Emotional Health · General Medical

Post-Traumatic Stress Disorder: Condition Affects Significant Number of Women

An important feature of diagnosing PTSD is chronicity. For a diagnosis, these symptoms must continue for at least four weeks after the initial trauma. That is because, in the beginning, many of these symptoms are a normal response to a terrible experience. In the immediate aftermath of a traumatic event, it is normal to experience periods of being flooded by intense emotions and memories of the events, while at other times feeling emotionally numbed and distracted. This yo-yoing back and forth between flooding and numbness seems to be the mind’s way of both processing the experience and protecting the individual from what has happened. For most, these symptoms slowly fade over the ensuing weeks as life shifts back to a semblance of normal. However, not for everyone. Most studies suggest that women are twice as likely to develop PTSD as men. This may be due to the often very personal nature of a woman’s trauma. Such experiences as rape – where one human volitionally violates another – carries with it a much higher likelihood of evolving into PTSD than something that may be severe and frightening but lacks the sense of betrayal and brutality – a car accident on an icy road, for example.  

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Who develops PTSD most likely stems from a complex interaction of individual risk factors – genetics, childhood experiences, personality – and the nature of the trauma itself. Prior trauma exposure, particularly stress and trauma at a young age, increases an individual’s risk. A chaotic, unstable family life further increases risk, while a strong social support network is associated with reduced risk.  However, even those with a loving childhood, and many caring friends and family can develop PTSD after trauma.

Fortunately, we have a number of treatment options. In the immediate aftermath of trauma, most have found that the most important thing is to offer support to those affected, but not to force someone to speak about the event if she does not want to. However, if the symptoms do not begin to fade over the following weeks, it may be beneficial to seek additional help. The two main forms of treatment are Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). The challenge with PTSD is that, left on its own, the symptoms are self-perpetuating. Returning to the woman assaulted when leaving work, her fears about walking to her car prevent her from doing just that. So she avoids that situation and, as a result limits her activities. Because she never challenges that thought – “Walking to my car is really dangerous” – it continues to feel true. PE and CPT both work by challenging those thoughts while also providing gradual and safe exposure to feared cues associated with the trauma. While neither can erase the traumatic event, both help ease the psychological and physiological impact and help an individual get back to the life she wants to lead rather than one ruled by trauma and its aftermath.

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References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.

National Institute of Mental Health.  Post-Traumatic Stress Disorder. 2016

Halligan S, Yehuda R. Risk Factors for PTSD.  PTSD Research Quarterly.  2 (3); 2000.

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