Something Was Wrong - Data Points: PTSD

Starting point is 00:00:00 Wondery Plus subscribers can listen to Something Was Wrong early and ad free right now. Join Wondery Plus in the Wondery app or on Apple Podcasts. Hi, friends. It's Amy B. Chesler from Season 7 of Something Was Wrong and host of What Came Next. I'm guest hosting this episode of Data Points, which was written by the amazing Dr. Danielle Moore of the nonprofit organization, the Army of Survivors. This episode is part of Broken Cycle Media's new series of educational episodes entitled Data Points. These special episodes will include educational information,

Starting point is 00:00:39 statistics, and support on different topics that are important to our community. Thank you so much for listening. Post-traumatic stress disorder, otherwise known as PTSD, is a mental health condition that some people develop after experiencing or witnessing one or more traumatic events that can involve actual or threatened death, serious injury, or sexual violence. Trauma can include events such as combat, a natural disaster, a car accident, or a physical assault.

Starting point is 00:01:13 Symptoms of PTSD can include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. It can affect a person's ability to function in daily life and can occur soon after the traumatic event, months, or even years later. According to the National Center for PTSD, the prevalence rate for individuals in the US who experience PTSD at some point in their lives is approximately 6%. The prevalence rates do vary depending on the population examined, though. For example, each year between 11 and 23% of veterans and 30% of first responders experience PTSD.

Starting point is 00:01:59 As a study done by the Department of Psychiatry in the Medical Center of the University of Amsterdam explains, a man's lifetime prevalence rate of PTSD is about 5 to 6 percent, compared to 10 to 12 percent in women. According to the Psychiatric Association of America, certain ethnic groups, specifically U.S. Latinos, African Americans, Native Americans, and Alaskan Natives, are disproportionately affected and have higher rates of PTSD than non-Latino white communities. One way to examine PTSD is in relation to the disorders precipitating the trauma. The PTSD Alliance fact sheet shares that of the various types of trauma one may experience,

Starting point is 00:02:46 PTSD is present in 49% of sexual assault cases, 32% of victims of physical assault or severe beatings, 16.8% of those who experience serious injuries, 15.4% of stabbing or shooting victims, 14.3% of people grieving an unexpected or sudden death of a loved one, 10.4% of people who witness or experience a life-threatening illness of a child, 7.3% of witnesses of violence ending in murder or serious injury, and 3.8% of people who experience natural disasters. Some who experience or witness a tragic event may not develop PTSD while others do. An individual's personality characteristics, education and intelligence, past experiences, prior mental health struggles, amount of social support, and previous exposure to trauma are some factors

Starting point is 00:03:52 that affect whether if an individual may develop PTSD or not. Other factors can include the magnitude of the identified traumatic event, how the individual perceived the threat, the severity of physical injury, and interpersonal violence. All of these factors can be classified as risk or protective factors. For example, prior mental health disorders such as depression and anxiety are risk factors, while having strong social support and connections are protective factors. The Diagnostic Statistical Manual of Mental Disorders, or DSM, outlines and describes the diagnostic criteria for PTSD. In other words,

Starting point is 00:04:34 in order to receive a clinical diagnosis, one must experience specific symptoms under specific categories. However, if an individual does not meet the full criteria for PTSD, their symptoms and struggles should never be minimized. PTSD can develop months or even years after a traumatic event. If symptoms occur immediately after a traumatic event, the individual is typically diagnosed

Starting point is 00:05:03 with acute stress disorder. This is because most individuals have a negative reaction to a traumatic event, but that negative reaction might not meet the full clinical criteria for PTSD. If the individual's symptoms exceed approximately one month, then they may be diagnosed with PTSD. However, some individuals have a delayed reaction to a traumatic event and still meet criteria for PTSD.

Starting point is 00:05:31 This is called delayed expression. The symptoms of PTSD are clustered into multiple categories. The first category is exposure to a traumatic event. This includes directly experiencing the event or witnessing in person the event. According to the DSM-5-TR, it also includes learning about a close family or friend experiencing actual or threatened death or having repeated exposure to the horrific details of a traumatic event.

Starting point is 00:06:01 For example, this can include collection of human remains by first responders or investigators being exposed to the details of child abuse. Having repeated exposure to horrific details does not include through TV, movie, picture, or media, except if the exposure is related to the individual's profession or personal life, thus something that is witnessed firsthand at some point. The other categories of PTSD symptoms include intrusion, which is a recurring involuntary and intrusive distressing memories of the traumatic event, nightmares, or flashbacks where individuals feel or act as if the traumatic events are recurring.

Starting point is 00:06:47 In children older than six years, this might be seen in their play. The child may reenact the trauma or themes of the trauma. Another category of PTSD symptoms is avoidance, which is a persistent effort to avoid distressing memories, thoughts, or feelings closely associated with the traumatic event, or external reminders of the event, such as people, places, conversations, activities, objects, or situations. Another category of PTSD symptoms are negative alterations in cognition and mood, which can include an inability to remember

Starting point is 00:07:26 an important aspect of the traumatic event, having persistent and exaggerated negative beliefs about oneself, others, or the world, persistent distorted thoughts about the cause or consequences of the traumatic event that lead the individual to blame themselves or others, and persisting in a negative emotional state. Another category is alterations in arousal and reactivity, which can include irritable behavior and angry outbursts, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbance.

Starting point is 00:08:06 One might typically think of the loud noises and exaggerated startle response in individuals who have experienced combat. However, in individuals who experience PTSD, the fight, flight, or freeze mechanism in their brain has a lower activation threshold, meaning it's easily triggered. Thus, when startled, the individual might have a reaction, such as jumping. So even for individuals whose trauma did not include loud noises, such as perhaps a sexual assault, the individual may still jump at loud noises. The diagnostic criteria for children under the age of six years old is similar, but it recognizes the unique ways younger children experience and manifest symptoms of trauma, focusing more on behavior and play rather than verbal expression and complex emotional states. For example, witnessing a traumatic event focuses more on trauma to the caregiver versus a broader range of witnesses. Under the intrusion category, a child may experience distressing memories that may manifest

Starting point is 00:09:08 as repetitive play, distressing dreams that might not have a recognizable content, and flashbacks or trauma-specific reenactment that again might occur in play. Under the avoidance and negative alterations category, a child may avoid activities, places, and reminders of the trauma, which might be seen in the children's play or behavior too. Negative alterations may also include socially withdrawn behavior and a reduced expression of positive emotions. Children may also exhibit extreme temper tantrums. This behavior can deeply affect a child's relationships with their caregivers,

Starting point is 00:09:45 siblings, peers, and behavior in school. Relatedly, according to a study done by the Institute of Psychiatry at the Medical University of South Carolina, PTSD, quote, commonly occurs with other psychiatric disorders. Data from epidemiologic surveys indicate that the vast majority of individuals with PTSD meet criteria for at least one other psychiatric disorder and a substantial percentage have three or more other psychiatric diagnoses." Individuals with PTSD have an increased risk for suicidal ideations, behaviors, attempts, and completed suicides. The symptoms of PTSD may have a negative impact on employment, social relations, and other

Starting point is 00:10:35 areas of functioning. The symptoms can also vary over time, depending on life stressors, experiencing new traumatic events, or exposure to triggers, which can act as reminders or facets of the original traumatic event. In approximately half of the adults who are diagnosed with PTSD, recovery occurs within three months. However, for others, symptoms can persist for years and even decades. This greatly depends on the individual, the trauma, and the protective and risk factors. There are many treatments and management strategies for PTSD. Some effective treatments of PTSD include cognitive behavioral therapy, or CBT, EMDR,

Starting point is 00:11:18 or eye movement desensitization and reprocessing, dialectical behavior therapy, otherwise known as DBT, and narrative exposure therapy, dialectical behavior therapy, otherwise known as DBT, and narrative exposure therapy, or NET. There is also psychodynamic therapy. To add, there are medications that can help manage symptoms such as antidepressants and anti-anxiety medications. In addition to therapy and medications, some include lifestyle changes and alternative therapies.

Starting point is 00:11:45 These may include having a balanced diet, joining support groups, incorporating mindfulness and meditation into daily practices, acupuncture, animal-assisted therapy, yoga and art and music therapies. Since there are many treatment options for PTSD. Having a personalized treatment plan is crucial for several reasons. PTSD can manifest differently in each person. The differences exist in the nature and context of the traumatic event or events. An individual's cultural background and personal beliefs differ too. Plus preferences and therapy modalities also affect our trajectory. Additionally, recovery from PTSD can be a non-linear process. In other words, individualized treatment plans cater to the unique symptomatology, trauma

Starting point is 00:12:36 history, cultural context, and preferences of each individual, leading to more effective, respectful, and sustainable treatment outcomes. Newer treatments for PTSD are also continuously being developed and studied to provide more effective and personalized care. Some of these new emerging treatments include virtual reality exposure therapy, where individuals in a controlled environment use virtual reality technology to simulate trauma relatedrelated environments. This allows the individual to confront

Starting point is 00:13:08 and process their traumatic memories in a safe and controlled way. Research has shown significant efficacy in clinical trials, leading to deeper emotional processing and reduced PTSD symptoms. There are also many nonprofit organizations that help individuals with symptoms of PTSD through advocacy, research, mental health services, specific treatment for veterans, service members and their families, and more. These include but are not limited to HeadstrongProject.org, ptsdusa.org, 22zero.org, and aptsda.org.

Starting point is 00:13:52 For more information about the nonprofit organizations and research studies mentioned above, please visit the episode notes. For a more comprehensive list of organizations that are working to help those who suffer from PTSD, please visit somethingwaswrong.com forward slash resources. Many of the amazing groups listed on the website are only able to exist because of the community's help and support from people like you. If you'd like to find out more information about volunteer opportunities, please feel

Starting point is 00:14:21 free to visit the resources page as well and reach out directly to the organization of your choice. I would love to once again thank Dr. Danielle Moore for writing this incredibly informative Data Points episode. To hear more of Dr. Moore's journey, listen to episode number 17 of What Came Next, entitled No Longer a Number, wherever you listen to podcasts. I'm Amy B. Chesler, and I thank you deeply for listening and learning with us. If you like Something Was Wrong, you can listen early and ad free right now by joining Wondery Plus in the Wondery app or on Apple Podcasts. Prime members can listen ad free on Amazon Music. Before you go, tell us about yourself by filling out a short survey at Wondery.com slash survey.

Something Was Wrong - Data Points: PTSD

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