There are many myths and misconceptions about post-traumatic stress disorder (PTSD), and although most people will experience some type of trauma in their life, not everyone goes on to develop PTSD. These are some of the common myths and facts related to PTSD. 

1. Myth: PTSD only affects military veterans.

Fact: PTSD can impact anyone who experiences, witnesses or has second-hand exposure to a traumatic event.

PTSD is often associated with military veterans, and although they are not the only people affected by PTSD, they may be at increased risk given the traumatic and violent nature of war or military service. But trauma comes in many forms and can impact people from all walks of life.

There is a wide range of events that can be considered traumatic for people, such as experiencing or witnessing domestic violence, an accident, sexual assault, or the death of a loved one. While there are no specific criteria for those who might develop PTSD symptoms, there are some factors that can increase risk. For example, some groups of people may be at increased risk of developing PTSD, including:

  • People who have experienced trauma in childhood 
  • People with anxiety or depression
  • People who live or work in high-risk or stressful environments

While military veterans likely have higher exposure to traumatic events, PTSD can impact people from all walks of life. 

2. Myth: PTSD occurs immediately after a traumatic event.

Fact: Symptoms of PTSD can take months or years to appear.

When someone goes through a traumatic experience, the assumption may be that if they are going to have symptoms of PTSD, the signs will emerge quite quickly after the event. However, this is not always the case, and some people may not show symptoms of PTSD for years. Formally, this is known as delayed onset PTSD, and is diagnosed if the condition develops at least 6 months after the traumatic event. This affects a small proportion of people with PTSD, with estimates that just 4–6% of this population develop delayed-onset PTSD. 

Initially, delayed onset PTSD presented in war veterans who had returned home. It was thought that because the stress response or reactions to traumatic events were not helpful — and potentially life-threatening — in combat, that there was a delay in the reaction to trauma. More recently, alternative explanations have been put forward. For example, an extremely stressful situation can impact the way memories are stored, making them less accessible to conscious thought. People might also change the way they think about a traumatic experience over several months, and their perception of threat might increase. Although symptoms of PTSD typically emerge around three months after a traumatic event, some people may not experience any symptoms at all for a number of years.

3. Myth: PTSD is a sign of weakness.

Fact: PTSD is not at all related to weakness.

PTSD is a diagnosable mental disorder, linked to changes in the brain and alterations to the fear response. For example, experiencing trauma can impact cognitive functions like memory, attention, and problem-solving. Trauma can also be related to an increased fear response, even when a situation is not truly threatening. These processes can become learned or automatic following a traumatic experience, as the brain’s way of protecting itself. 

The responses and behaviors that are part of PTSD are not voluntary; they are the brain’s way of protecting a person from threat or danger. The fear response must happen quickly (like the fight or flight response) and does not involve rational thought. Therefore, people with PTSD do not have a choice and simply exert strength over PTSD symptoms.

Living through trauma can shape how a person behaves, and they can become particularly vulnerable to feelings of fear or extreme sadness. However, these reactions are part of changes to the body and brain following trauma and are due to a mental health condition. There is nothing weak about PTSD.

4. Myth: Everyone who experiences trauma will develop PTSD.

Fact: Relatively few people who experience trauma will develop PTSD.

Although most people will experience a traumatic event in their life, it is estimated that just 6.8% of American adults will develop lifelong PTSD after trauma. It’s not entirely clear what predicts whether someone will develop PTSD, but several theories have been put forward as to factors that might increase someone’s vulnerability. For example, rates of PTSD are typically higher among women, people from higher income countries and among people who suffer from comorbid mental health conditions. 

Other factors that might contribute to being more vulnerable following traumatic events are:

  • Experiencing repeated trauma
  • Having had more negative life events (i.e. divorce, problems at work)
  • Low social support
  • Low self-esteem

Importantly, these factors are not related to personal choice but are likely a result of a person’s environment or life circumstances. It’s thought that these environmental or personal factors can reduce a person’s resilience, which is their ability to cope with hardship or change. When a person experiences repeated difficulty, they may have fewer resilience resources left, which can amplify the effects of additional trauma.

5. Myth: Everyone with PTSD experiences the same symptoms.

Fact: PTSD can present very differently, depending on the person and type of trauma experienced.

The diagnosis of PTSD includes a variety of symptoms, and there are many different ways that PTSD can present. Based on the Diagnostic and Statistical Manual of Mental Disorders, version 5, PTSD symptoms are included in four clusters. These are:

  1. Re-experiencing symptoms — intrusive thoughts or dreams related to re-living the trauma
  2. Avoidance — actively avoiding any thoughts, places or potential triggers related to the trauma
  3. Negative thoughts and mood — difficulty remembering parts of the trauma, unusual or illogical thoughts related to why the trauma happened 
  4. Arousal symptoms —difficulty sleeping or concentrating, being easily startled 

A diagnosis of PTSD requires that a person has at least one symptom from each of these clusters for at least a month. Because a range of symptoms fall under each cluster, someone with PTSD could have any combination of symptoms. This means that PTSD could look very different from one person to the next. For example, while one person may have symptoms involving re-experiencing dreams and having difficulty concentrating, someone else may not have any difficulty sleeping but have an elevated startle response. There is no one way for PTSD to present, and the symptoms experienced can depend on the person and the type of trauma experienced. 

6. Myth: People with PTSD are violent.

Fact: People with PTSD are not usually violent.

Having PTSD can be extremely distressing, as people are re-living their most traumatic experiences frequently. People can deal with these stressful and challenging symptoms in different ways. Some people may withdraw, some may appear fearful or jumpy and a small proportion may act violently. There is a common misconception that people with PTSD are violent or dangerous, but this is not universally true.

It’s important to note that people with PTSD who become violent are in the minority, and violence is not included as a feature of a PTSD diagnosis. Research supports that there is little or weak evidence to show that PTSD is related to higher rates of violent crime. People can deal with PTSD and triggers in many different ways, but reactive behavior comes from a place of fear and threat, rather than violent desire. For the portion of people with PTSD who may demonstrate violent behavior, they are more likely to have more symptoms in the hyperarousal cluster.

Violence among people with PTSD has been shown to be much higher in people who also have a substance abuse disorder. Substance use can amplify some of the feelings of fear that occur with PTSD and can lead to more extreme reactions, including violence. 

7. Myth: PTSD will just go away over time.

Fact: The majority of PTSD cases will not resolve on their own.

One of the underlying factors of PTSD is that a person has built an association between experience or trigger and distressing thoughts or behaviors. These associations can be strong, and it can take a long time and much work to undo them. People with PTSD might avoid treatment for obvious reasons; treatment often requires talking about and thinking about trauma. While the experience of working through trauma can be difficult, it can also allow a person to return to living their life without fear or anxiety.

There are certainly cases where PTSD may be reduced or even go away on its own over time. However, this can depend greatly on the type of trauma experienced, personal history of trauma, any other mental conditions, personality and other aspects of a person’s life at the time. These factors can make it hard to predict who may or may not experience a reduction in PTSD symptoms over time. 

Seeking support for PTSD from a professional can help a person get a sense of what recovery might look like for them. With the right type of help, someone who suffers from PTSD may be able to return to their normal functioning sooner and experience fewer symptoms in the future.

8. Myth: PTSD isn’t treatable.

Fact: PTSD can be treated, and there are many different treatment options.

PTSD can be highly distressing and persistent, and people with PTSD may feel like they will forever carry feelings of fear or threat. Thankfully, there are several evidenced-based treatments for PTSD that can help people address triggers and symptoms and move beyond their traumatic experience.

The type of treatment that may be most suitable can depend greatly on the type of trauma experienced, the severity and type of symptoms, and the personality and environment of the person suffering from the condition. Talking through experiences, personal background, beliefs about trauma and any other mental health conditions can help a professional provide advice on the most suitable treatments.

Some of the treatment options for PTSD include:

  • Eye movement desensitization and reprocessing (EMDR)
  • Cognitive behavioral therapy
  • Group therapy
  • Prolonged exposure therapy
  • Medication
  • Family therapy

Seeking treatment for PTSD can greatly improve symptoms, health, and quality of life. Understanding and re-evaluating traumatic experiences can help people to move beyond trauma, and regain control over thoughts and feelings related to trauma. 

If you or someone you care about is suffering from PTSD and is using substances to cope, contact The Recovery Village today to discuss treatment options for co-occurring disorders.

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