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PTSD – “A War Within Yourself”

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By: Fatima Akmal

“It’s not the person refusing to let go of the past, but the past refusing to let go of the person.”
“It would have been a helluva lot easier to fall down over there, and just not get back”- US Marine victim from Iraq war from the documentary “Of Men and War”

“We were not allowed to speak of the unseen wounds of war. We were not allowed to prepare for them.” – Brig. General Loree Sutton from the documentary “Thank You For Your Service”.

Yes, you might have heard these lines in some movie or documentary but this is no fiction. This is as real as real life gets. And these are the words coming straight from the deeply inflicted trauma of actual people, most of whom were considered the best, and who were prepared and chosen to deal with the most difficult of situations, both physically and mentally.

Though the more dramatic of us might casually throw around phrases like “I’d rather die,” this sentiment is not an exaggeration for some who endure actual Post Traumatic Stress Disorder (PTSD). But although we see the most explicit cases of PTSD in the war combat veterans and survivals, this is most definitely just the tip of the iceberg. The term “post-traumatic stress disorder” came into use in the 1970s in large part due to the diagnoses of U.S. military veterans of the Vietnam War, but it wasn’t until 1980 that the American Psychiatric Association added Post-Traumatic Stress Disorder (PTSD) to its manual, making this disorder a comparatively new one that many in the public still misunderstand.

“It’s a war within yourself that never goes away”
These words came out of one Sgt. Brandon Ketchum who was on a rescue mission with Iowa Army National Guard in 2016. While these words may have just randomly slipped out of him during a psychiatric treatment session 2 years after he was about to end his life, they might just be the most succinct description of PTSD you’ll ever read. Because this doesn’t limit to specific kind of victim or a specific sort of trauma but covers every trauma that has its post-traumatic effects. Be it, rape victim, sexual assault victim, terrorism, accident or child abuse and the list goes on.

Unfortunately, unlike every other patient and every other disease, the harsh paradoxical reality of a PTSD victim is the inability and fear of the victim to actually describe his/her accident both due to the fact that they would have to relive the trauma every time combined with the fear of “what if no one gets it.” Because even after about 4 decades of realizing and establishing PTSD as a real mental disorder, unfortunately, there is a major percentage of traumas (apart from war combat traumas) that are still not considered serious and a lot of victim blaming and shaming is a part of societal norms.

Let’s now delve into some basics of PTSD and some hard and real statistics to understand its importance. PTSD can start with any traumatic event or a continuing reinforcing behavior which categorizes as abuse of any sort. A traumatic event could range from you being threatened, seeing other people dying or getting injured to being a part of accident, sexual assault, hostage situation or terrorist attack etc. While these categorize as a one-time or a short-term event, a reinforcing child abusive behavior on part of parents or living in an inhospitable environment are a long-term recurring event. The symptoms of PTSD may start appearing within days, weeks or maybe even months.

According to a recent study, an estimated 70% of adults in US have experienced at least one traumatic event in their life while around 16% of these have developed PTSD. In the past year, PTSD affected an estimated 3.6% of American adults over the age of 18. While most statistics focus on PTSD in adults, all age groups can be affected. PTSD in youth does occur, though sometimes trauma experienced in childhood does not result in PTSD until after the brain has further developed in early adulthood. In gender comparison, the studies have shown that while men have been found to experience more traumatic events during their lifetime than women, the PTSD symptoms in adult men are far less common (1.8%) than symptoms in adult women (5.2%). This is most likely due to the fact that while men might have a higher chance of encountering traumatic events, women are more likely to be involved in rather high-impact traumatic events like sexual violence and domestic abuse etc. The traumatic events who have higher association with PTSD are considered as high-impact traumatic events.

A diagnosis of PTSD requires exposure to an upsetting traumatic event. And while the symptoms might not be that obvious for a random observer, there are always some “Triggers” which would sort of make the victim relive that memory and set them back in some sort of a haunted abyss with no escape. Identifying these triggers is the key to treating any PTSD. While every trauma have their own dominating symptoms, there are few that encompass the symptoms as a whole. These include Intrusive distressing thoughts, avoiding social contact, negative thoughts and feelings of hopelessness and reckless behavior and angry outbursts to name a major few. While for every victim, these symptoms may appear in a different order or with different intensity, they are some of the major symptoms to look out for. Moreover, substance abuse, suicidal thoughts and depression and anxiety are some of the most common follow-up problems.

It is important to note that not everyone who experiences trauma develops PTSD, and for many people, symptoms of PTSD subside over time. Others get better with the help of family and friends if taken care of properly. But many people with PTSD ultimately need professional treatment to recover from psychological distress that can be intense and disabling and unfortunately, this is a social stigma in many societies which will take time to disappear. It is important to remember that trauma may lead to severe distress and that distress is not, in any way, the individual’s fault. PTSD is treatable and the earlier a person gets treatment, the better the outcome.

The writer is a student of Psychology at Riphah International University, Islamabad. She can be reached at   [email protected]

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