PTSD –Post Traumatic Stress Disorder – is a psychiatric disorder that can happen if someone experiences a traumatic event in their lives that can be considered life-threatening.
It was once known simply as something affecting war veterans and was often referred to as “shell shock.”
Through medical advancements it has been found that a person can develop PTSD through multiple experiences such as witnessing a murder, surviving a rape, being involved in or witnessing a car accident, death of a loved one, kidnapping or living through a natural disaster.
There is no cure for PTSD, but it is manageable.
There are some people who can return to normal in time and for others, if they receive treatment immediately following the event, can also recover to varying degrees.
For many, the symptoms do not go away and may even get worse over time.
In 2015, over five million people in the United States had been diagnosed with PTSD.
If you have PTSD, or know someone that does, there are some facts you should be aware of and here are 10 of them:
1. The statistics.
In order to fully understand the impact that PTSD has on American society, you have to know the statistics:
• 70% of people will experience at least one traumatic event in their lives and out of that number, 20% will go on to develop PTSD.
• 5% of Americans will have PTSD at any moment in their lives.
• 8% of adults will develop PTSD.
• Women are twice as likely to develop PTSD as men.
• One out of ten women will get PTSD.
• PTSD costs the United States over $42 billion a year due to misdiagnosis and under-treatment.
• 50% of people who receive outpatient medical services have PTSD.
• 6-11% of military personnel who served in the Afghanistan war have PTSD.
• 12-20% of military personnel who served in the Iraqi war have PTSD.
• Over 300,000 soldiers who have been deployed over the past three years have PTSD.
• 21% of inmates have PTSD.
• 45% of PTSD sufferers smoke to deal with the anxiety.
• 35% of PTSD suffers abuse prescription drugs.
• 34% of men and 27% of women who have been diagnosed with PTSD will develop a drug addiction (this also includes heroin and cocaine in addition to prescription drugs).
• 28% of women and 52% of men will become alcoholics.
• 12% of PTSD sufferers who are 65 years of age and older will attempt suicide at least once and an additional 6% will commit suicide.
2. Symptoms of PTSD.
There are three categories of symptoms that are related to PTSD:
• Bad dreams/nightmares
• Scary thoughts that you can’t control
• Staying away from people, places or things that remind you of the event
• Feeling emotionally numb
• Feeling guilty or depressed
• Having trouble remembering especially about the traumatic event
• Changes in your personal routine
• Suffers from low self-esteem
• Disconnects from relationships and their own life
• These symptoms are constant
• Easily startled
• Feeling on edge
• Difficulty sleeping
• Angry outbursts
• Difficulty concentrating
3. Toxic Stress Syndrome.
Toxic Stress Syndrome is a diagnosis used by psychologists/psychiatrists to describe the impact that severe abuse/neglect, the experience of having a mentally ill or addicted parent has on a child’s development.
It is the overburdening of a child’s brain and emotional system of intense, chronic stress.
This diagnosis also has an impact on brain structure and development.
It will cause a child who is living in these circumstances to always have a fight or flight system of operation that always stays on.
The flight or fight system conditions someone to react either by fighting or running away whenever they believe that a situation threatens them.
Everyone has the fight or flight system automatically programmed into their beings, but for a child with this syndrome it’s all they know and how they deal with any problem or situation.
For such children, 60% are diagnosed with Toxic Stress Syndrome which puts them at a greater risk of developing PTSD and 19% of them do eventually get diagnosed with PTSD as adults.
It also puts them at greater risk to develop other problems such as diabetes, heart disease, cancer, obesity, asthma, and learning disabilities.
Toxic Stress Syndrome: http://www.centerforyouthwellness.org/what-is-toxic-stress/
4. Circumcision and PTSD.
For centuries infant males have been getting the loose skin on their genitals taken off for various reasons such as religious, health or cultural.
It has been believed that performing this type of surgery reduces the chance of getting cancer in certain areas, urinary tract infections and sexually transmitted diseases.
There have been a lot of strides made in medicine since this belief was formed and the possible risks now have alternate medical treatment available.
It is also important to note that 80% of the world’s male population isn’t circumcised and the rates of cancer, infections or sexually transmitted diseases are not any higher due to being uncircumcised.
However there have been skeptics who believe that this surgery was unnecessary causing the infant unnecessary physical and emotional pain.
Over the last five years there have been even more people who claim, mostly through the internet and with no medical proof, that having this surgery increases the chances that this infant will contract PTSD either in infancy or in adulthood.
So is this true?
Prior to the 1980s it was believed that the circumcision surgery wasn’t painful because infants couldn’t feel pain and therefore didn’t need anesthesia.
In the early 1990s studies found circumcision to be a traumatic event and in 1996 The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) description of a traumatic event applied to the medical procedure.
The DSM-IV also stated that trauma can occur anytime between infancy throughout an adult’s life.
However, the application of determining the effects of traumatic events in children cannot be measured on infants, but if a child got circumcised later (after five years of age) it can be measured because they can talk and have the ability to access their memories.
In the United States 60% of male infants have the surgery prior to leaving the hospital and right after birth.
In countries such as Africa, the United Kingdom, and Iran the surgery is sometimes performed on boys up until the age of 15.
There are no published studies available on the effect of trauma experienced through circumcision because as infants they lacked any awareness of the surgery or even the recovery period afterwards.
The attitudes men in America develop regarding their genitals is complex and there are numerous factors that could feed into any trauma or PTSD symptoms that may or may not be related to the circumcision.
Circumcision trauma: http://www.cirp.org/library/psych/goldman1/
5. Therapies for PTSD.
Therapy for sufferers of PTSD is a very effective way of helping them deal with the symptoms that come with the disorder.
What sets this type of therapy apart from others is that it works on specific types of symptoms which means not every type of therapy or more generalized therapy will work.
It’s also important to have a doctor or clinician who has experience in treating someone with PTSD.
A popular type of therapy when treating PTSD symptoms is referred to as Talk Therapy or Prolonged Exposure.
This is when the patient tells the story of their trauma repeatedly. Often the ability to revisit the trauma instead of repressing it allows them to start to heal.
Some of the therapies help the patient develop new coping skills and teaches them relaxation techniques.
One obstacle that may hinder the successfulness of therapy is the patient.
Many therapies require a type of stability in order to have the patient focused enough to do the work.
Some points of instability can be homelessness, an active addiction or ongoing panic/anxiety attacks and even suicidal thoughts.
Sadly, many PTSD patients experience these factors as part of the disorder.
As stated earlier, having an experienced doctor is important because they will understand that a successful therapeutic approach will include a treatment that will include three phases:
• Phase 1 is a skill building phase that focuses on increasing tolerance of stress, developing an awareness of the conscious, developing skills to help the patient handle/deal with relationships and relaxation techniques.
• Phase 2 is the recollection of the trauma. Depending on the severity of the trauma, will depend on how long this procedure will take. A trauma that is severe could take months and may need additional work of the first phase in order to handle recalling the trauma.
• Phase 3 is the application of the new skills that have been learned, developing a better understanding of themselves as well as the trauma that was experienced and developing a plan for ongoing care.
In addition to this type of therapy as well as Talk Therapy/Prolonged Exposure there is Reprocessing Therapy that uses images and body sensations to help address experiences associated with the trauma that hasn’t been resolved.
There are several types of medication that is used to treat some of the symptoms of PTSD.
Some people prefer just to do the therapy and there are others who combine the therapy with medication.
There are even more who must take medication to deal with symptoms like anxiety/panic attacks or other issues in order to be able to focus on the therapeutic process.
There are currently 22 medications that can be used to treat PTSD, but 19 of them are called off-label medications.
Label medications are medications that have gone through clinical trials and have been found to work the way it’s supposed to and is deemed safe by the U.S. Food and Drug Administration (FDA).
The term label is basically a report that contains certain information about a drug.
Off-label medications are older medications that are used to treatment ailments/diagnosis’ that are different than the original use that was included as part of the original label.
Even though off-label drugs are legal, it is illegal to market these drugs for uses they weren’t intended for.
The drug companies can easily go through the process to have these drugs approved for different uses.
The FDA moves slower than a slug in a pile of mud and it would make the process very expensive as well as long.
It is also difficult for insurance companies to get reimbursed for off-label drugs and often list these drugs as experimental or investigational in order to avoid having to pay for them.
The two remaining drugs on the list of PTSD medication –Zoloft aka Sertraline and Paxil-are both anti-depressants.
Sertraline and Zoloft are often listed separately, but they are basically the same as Sertraline which is the generic form of Zoloft.
Depending on the complexity or severity of the initial trauma, some doctors may describe a benzodiazepine such as Adinazolam, Alprazolam, Bromazepam or Diazepam to reduce anxiety or stress levels.
Many PTSD sufferers have a difficult time finding a medication that will work or work over a long period of time which may be why many forgo this option in favor of just therapy, but for those with severe PTSD medication is usually not an option.
PTSD medications: http://www.webmd.com/drugs/condition-1020-Post+Traumatic+Stress+Disorder…
Others medication: http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disord…
In 2014, it was reported that:
• 2.7 million veterans that served in the Iraqi and Afghanistan wars were diagnosed with PTSD.
• 50% do not get treatment for the disorder
• 7% also suffer from brain injuries in addition to the PTSD
• That those who do get treatment (usually from the Veteran’s Administration), the treatment it been found to be woefully inadequate
• Every year there are 5,000-8,000 veterans with PTSD commit suicide
• That 10% or 2.2 million female veterans who have PTSD were diagnosed after experiencing MST (Military Sexual Trauma)
An important component of the treatment of PTSD is that treatment should start when symptoms appear and in some cases that is within two weeks of the trauma.
If the person is still on active duty at that time, the military will get them help.
The problem is that many times symptoms don’t appear for months, even years and by that time the soldier is now a veteran.
Getting help through the Veteran’s Administration (VA) is often frustratingly difficult.
They just don’t make it easy for returning female soldiers who come to them for help.
Despite women becoming the fastest rising population in the military, the VA hasn’t kept up with the changes that would come from providing services for their female vets.
Nearly one third of all centers don’t have the staff to treat this type of trauma such as qualified gynecologists.
An additional 31% of the administration’s health centers can’t even begin to treat the trauma because they also lack qualified facilities as well as staff. Many of these centers don’t even have female bathrooms despite the fact that females have been joining the military, and coming home, for years.
An additional problem is the military’s age-old boys’ club problem where women were strongly discouraged from reporting an assault and the perpetrators’ were protected from the judicial system.
These actions also made it difficult for trauma survivors from getting the help that they needed because they lacked the proof to show that anything even happened.
Since they’re unable to provide any paperwork, they are often denied disability benefits.
To further complicate matters, the Defense Department permitted the rape kits to be destroyed after one year and any reports of assault after two years.
In Pennsylvania the statute of limitations for these assaults is 12 years.
In states that have military bases on them the statute of limitations is:
Texas: 10-13 years
Georgia: 7-15 years
California: 10 years
Oklahoma: 12 years
It is contemptible why the VA and the military makes their veterans jump through hoops just to get what is owed to them.
Veteran PTSD statistics: http://www.veteransandptsd.com/PTSD-statistics.html
Statute of Limitations by state: http://victimsofcrime.org/docs/DNA%20Resource%20Center/sol-for-sexual-as…
8. The cost.
Like many disorders, people who are diagnosed with PTSD can be affected by it during their entire lives in one way or another.
For people who have been diagnosed with PTSD the cost can be staggering because having the disorder ain’t cheap.
For veterans who have PTSD, the mountain of paperwork and the mind-numbing bureaucracy involved to approve a claim can take months or even years although the VA claims that the average time is 277 days which is still too long.
For those who have PTSD that isn’t service connected and who either can’t work or are unable to hold down a job, their option is to apply for disability through the Social Security Administration (SSA).
This isn’t any better than the VA. For a claim to be approved, it takes over 18 months and sometimes as long as two years.
In addition to that time, Social Security is likely to deny your claim and then you have to file for an appeal.
The number of people who do get disability through the SSA is staggering as well. It is estimated that over two million people who have PTSD receive some kind of disability through them.
For those who can’t get approved from the SSA, have never been an active duty soldier or who have had to file an appeal, they usually receive public assistance through state funding, but this amount isn’t anywhere near what is needed to sustain their lives.
The first year of treatment can cost over $4,000 and for those who either have to pay for the therapy themselves, or pay for the medications that their insurance company won’t pay for because it’s not on their approved medication list that amount can be elevated to around $12,000 per year.
Even if the insurance company or the VA will pay for the treatment as long as it’s at whatever facility they approve, that facility may not provide good care or have staff who are trained in the treatment of PTSD thus forcing the afflicted person with either not getting treatment at all or paying for it themselves.
Many who have been diagnosed but can’t afford the care will often self-medicate using drugs or alcohol.
If they choose to use alcohol to treat their symptoms, it can cost them over $500 per year depending on what type of alcohol they consume.
Inpatient rehabilitation for alcoholism for those without insurance or who self-pay starts at $1,000 per day in Philadelphia.
For the drug addicted, depending on the drug of choice and the severity of the addiction, the cost can be $100 per day and up.
Rehabilitation for an addiction can skyrocket up to $28,000 per stay.
Even for those who have health insurance, most HMOs will only cover about three-five days of treatment in an inpatient rehabilitation facility which isn’t enough.
For people who are active in their addiction there is the additional cost of dealing with the law enforcement community (bail and attorneys) as well as increased car insurance for those who still drive.
There are 44.7 million people who have long-term PTSD. Half of those people (over 22 million) smoke in order to cope with their symptoms.
The cost of one pack of cigarettes in Philadelphia is $8.00 and since most people with PTSD tend to be heavy smokers, they smoke more than a pack a day usually two or three packs.
A carton of cigarettes runs them –depending on the brand and where you purchase them at in Philadelphia – between $65-80.
Again, depending on how much they smoke will depend on how many cartons they go through in a month.
Typically, someone who smokes three packs a day will go through about 7 cartons per month costing them $450-550.
Aside from physical ailments related to smoking (cancer, COPD, diabetes, and heart disease), addiction (HIV/AIDS, hepatitis, lung and liver disease) there are also ones that are related to PTSD: obesity, diabetes, high blood pressure and heart disease.
Drug treatment costs: http://alcoholrehab.com/drug-addiction-treatment/drug-and-alcohol-rehab-…
PTSD percentage: http://www.ptsdunited.org/ptsd-statistics-2/
9. The families.
If you want to know what it is like living with someone who has PTSD, just ask a member of their family.
What they will tell you is critical about how this diagnosis not only affects the sufferer, but family members as well especially if they knew the person both before and after the traumatic event that caused them to become diagnosed with PTSD.
There are many families who will stick with someone who has been diagnosed out of the love and loyalty they feel for that person.
There are even more families who will abandon someone once they have been diagnosed and even blame them for having PTSD.
Having to experience the symptoms of someone who has the diagnosis is difficult regardless as to the road a family member or love one will take.
Although there is a lot of statistics indicating that military veterans with PTSD have been violent it is also important to note that many veterans are also diagnosed with Traumatic Brain Injury in addition to the PTSD.
It has also been discovered that the chances of a veteran becoming violent may be caused by being returned to active duty and/or serving more than one tour of duty.
There are no statistics for non-veterans with PTSD committing acts of violence because the numbers are low and alcohol/drug abuse has been a mitigating factor in violent behavior.
Still, dealing with a person who has PTSD is not easy due to their recurring flashbacks of the trauma, depression, avoidance, isolation, the difficulty in expressing certain emotions, sudden outbursts, and feeling numb.
Many family members who do stay with the affected loved one choose to attend therapy and participate in support groups.
Families coping with PTSD: http://ptsd.about.com/od/infoforfriendsfamily/a/PTSDfamily.htm
10. Changes that need to be made.
On the February 2016 cover of O Magazine, founder and editorial director Oprah Winfrey declared, “You are not alone! We’re starting a conversation about anxiety, depression, help and hope.”
Starting with the current issue, the magazine decided to do a three-part series on mental health that would include stories, tips and information for those struggling with various forms of mental illness or conditions.
In the first article in the series was a woman’s story about her PTSD.
The problem was that this series didn’t appear until page 96 out of the magazine’s 138 pages although many of these pages are advertisements.
So why was the positioning of this article a problem?
On the cover, Oprah’s declaration, made it seem like the topic was really important, but not as important as the Valentine’s edition of Oprah’s Favorite Things, two full page ads for men’s cologne (Polo Blue by Ralph Lauren and Gio by Giorgio Armani), a brief interview with Danai Gurira who portrays Michonne on The Walking Dead, or The World According to Gayle.
So it seems that there are some things more important than starting the conversation that Oprah declared was important.
This is the attitude that has side-lined conversations and actions regarding mental health care for many people but more so for those with PTSD.
Mental health care in this country is abysmal.
Insurance companies will pay more for inpatient care than they do for outpatient care.
The ones who do pay for both usually won’t pay for enough treatment or the co-pays are so high the client can’t afford to go as often as they should.
There is some talk about providing more help for people who have been diagnosed with PTSD, but the aid will be given to veterans.
Although PTSD was originally believed to be a condition that affected those who served in the military, that is no longer the case.
Even in the case of military vets, treatment of PTSD for their female veterans is lacking.
In the United States there are over 44 million people who have PTSD and half of them (22 million) are veterans.
The treatment should be equal across the board. There should be no preferential treatment to any race or class who has been diagnosed.
Male veterans, for example, fare better when getting treated than the female veterans.
While serving in the military the females must comply with the same rules and go through the same training as the males. They all put on the same uniform and must make the same sacrifice.
Once they finish their time in the service, they also are eligible for the same benefits except when it comes to the medical benefits.
PTSD is a double edge sword.
While people who have been diagnosed can appear to be normal (do daily tasks, take care of their families and maintain a certain lifestyle), they can also struggle to function by holding a job or maintaining relationships.
PTSD affects many aspects of society and for those whose diagnosis isn’t a result of serving in the military it is too often a result of the violent culture that America has become.
Educating the public about PTSD-the facts as well as the fiction, demand for better mental health care, for movies and television studios to stop using PTSD to explain a criminal’s behavior for violence and for the politicians to address this health issue through bills needs to happen.
There needs to be an acknowledgement of the strain PTSD puts on families, healthcare providers, the economy as well as the legal system.
If the politicians are unwilling to do something about the culture of violence that has besieged this country perhaps they should be doing something about the victims it leaves behind.