It’s not possible to predict who will get PTSD; it occurs in people of all ages and races. Some factors, however, may increase its risk:
In U.S., nearly 8 million suffer from condition —
and not all are combat vets
Tina Chéry (in cap and gown) received an honorary Doctor of Law degree from Mt. Ida College. Shown (from left to right) are her mother, Zoila Wedborn, Rev. LeSette Wright, her daughter, Alexandra Chery and co-workers Milton Jones and Rachel Razzino.
Tina founded the Louis B. Brown Peace Institute following the murder of her 15-year-old son. (Photo courtesy of Louis D. Brown Peace Institute)
Nearly 20 years have passed and Tina Chéry still remembers the shock of hearing the news that her son had been murdered. Louis was 15 years old at the time when he was caught in crossfire near Field’s Corner. Ironically, he was on his way to a Teens Against Gang Violence meeting.
For Chéry, dreams of what Louis might have become — he often told his mother that he would be the first black president — turned into a debilitating mix of nightmares, anger and guilt. She blamed herself for allowing her son to walk the dangerous streets. She often lashed out and started having headaches. She avoided the spot where he died.
Most of all, she was just plain numb, unable to concentrate or focus on anything. “I didn’t know what it was,” she said. “But I was a walking basket case.”
What Chéry did not know at the time was that she was probably suffering from post-traumatic stress disorder (PTSD), an anxiety disorder that results from a major trauma that involves the threat of injury or death. It has many sources — natural disasters, plane or car accidents, physical or sexual abuse, assaults, even the sudden violent death of a loved one.
Though most people are able to bounce back from such episodes — and continue on relatively unscathed — many are not. According to the National Institute of Mental Health (NIMH), 7.7 million adults in this country suffer from PTSD.
PTSD can be quite varied. Its impact can change from person to person. Symptoms can develop within hours or days of the trauma. For some it takes weeks to months to appear. It’s not necessary to actually experience the traumatic episode. Merely witnessing the traumatic incident or involvement in the aftermath is all it takes. And the more severe the trauma or the more traumas experienced, the more significant the PTSD. People living in crime-ridden neighborhoods may suffer continuous trauma, thereby increasing its risk.
Marie Pierre-Victor, LICSW, clinical manager of the behavioral health department at Codman Square Health Center, has seen her share of PTSD. Not everyone who experiences horrible trauma will get the disorder. Two people may experience the same trauma with completely different outcomes. “People process things differently,” Pierre-Victor explained. “Some people get frozen in time. Their thoughts put them back at the place of trauma.”
Such was the case for many responders of the September 11 attack on the World Trade Center. A study of roughly 29,000 persons who performed rescue and recovery work there found that they had an increased risk of PTSD for up to three years later, especially if they lost co-workers as a result of the attack.
Anxiety in itself is not a bad thing. It’s natural to be fearful when in danger. The “fight or flight” response kicks in to protect a person from harm. But people with PTSD often still feel stressed or frightened when the danger has passed. It is not uncommon for people to suffer anxiety after a horrible trauma, but if the symptoms persist several months later, a person might be experiencing PTSD.
The cause of PTSD is not well understood and is the subject of several studies. Researchers from Emory University found that women, but not men, with higher blood levels of a particular stress hormone displayed more symptoms of PTSD. A recent study published in Biological Psychiatry suggests that the size of the region of the brain (hippocampus) that controls memory may have an impact.
The symptoms of the disorder are varied and tend to fall into three main categories — reliving the event, avoiding the event or hyperarousal.
People with PTSD most often experience flashbacks and relive the trauma over and over. The backfire of a car — a sound very similar to a gunshot — can set the symptoms in motion. Sleep does not always provide a respite. Replays of the event can occur in bad dreams.
Marie Pierre-Victor, M.S.W., L.I.C.S.W.
Clinical Manager, Behavioral Health Department
Codman Square Health Center
Those with hyperarousal symptoms startle easily, feel “on edge,” or have difficulty sleeping or concentrating. According to the NIMH, symptoms of hyperarousal are typically constant feelings of stress and anger.
The disorder does not always exist in a vacuum. Depression or physical aches and pains can result if PTSD goes undiagnosed or untreated. PTSD sufferers might attempt to self-medicate with alcohol and drugs.
Research by Boston University Schools of Public Health and Medicine bore that out. In the PRISM study, the schools determined the prevalence, predictors and associations of PTSD in a predominantly minority urban primary care practice. The researchers found that mental health disorders — most typically heavy drinking, substance dependence and major depression — were closely linked to PTSD.
Roughly 25 percent of those studied engaged in heavy drinking or substance dependence; more than 30 percent suffered major depression and more than 40 percent had anxiety disorders.
It wasn’t only mental health disorders that were disproportionately high in this group. A noticeable percentage suffered chronic pain and various illnesses, such as irritable bowel syndrome. Those with PTSD were hospitalized more often with longer lengths of stay and utilized mental health services more than the group without PTSD.
The perception of the disorder has changed over the years. At one time it was considered a psychological condition suffered by combat veterans and went by names such as “shell shock” or “battle fatigue.” In 1980 it was recognized as a disorder with specific symptoms that can affect survivors of other trauma and was added to the American Psychiatric Association’s manual of mental disorders.
Children and teenagers are severely affected and may respond differently to trauma than adults. For instance, young children may wet the bed or act out the event during play or cling to an adult. Teens often develop disruptive behavior, feel guilt or have thoughts of revenge.
Fortunately, PTSD responds to several types of treatment including medications, talk therapy and cognitive behavior therapy. “People do get better,” Pierre-Victor said.
The key is recognizing and facing the trauma. Failure to do so begins to impact a person’s ability to function. Unrecognized and untreated PTSD can also take a toll on a person’s physical well being. Back pains and stomach pains, for example, can result.
Chéry admits she never considered receiving mental health services from a trained specialist because of the stigma, a sentiment too often shared by many victims, according to Pierre-Victor. Instead she relied on a network of friends, some of whom are mental health specialists. “No one ever used those words [PTSD] with me, but I think they were trying to be gentle,” she said.
Chéry credits her priest for her survival. “He was a safe place for me,” she explained. “He allowed me to talk and go through grief at my own pace. He did not let me get stuck. Sometimes it’s easier to get stuck. It’s easier to not have to deal with things.”
Chéry readily admits she is a very different person from the one before her trauma. She says her life has changed, and surprisingly for the better. She established the Louis D. Brown Peace Institute whose purpose is to “transform pain and anger into power and action.”
More important, her healing journey allowed her to be a better mother to her two remaining children.
About five years ago, Chéry said she turned another corner. “I learned what joy feels like and not feeling guilty that I can laugh again.”
And she did something else she had not done in years. She danced.