe the fresh, seasonal air.

In my hypnotic slumber, I lose track of the trail before me, look down and startle at a two-foot-long garter snake warming its scales on the path ten feet in-front of me. Reacting before thinking, I firmly pull my front tire brake which does its job, instantly stopping the tire from rotating. While flying over the handlebars of my bike I literally think, "This is going to hurt," and it does. I hit the pavement head and wrists first, with my bikes handlebars stabbing my ribs with great force as my crumpled body slides to a stop.

As my body comes to rest, my wife's body begins the same journey mine just ended. Attempting to avoid her husband lying in the trail, she applies her brakes and lands hard on the trail behind me.

My world goes quiet for a few minutes; as it often does when one does a physical and mental check of each body-part after a traumatic event. Lying on the trail with my right cheek on the asphalt I noticed the snake I attempted to avoid, staring at me a few feet away. I think, "If we were going to be this close to each other, I should have just run you over." The snake, caring little for my acrobatic misadventure, turns and slowly slithers off the trail disappearing in the newly grown grass.

Three years after this accident, we still have not ridden our bikes. The fear of re-experiencing another wreck is too real. The negative effect of this wreck is not just to my body but also to my mind. For the following three years, every unexpected movement or sound heard while hiking causes me to startle. I often jump quickly backwards and scream like a little girl. I also develop an unnatural fear of snakes, pictures of snakes or even become anxious when someone starts talking about snakes.

The year after the wreck, I would often flash back to the event and literally shiver as I feel my body hit the pavement. These flashbacks have subsided and are rare today. Also, I can now tolerate unexpected movement or sounds while hiking.

Do I have PTSD? No. Diagnoses of a psychological disorder should be reserved for severe sufferers. I did experience anxiety over my bike accident but the anxiety I experienced is a natural effect of a traumatic personal event, not a diagnosable disorder. Does my non-diagnosis dismiss one suffering from PTSD? Again, no. PTSD is a real disorder that causes debilitating inability to enjoy life and should be treated immediately by a PTSD trained therapist.

As the rancher says, "When you fall off the horse, you have to get back on." The rancher's wisdom is therapeutically sound. This spring, my wife and I plan to start riding again - we are ready. Before our maiden journey my wife makes an intelligent suggestion, "Cut the front brakes on both bikes." Great idea! See you on the trail.

Bill Rutherford is a psychotherapist, public speaker, elementary school counselor, adjunct college psychology instructor and executive chef, and owner of Rutherford Education Group. Please email him at [email protected] or visit www.dietingwithdignity.com.