Since “post-traumatic stress disorder” appeared in the DSM-III in in 1980, the concept of PTSD in the public imagination has grown from a novelty to an accepted reality to a comic hyperbole that can be used to mean “overreaction” or “lingering stress,” as in “Ugh, that traffic jam gave me PTSD!”
PTSD is real, but its symptoms often look like plain old anxiety or depression or even bipolar disorder. And there may be more than one kind. There’s adult-onset kind, that an otherwise healthy veteran might have as a result of a specific trauma during a combat experience. The other is Complex PTSD or CPTSD, which is from long-term exposure to trauma. Examples of this kind might arise from a childhood riddled with neglect or abuse, or from the ongoing trauma of, say, being in prison or having chronic and life-threatening medical problem.
So obviously, EVERYBODY didn’t go through this kind of thing. Even when they do, they don’t all develop PTSD. So why, now, is there so much PTSD? The following are ten guesses. I invite you to give your opinion in the comments section:
- Because there’s is a name for it. Let’s just get this one out of the way. Whenever an old problem finally gets a name, cases can finally be recorded in clinical records. The numbers appear to skyrocket.
- Because people liberally self-diagnose. PTSD gets a lot of press these days. A lot of treatments and therapies claim to help PTSD. There may even be a bit of hipness to it, so a lot of people claim to have it who have not been formally diagnosed. (For the record, formal diagnoses is not always accurate either.)
- Because people are actually more traumatized now than they were in the past. I rather doubt that the traumas people experience today are worse than what people have experienced in past generations. This is debatable.
- Because more people with life threatening injuries survive long enough to develop PTSD. Medical technology and field medicine have advanced enough to save the lives of injured people who, in the past, would not have survived long enough to develop PTSD.
- Because more people go to psychotherapy than in the past, and talking about trauma can actually make PTSD worse. Luckily, new research is guiding people in the helping professions to provide “trauma informed care,” interventions that calm rather than trigger the PTSD response. As interventions get better, PTSD may become preventable after trauma. Those who already have PTSD — and who may be limited in terms of their capacity to heal, learn and regulate mood — may benefit from these new therapies.
- Because more people are on antidepressants and this can interfere with our response to trauma. Drugs have been used with mixed, but very modest results with different populations affected by trauma, yet they remain the dominant approach to treatment. Bessel van der Kolk, MD points out in his landmark book on PTSD, The Body Keeps the Score (2014, Penguin Books), “If antidepressants were as effective as we have been led to believe, depression should by now have become a minor issue in our society. Instead, even as anti-depressant use continues to increase, it has not made a dent in hospital admissions for depression.” So reliance on an ineffective treatment precludes the pursuit of other treatment that could work. And further, the drugs’ alteration in brain chemistry — most likely coupled with therapy that may promote archaic theories about the nature of and solution for PTSD (“You need to talk about it!”) may disrupt a natural resilience and healing that would otherwise have taken place.
- Because overly violent and sexual images in media are changing our brains. I confess I love the show Game of Thrones even though allowing myself to watch vivid depictions of sexual assault, disfigurement, poisonings and decapitation, actually make me feel adrenaline-charged and “out of my body” for days. The endless lewd and vicious acts to which we are exposed, in games, the internet and TV are, it seems to me, exponentially more shocking and realistic than anything available even 20 years ago. I thought this was my oddball hypotheses, but research is now indeed showing that watching violent news does indeed produce PTSD symptoms. Among people who already have a history of trauma, this exposure could be exacerbating symptoms and preventing the natural healing process.
- The protective influence of strong families and communities is breaking down. This is a huge topic and I intend to write about it much more depth. But for today, let’s just look at one aspect of social breakdown — children raised without their fathers. In 1960, 8% of children lived with their mother only. Today it’s more than 24%. Fatherlessness is just one thing and it may not always bad and and it may not always be the primary cause of bad outcomes. But look at the stats: (From The Fatherless Generation):
- 63% of youth suicides are from fatherless homes (US Dept. Of Health/Census) – 5 times the average.
- 90% of all homeless and runaway children are from fatherless homes – 32 times the average.
- 85% of all children who show behavior disorders come from fatherless homes – 20 times the average. (Center for Disease Control)
- 80% of rapists with anger problems come from fatherless homes –14 times the average. (Justice & Behavior, Vol 14, p. 403-26)
- 71% of all high school dropouts come from fatherless homes – 9 times the average. (National Principals Association Report)
- Our diets have changed. Many people exposed to trauma don’t develop PTSD, and not much is known why others do develop it — and seemingly at a higher rate than in the past. It is plausible that our collective, accelerating Western shift from whole foods to highly processed and high carbohydrate foods over the past 40 years or so — the same shift responsible for the obesity epidemic — could be lowering our resistance to the destructive brain changes that occur when PTSD develops. Trauma also appears to play a causal role in obesity as well.
- We are growing more isolated socially. Since the 1980s, the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent. (Dhuruv Khular, New York Times, December 2016). In my opinion, loneliness is at the heart of just about everything bad, and human connection is the agar in which all good things grow. I have a friend who was burned alive by his neighbors, at the age of 10, along with 300 others in a church in Kenya (this was following an election that the attackers believed was rigged). He survived and underwent years of painful reconstructive surgery, and carries significant scars .on his hands, face and head. I’ve watched as his mother, his father, and their new community in the U.S. have loved him, taken time to know him, held him to high standards and celebrated his accomplishments (there were about 250 people at his high school graduation picnic, all making speeches). He is a healthy, positive successful young adult now, who wonders why the rest of us complain so much. A close-knit family and the extended family of community is all too rare in the U.S., and trauma at home happens far more easily in isolation. I believe this points to the most powerful and most important intervention for PTSD. If a culture of closeness is an audacious goal for all of us, it is a journey we have the means to begin, right now.
Your comments and contributions to these theories are welcome!