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Abbigail Saul

Dr. Cassel

ENG 1201-B51

20 July 2018

Post- Traumatic Stress Disorder

Imagine that one has been in a car accident or some tragic event and every night when

they go to sleep they relive that event in their dreams. Sounds terrible right? It is as if they

cannot get away from what happened to them and it is now haunting them. Every time they

close their eyes or drift off into a day dream they see it happening again and again. One may

begin to wonder what is wrong with them and why this is happening. They could possibly be

suffering from Post-Traumatic Stress Disorder (PTSD). “PTSD is a mental health problem that

some people develop after experiencing or witnessing a life-threatening event, like combat, a

natural disaster, a car accident or sexual assault” (National Center for PTSD). During the time of

World War I, PTSD was called shell shock and then referred to as combat fatigue after the

completion World War II. It seems that most people associate Post-Traumatic Stress Disorder

with military personnel, but PTSD does not just affect them. It can make a deep impression on

anyone that has experienced or observed a traumatic event. Even though it seems that many

people believe that Post-Traumatic Stress Disorder only affects military personnel, it can

actually affect anyone that has experienced a tragic event in their lifetime. Not all suffers

choose to receive treatment, but they should seek help and support from others if it becomes

an issue. The best treatment methods are a combination between medication and talk therapy.
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Some may feel that PTSD is a sign of weakness when suffering with this disorder, but it

is not, anyone can have PTSD. Numerous things can cause someone to be affected with PTSD;

many of which a person has no control over. Common events that can cause PTSD could be

from a hostile event, war, or a sexual assault.

There are also personal factors that can determine if one will be diagnosed with PTSD.

These factors can include the person’s gender, so whether they are male or female. Their age,

so if they are young or old. What kind of previous traumatic events have happened in one’s life

can be a big factor. What one does to cope after the traumatic event plays a factor in whether

or not one may be diagnosed with PTSD. Stress can likely onset PTSD, where as social support

can be helpful to help prevent the onset of PTSD (PTSD: National Center of PTSD).

How can one be sure if they have Post Traumatic Stress Disorder? What should a family

or friend look for in their loved one? A lot of time the symptoms that come from having PTSD

start after a traumatic occurrence but may not come until later in someone’s life when they

have been triggered by something that reminds them of the traumatic event. It is even possible

for the symptoms to come and go. If the symptoms last longer than a month and begin to

interfere with ones work or home life, then they should be checked out (PTSD: National Center

of PTSD). The symptoms range into four different types but may not be the same for everyone.

Each person will experience their symptoms in their own ways.

One of the types of symptoms are reliving the event. That means one may have bad

memories of what happen. When sleeping, someone who has PTSD could have bad nightmares

about the tragic event. The person may even feel like they are continuously reliving the event

(PTSD: National Center of PTSD). Another symptom people have is staying clear of situations
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that reminds them of the event. They may choose to avoid the places that remind them of their

tragic event. They may quit going to these places all together if it causes a trigger for them.

They may begin avoiding people that remind them of their traumatic event. Their presence

would cause a tick for the person suffering, so the person may avoid the people that cause

them to remember their traumatic event all together. It’s not necessarily that person’s fault, it

is just easier on the one suffering (PTSD: National Center for PTSD).

Having more negative beliefs and feelings is symptoms that one could experience. Due

to the trauma one is suffering from they may begin to view themselves or others in a negative

way. They could feel shame or guilt from the trauma depending on what the trauma was. The

person could lose interest in the activities they used to enjoy. Example, if someone enjoyed

drag racing but was in a bad car accident, they may no longer enjoy doing that. They could

begin to think the world and everyone around them is dangerous or feel as if they cannot trust

anyone anymore. The sufferer may find it hard to find reasons to be happy or feel that they are

not happy anymore. They could possibly feel numb to the world (PTSD: National Center of

PTSD).

The final symptom that can be caused from PTSD is feeling keyed up also known as

hyperarousal. Hyperarousal symptoms are someone being more alert and constantly looking

out for danger. They may always be on their toes awaiting something to happen. The person

could feel jittery or have a hard time concentrating or focusing on tasks or even sleeping. The

no sleeping could lead to one being irritable. The sufferer could begin acting out in ways they

previously had not such as smoking, the use of drugs and alcohol, or driving recklessly (National

Center for PTSD).

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To find out if a person has symptoms of PTSD, and to be diagnosed with Post Traumatic

Stress Disorder, one must experience all the symptoms for up to 30 days at minimum. They

must spend one month experiencing one re-experiencing symptom. A month dealing with one

avoidance symptom. They have to spend a month experiencing two arousal and reactivity

symptoms. One must deal with at least two cognition symptoms and mood symptoms for at

least one month (The National Institute Mental Health). It can be natural to experience these

symptoms after a traumatic event but just because a person experiences these symptoms does

not always mean that they have PTSD. That is why it talks about if the symptoms are ongoing,

then that one could possibly have PTSD. If someone experiences the symptoms for a few weeks

or a short amount a time, then they could have Acute Stress Disorder(ASD) (National Institute

of Mental Health). But if a person experiences the symptoms for a long-extended period of time

that is when they should look into seeing their doctor about checking for Post-Traumatic Stress

Disorder.

Those symptoms are what one would expect to see in adults. But remember that

anyone can be diagnosed with PTSD including children and teens. This could lead them to have

a severe reaction to the trauma that happens in their life, but that the symptoms will not

always be the same as adults. In children, under the age of 6 years old, their symptoms could

include being clingy with a parent. Them not wanting to leave their parents side. The kid could

begin wetting the bed even though he or she was potty trained. They may even forget how to

talk or be unable to talk about what they are experiencing. As for older children and teens, their

symptoms will be more similar to those of adults. They can even become disrespectful and

partake in destructive behavior (National Institute of Mental Health).

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Based off all the symptoms that can come with PTSD, one would think that someone

would know how to spot somebody suffering or at least notice something is wrong. But that is

not the case for people suffering in the country of Lithuania. A problem in Lithuania was found

that the National Health Care was failing to Identify people suffering from PTSD “(Kazlauskas et

al.). A study was done through the National Health Insurance data registry in the years of 2014-

2015 to identify the percentages of people in Lithuania diagnosed with Post- Traumatic Stress

Disorder and other disorders that go hand and hand with stress. Lithuania had a big population

of about 3 million people. Not just anyone can provide treatment to the people In Lithuania. It

must be a licensed medical institution to provide medical services. Primary care practitioners

are the only ones that can diagnose mental health disorders and provide treatment to the

people in this country. They could also refer them to mental health professionals (Kazlauskas et

al). Yet, the cost to be treated by them was very high, so due to the cost of health professionals

not many people choose to seek help from them. “0.01% to 0.02% of Lithuania population is

diagnosed with PTSD annually” (Kazlauskas et al.). Based off the large number of people in

Lithuania’s population compared to the percentages of people annually being diagnosed with

PTSD brought up concern. How could just a small percent be diagnosed each year?

There are many ways someone could be diagnosed with Post Traumatic Stress Disorder,

and one of the ways involves a Natural Disaster. One may think that a natural disaster could not

cause one to have PTSD, but it is possible. On September 20, 2017, the largest scale natural

disaster hit Puerto Rico. They were affected by Hurricane Maria. Many months after the

hurricane people of Puerto Rico were still facing obstacles to get their lives back to normal.

“The disaster left many people with bad mental health” (Alfonso. 1).
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The residents living in Puerto Rico after the hurricane was faced with poverty, and

damages up to one hundred billion dollars (Alfonso 1). Four months later an average of about

32% of the residents still had no electricity in their homes. Also, about 14% of the residents

didn’t have potable water. The death toll since the hurricane is still being questioned but there

was an increase in the number of deaths most likely due to the lack of medical care access.

Many people’s first concerns after the hurricane was to check in with their loved ones, which

was kind of hard to do with no electricity.

Alfonso says in his article that “PTSD after a natural disaster is extensive” (Alfonso 2).

The results found from a survey done was that PTSD was prevalent among victims of the

disaster of 30-40% compared to the 5-19% of the general population dealing with PTSD.

Another study was done in Florida in 1992 after Hurricane Andrew hit. Their results showed

that the prevalence of someone becoming diagnosed with PTSD increased to twenty-six

percent at six months post Hurricane Maria and twenty-nine percent at thirty months (Alfonso

4).

Many factors could have caused anyone affected by the natural disaster to experience

symptoms or even to be diagnosed with PTSD. Those factors could include the elderly or

children, so a person’s age. Whether or not a person is part of a minority. One could have had a

physical injury, or a factor could be the person’s exact location compared to where the disaster

took place. People of Puerto Rico experienced power outages and were living in the dark due to

the natural disaster. These kinds of conditions can start to affect people’s mental health which

can start leading to the symptoms that cause PTSD.

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Suicide is another type of disorder/disease that can follow along with PTSD. The author,

Alfonso talked about the rates of suicide before the hurricane in Puerto Rico compared to the

rates after the hurricane struck. “In Puerto Rico there was an average of 19 suicides per month

in the 8 months before Maria in 2017, and 25 suicides per month in the immediate 3 months

post Maria” (Alfonso 2). Many people lost their homes, their family and friends. It was as if

some of them had nothing left.

Many servicemen and women are suffering from PTSD due to deployment overseas and

the things they experience. Whether it be serving in Afghanistan, Iraq, or any other war, many

have participated, witnessed something or was unable to help someone. The guilt of not being

able to help someone or the guilt of shooting someone can eat away at the person. For some of

the veterans who had been deployed it was leaving physical and emotional wounds that time

alone can’t heal. “This is known as: moral injury “(Brody). Moral injury is similar to and can be

related to Post-Traumatic Stress Disorder. It is said that moral injury is not a recognized

diagnosis yet at this time. The article War Wounds That Time Alone Can’t Heal, includes a clip

from “Almost Sunrise” (Jane Brody).

In the clip Almost Sunrise, it is said that “War is the opposite of love and the hardest

thing about being a veteran is that when you are so young, and you go to war and kill, you don’t

know what love is yet” (Almost Sunrise 2016). It goes on to say that it is not until later when the

young veteran falls in love that he begins to realize what exactly love is. Once they know what

love is, it begins to make them think about all the people that were taken when deployed, and

all the love from those families that are now no longer alive. That is when people begin to have

flashbacks and begin to relive the tragic event that happened in their lives. The film shows the
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pain one goes through (Brody).

Fig.1. Pictured here is SSG Saul (my mom), who is a sufferer of Post-Traumatic Stress Disorder.

(Price).
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The factors and the symptoms of PTSD go along with the effects it has on a person. A person

that is diagnosed with PTSD may begin to have different effects during their everyday life. One

may begin to have problems at work. Certain effects of PTSD can cause trouble sleeping and

difficulty focusing. Meaning that will begin to effect one’s work performance. People diagnosed

with PTSD tend to miss more days of work and their work ethic is less efficient compared to

people who do not have PTSD (Tull). People with this disorder tend to have a higher rate of

unemployment. Since trouble focusing is a side effect of PTSD it is mentioned that “if a teen or

child is suffering then they may have problems at school. It can be common that those battling

PTSD during high school or college are less likely to make it through” (Tull).

People with PTSD can experience relationship issues. Whether that be problems with

their marriage, friends, or family. The spouse of one who has PTSD can be faced with a lot of

stressors. Depending on the severity of the person’s case, “the spouse may have to help them

with every day activities. The spouse can have the stress of financial challenges, especially if

one is seeking treatment. There can be a loss of intimacy when dealing with a loved one who

battles PTSD. All the negatives can have an impact on their relationship” (Tull).

People who are battling Post-Traumatic Stress Disorder are at higher chance of

developing other mental health disorders as well, which could be depression, anxiety,

substance abuse, eating disorders, and possibly could become suicidal. Ones that battle PTSD

are more likely to develop depression and more likely to develop anxiety. They can be more

likely to try and commit suicide compared to someone who does not have PTSD (Tull).

Aside from having mental illnesses, people with PTSD are more probable to experience

physical health problems too. Health problems could be, heart problems, diabetes, over weight,
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pain, breathing problems, and sexual dysfunction. Symptoms of PTSD can have a predominant

result in the release of stress hormones. If one is stressing over their problems, it can cause

them to be overeating to help cope. The overeating then could cause them to become obese.

People with PTSD also tend to partake in unhealthy behaviors. Which can further problems with

one’s physical health (Tull).

All of these things that come with PTSD can really mess with someone’s life. But there is

treatment for PTSD and there is answers to help one get better. Not everyone who experiences

PTSD symptoms reaches out to seek medical help. Some chose to get help from their family or

friends, while some do not seek any medical attention (American Psychiatric Association). Brett

Liz was featured in the article War Wounds That Time Alone Can’t Heal, and he said, “A lot of

vets will not seek help because what is haunting them are not heroic acts, or they were

betrayed, or they cannot live with themselves because they made a mistake” (Brody). That is

the exact reason sufferers need to seek out treatment, so they do not have to live the rest of

their life feeling that way. Medication and talk therapy or a mixture of both came out to be the

main treatments that were effective for treating people with PTSD (The National Institute of

Mental Health). Every person is different, so some may react to treatments differently than

others. Which makes it important to find out which treatment works best for them.

Antidepressants are the common medication prescribed to one battling PTSD. The

medication can help with the symptoms of sadness, anger, feeling numb to the world, and

being worried. It is not officially FDA approved, but it is said that Prazosin can be helpful for

sleep problems such as nightmares that people with PTSD suffer from. When reaching out to a
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health care professional, they can help their patients find which medication is best for them

and the correct amount to take daily (The National Institute of Mental Health).

A treatment form known as Psychotherapy incorporates talking to a health care

professional to treat an illness. Talk Therapy, another name for Psychotherapy is usually for 6 to

12 weeks and can be in a small group setting or one-on-one. The treatment can be longer if

needed. There are two main types of therapy where people can talk about PTSD; Cognitive

Processing Therapy and Prolonged Exposure (The National Institute of Mental Health, PTSD:

National Center for PTSD).

CPT is a therapy where one learns the skills to understand how the trauma changed

their of way of thinking, their feelings and thoughts. If one is able to change how they think

about the tragic event, then that can help them change how they feel. Whereas, PE therapy is

talking about memories from the trauma until it is no longer upsetting to the patient. This helps

with getting control of one’s feelings or thoughts about the trauma. “The goal is to get one to

do things or go to the places they have been avoiding due to the trauma “(PTSD: The National

Center for PTSD). It is not as common as the Cognitive Processing Therapy or the Prolonged

Exposure Therapy, but another type of talk therapy is Stress Inoculation Therapy. This includes

muscle relaxation training, the working of social skills, positive thinking, thinking of oneself in a

positive manner, and looking for distraction techniques.

Does not matter if one is young or old, military personnel, traumatized by a car accident

or survivor of sexual harassment, anyone can be diagnosed with PTSD. There is no reason

anyone should have to face the struggle alone. No reason to feel that because of what

happened to them that they do not deserve to be treated. Get treated so one can move on with
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their life. There is medication and professionals out there to talk to, even though everyone

doesn’t choose to get help they should. No one deserves to live a life in misery.
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Works Cited

Alfonso, Cesar A. " PTSD and Suicide After Natural Disasters." Psychiatric Times, Vol. 34,

Issue 4. Apr. 2018: 1-14. https://eds-b-ebscohost-

com.sinclair.ohionet.org/eds/detail/detail?vid=4&sid=1f35dd4f-760f-47e6-9167-

3184b3ef3012%40sessionmgr104&bdata=JnNpdGU9ZWRzLWxpdmU%3d#AN=12875

8537&db=ccm Sinclair Library, Dayton, Oh. 9 Jul. 2018.

Brody, Jane E. “War Wounds That Time Alone Can't Heal.” The New York Times, The New

York Times, 6 June 2016, https://well.blogs.nytimes.com/2016/06/06/war-wounds-that-

time-alone-cant-

heal/?rref=collection%2Ftimestopic%2FVeterans%20and%20Post%20Traumatic%20Str

ess%20Disorder&action=click&contentCollection=timestopics&region=stream&module

=stream_unit&version=latest&contentPlacement=6&pgtype=collection.

Kazlauskas, Evaldas; Zelviene, Paulina; Eimontas, Jonas. “No Posttraumatic Stress Disorder in

Lithuania”: National Health Care Fails to Identify PTSD.” Journal of Traumatic Stress,

Vol.30,Issue1.Feb.2017,pp.99-

102.http://dx.doi.org.sinclair.ohionet.org/10.1002/jts.22152. Sinclair Library, Dayton,

Oh. 9 Jul. 2018.

Price, Jahn. Operation Iraqi Freedom. 2004. Digital File Type.

“Post-Traumatic Stress Disorder.” National Institute of Mental Health, U.S. Department of

Health and Human Services, Feb. 2016, www.nimh.nih.gov/health/topics/post-traumatic-

stress-disorder-ptsd/index.shtml.
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“PTSD: National Center for PTSD.” Negative Coping and PTSD - PTSD: National Center for

PTSD, U.S. Department of Veteran Affairs , 1 Jan. 2007, www.ptsd.va.gov/public/ptsd-

overview/basics/what-is-ptsd.asp.

Tull, Matthew, and Steven Gans. “What Are the Effects of PTSD on a Person's Everyday

Life?” Verywell Mind, Verywellmind, 2018, www.verywellmind.com/how-does-ptsd-

affect-daily-life-2797536.

“What Is Posttraumatic Stress Disorder?” Mindfulness Practices May Help Treat Many Mental

Health Conditions, 2013, www.psychiatry.org/patients-families/ptsd/what-is-ptsd.