Everyone knows about post-traumatic stress disorder (PTSD), but there are “things everyone knows that just aren’t so.”
Misconception: All PTSD cases look alike.
Truth: No more than do all cases of autism, cancer, or Parkinson’s disease. Individual humans are far too complicated for any one-size-fits-all picture.
Misconception: PTSD is a problem exclusive to Veterans.
Truth: PTSD can result from any violent situation that involves fear of losing one’s life, way of life, or loved ones. Many such situations—especially crime or major disaster—happen to people who have never been in the military.
That said, combat Veterans do have higher-than-average PTSD rates, partly from dealing with the additional factor of moral injury. Where someone’s personal beliefs—their moral code—include the conviction that taking a life is always wrong, military combat forces them to choose duty over moral code. Uncertainty and guilt compound their trauma and increase the severity of PTSD symptoms.
Misconception: All Veterans have PTSD.
Truth: Despite the publicity surrounding PTSD in Veterans, it’s not that common. About 7 percent of Veterans get PTSD—only marginally higher than the 6 percent average for the general population.
Misconception: PTSD causes are entirely psychosomatic.
Truth: Physical injury, especially traumatic brain injury (TBI) can influence PTSD risk and severity. Also, whatever the triggering event, PTSD is associated with physical changes in the brain. For these reasons and more, it is highly inadvisable to assume someone is too emotionally “tough” to be at risk.
Misconception: People with PTSD are prone to violence.
Truth: This idea probably grew from reports of people lashing out under the influence of flashbacks—temporary mental states that involve reliving the original traumatic experience, in which case someone may “see” their original enemy in a bystander. (Flashbacks can be triggered by any sight, sound, or smell that the brain associates with the original trauma: a Veteran who survived a vehicle-related explosion, for instance, may flash back at the odor of burning rubber tires.)
Flashbacks make popular media fodder, but it’s extremely rare for one to trigger the “fight” side of fight-or-flight. Nor are flashbacks a universal symptom of PTSD. What is a major symptom is hypervigilance—being obsessively alert to potential threats, as the brain seeks to guard against the trauma ever recurring.
Notes one medically retired Army Veteran, “I still find myself looking for Improvised Explosive Devices whenever I drive, noticing every piece of trash. I can walk through a mall food court and come away remembering how many smartphones were visible, along with each phone’s model and case. I’ve actually had others verify that these details were accurate.”
Noticing so much, so compulsively, is exhausting; and, far from becoming aggressive, sufferers typically withdraw, avoiding busy settings and the associated sensory overstimulation.
Misconception: PTSD is just temporary shock that will go away on its own.
Truth: PTSD needs medical treatment, the earlier the better. “Wait it out” attitudes are cruel and dangerous; more than 25 percent of people with PTSD attempt suicide.
Misconception: All PTSD cases surface soon after the initial trauma.
Truth: As many as 1 in 4 cases may be delayed-onset, meaning that symptoms appear at least six months after the traumatic incident.
Misconception: Lots of people exaggerate or fake their PTSD to gain “victim” sympathy.
Truth: This is a prime example of unfair stigma associated with mental illness. The suffering caused by PTSD is very real and needs medical treatment—and empathy, not criticism, from peers.
It should be noted that most Veterans and other people with PTSD don’t see themselves as victims, but as survivors. In fact, many symptoms come from having learned to live in survival mode, which is a positive thing until brain and body reach the point of being in continuous overdrive.
Misconception or Truth? PTSD is curable.
Answer: It depends on how you define “curable.” Physical brain changes associated with PTSD are usually permanent. However, the disorder can be treated to eliminate or mitigate symptoms. (The same is true of most mental illnesses.)
The important truths to remember are:
- PTSD treatments are not “one size fits all”: what works for one patient may not help another. Fortunately, there are many options: cognitive behavioral therapy, Eye Movement Desensitization and Reprocessing, and biofeedback, to name just a few.
- Much recovery success comes from the patient’s own hard work. To come to terms with trauma, you have to be willing to face it and reframe it. Plan on exercising the resilience that helped you survive the original experience.
- PTSD is not a sentence to permanent dysfunctionality. There is hope.
Check out the PTSD Coach app for additional recovery tips.