Why Do Some Individuals Get PTSD While Others Do Not?
Everyone experiences fear and stress when experiencing a traumatic event.
These feelings are based in specific physical responses that help people manage immediate, violent threats to their own lives or those of others. However, for some people, these physical and emotional responses cause changes in the way the brain works that can result in long-term disruption of mental health and the ability to function normally. When this happens, the person may be diagnosed with a condition known as post-traumatic stress disorder, or PTSD.
Still, not everyone emerges from traumatic events with PTSD. For example, a study from the journal Clinical Psychological Science showed that, among soldiers who experienced potentially traumatic events in combat, only about 31.6 percent developed PTSD. To try to help those who do develop the disorder, research is ongoing to figure out why some people who experience traumatic events develop PTSD and others do not.
What Is PTSD?
Most simply, as described by the National Institute of Mental Health (NIMH), PTSD is a condition in which a person who has experienced a traumatic event continues to feel chronic fear and stress long after the danger is over. In order for a person to be diagnosed with PTSD, the symptoms have to be present for a month or more. These symptoms include:
- Re-experiencing symptoms, such as flashbacks or bad dreams
- Avoidance symptoms, like staying away from places that are reminders of the trauma
- Reactivity symptoms, such as insomnia, emotional outbursts, or being hyperaware
- Mood symptoms, such as guilt, depression, and memory problems
At least one type of the first two symptoms, along with two types of each of the second two symptoms, must be present for a month or more in order for PTSD to be diagnosed. PTSD can result from events like rape or sexual assault, childhood abuse or neglect, or exposure to combat.
According to statistics provided by the Nebraska Department of Veterans’ Affairs, nearly 8 percent of people will develop PTSD over the course of their lives, with women being twice as likely as men to experience this disorder. Veterans of war are more than three times as likely to experience PTSD than the general population.
The Brain and PTSD
Some research, such as an article from Neurobiology of Disease, suggests that PTSD occurs when chemicals in the part of the brain that processes memory – the hippocampus – are disrupted by an extreme stress response. Some of these studies indicate that high levels of adrenaline may have an effect on this part of the brain, causing the memories to remain powerfully present and real to the person, rather than becoming more manageable over time. Experience of trauma at a young age can also cause these chemical systems to become hyperactive, requiring a relatively slight level of stress to then chronically activate a stronger response than warranted.
However, PTSD is still not fully understood. Research to determine the causes of the disorder are ongoing, and answers are difficult to narrow down. The complexity of the brain means that there may be many different elements that contribute to these problems.
A person’s attempts to deal with PTSD can also have an effect on other brain functions. For example, an article from Psych Central states that people who have PTSD are also more likely to have depression or anxiety disorders that manifest from the symptoms of the PTSD itself. People with PTSD are also likely to develop substance use disorders as a result of trying to self-medicate the symptoms of PTSD
According to NIMH, there are a number of factors that contribute to a person’s likelihood of developing PTSD after a traumatic event, including:
- Experiencing life-threatening situations or witnessing someone else experiencing them
- Being injured during such an event, or knowing someone who is injured or dies
- Seeing someone injured or killed, or seeing a dead body
- Feeling extreme fear or horror
- Additional stress on top of the event, such as loss of loved ones or security
- Previous history or family history of mental health issues
As with many mental health disorders, the likelihood of a person developing PTSD seems to be connected to whether or not the person has had previous mental health problems, or has a family history of mental illness. This in turn also makes it more likely that someone who has PTSD will develop other mental health disorders, as described above, including mood or anxiety disorders and issues with substance abuse.
Interestingly, according to the National Center for PTSD, people who drink alcohol are also more likely to have PTSD – and this is true whether the alcohol use comes before or after the trauma occurs. People who drink alcohol are also more likely to experience a psychological trauma. Part of this is due to the fact that alcohol makes it harder for the body to manage the stress response. For this reason, it is important for a person struggling with PTSD to get help with alcohol abuse – or any form of drug addiction – in order to recover from all of these issues.
It is possible to treat PTSD using a combination of medical treatment and therapy. People who engage in PTSD treatment can learn how to manage the symptoms of the disorder and function in daily life again. According to the Royal College of Psychiatrists, these tools can be developed and strengthened through:
- Cognitive Behavioral Therapy to learn to recognize and alter thought patterns and responses
- Group therapy to provide interpersonal support from others who have PTSD
- Eye Movement Desensitization and Reprocessing (EMDR)
- Medications to manage depression or anxiety
- Body therapies, such as massage and physical therapy
All of these therapies can be used and combined in various ways, based on the individual’s needs and specific challenges. For example, a person who is dealing with PTSD and a co-occurring substance use disorder may need to take extra caution when using medications to treat aspects of PTSD, as this can risk continued or more complex substance abuse issues. At the same time, the treatment team may increase their vigilance to make sure that the person is not resorting to self-medication that could lead to substance abuse issues in the future.
Again, ongoing research will hopefully continue to illuminate the reasons that people develop PTSD, and what protective factors are involved with those who don’t develop it, deepening the understanding of how to help people with PTSD cope and more effectively manage the condition. In the meantime, getting treatment can make it easier to live with PTSD, and even help the person manage symptoms, to enable a better, more fulfilling life now and in the future.