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:
Orlando B. Lightfoot, M.D.
Chief of Psychiatry
Codman Square Health Center
Everyone is at risk of being exposed to traumatic events, but there is no certainty as to why some individuals are more susceptible or prone to developing signs and symptoms of PTSD. Research is underway to determine if specific biological and genetic differences play a role. Clinicians do know that people with supportive family and community relationships who readily seek help when needed and have solid methods of problem solving and coping with difficult situations may be more successful in avoiding PTSD.
2. Does the disorder differ between men and women?
Both men and women are at risk for PTSD. Surveys have shown, however, that in non-combat community situations, women are impacted more — 20 percent versus 8 percent in men. A reason for the disparity is the type of trauma. Females are more subject to childhood sexual abuse, rape, domestic violence and family conflict.
3. Is alcohol or substance abuse associated with PTSD?
Alcohol or substance abuse does not cause PTSD, but an individual suffering from the disorder is more likely to use alcohol or drugs as a way of escaping the feelings associated with the trauma. In most circumstances, alcohol and drugs can offer only temporary relief and escape, but can confound the long term management and recovery. Frequently alcohol or substance dependence is an accompanying diagnosis of PTSD.
4. Can people develop PTSD months or years after the trauma?
The timing of PTSD can differ. Many people experience signs and symptoms soon after a traumatic event, but can bring their response under reasonable control within a few months. Some, however, do not identify the difficulties they experience in life, such as feeling isolated, feeling fearful in crowds, problems keeping a job or excess use of alcohol or drugs, as possibly related to prior traumatic events or experiences. The awareness that this could be PTSD can be delayed for many years. Still other individuals do well over many years until a life change “triggers” the past trauma. Generally, a detailed and complete history can uncover material that strongly points to a diagnosis of PTSD.
5. Is the disorder curable?
Some individuals respond after a traumatic experience with minimal impairment and require minimal intervention. Others involved in the same event suffer tremendously. The signs and symptoms of PTSD are treatable; improvement can and does occur consistently. Clinicians use a wide array of tools — support, guidance and medication — to help in the recovery process. Many individuals have demonstrated an ability to get better when they have access to and take advantage of these interventions.
6. What differentiates “normal” bad dreams and nightmares from symptoms of PTSD?
One function of dreams is to allow an individual to “work through” the events of the day. Yet, disturbing dreams can occur in all individuals. Dreams associated with PTSD allow some revisiting of the traumatic event, and can offer a chance to revenge the hurt or shape a different outcome of an actual experience, making it more palatable. When PTSD dreams are frequent and disturbing they require an intervention by a mental health professional to help modify the intensity of the experience and assist with improved sleep.
7. Do children react differently from adults?
Several traumatic experiences can result in PTSD in children: desertion and abandonment, improper and inadequate feeding, physical and psychological abuse and sexual abuse, to name a few. While some children are more resilient, others may respond by withdrawing, not eating or overeating, crying excessively, agitation or other dramatic change in behavior. Fortunately, children do respond positively to treatment including changes in the environment, loving attention and reassurance.
8. Are certain physical ailments, such as headaches or stomach aches, associated with PTSD?
The relationship of physical ailments and PTSD has long been recognized. Studies have found that pain is one of the most regularly reported physical problems reported by people with PTSD regardless of the type of trauma. In many cases the pain is caused by physical trauma, such as automobile accidents. A special problem of the management and use of pain medication for legitimate chronic pain is an ongoing concern of medical practitioners. In some cases, however, pain, such as headaches, stomachaches or back pain that cannot be substantiated by diagnostic tests may be more closely linked to anxiety rather than a medical problem.