What is Post-Traumatic Stress Disorder?
Post-Traumatic Stress Disorder or PTSD is a complex psychiatric condition that develops in some people after they have experienced or witnessed a severe traumatic event. PTSD can affect a person physically, emotionally, mentally, socially, and even spiritually. People who suffer from PTSD often feel great distress when their symptoms occur. For this reason, those with the disorder often make attempts to avoid anything that will trigger their symptoms, including the avoidance of certain people, places, thoughts, feelings, and memories.
What causes Post-Traumatic Stress Disorder (PTSD)?
In order to develop Post-Traumatic Stress Disorder, a person must first be exposed to a severe traumatic event. Specifically, people who develop PTSD have usually experienced a situation in which they feared they would die in a violent way, such as from an assault, natural disaster, or accident. Someone who witnesses another person being hurt in such a way can also develop PTSD. (This includes first responders, medical personnel, and professionals who are repeated exposed to details of child abuse or sexual assault.) People who learn of the actual or threatened death (due to violence or accident) of their loved one are also at risk for Post-Traumatic Stress Disorder.
The difference between PTSD and psychological trauma
There is a big difference between the normal life stressors that cause normal psychological trauma and the unique stressors that cause Post-Traumatic Stress Disorder. In everyday life, there are many events that can make us feel traumatized. Divorce, the loss of a job, or a miscarriage are all things that can cause great distress. While these events are traumatic—and can certainly make us feel sad, anxious, angry, or depressed—they are not the types of situations that cause PTSD.
The types of stressors that can lead to PTSD are events that make a person panic and fear for survival. Terrifying events such as combat, assault, natural disasters, and horrific accidents trigger a person’s fight-or-flight instinct. This initial physiological response is a key requirement for the eventual development of Post-Traumatic Stress Disorder. (Witnesses who develop PTSD second-hand usually do so because details of the trauma trigger their own horror and fear for survival.)
How common is Post-Traumatic Success Disorder?
About 60% of men and 50% of women will experience at least one severe traumatic event in their lifetime. However, the vast majority of these people will not develop Post-Traumatic Stress Disorder. Only 7-8% of the population suffers from PTSD at some point in their lives.
Although slightly more men experience severe traumatic events, women are far more likely to develop PTSD. One explanation for this may be that people who suffer multiple traumatic events are at increased risk for developing the disorder. As females are far more likely to be sexually abused in childhood, sexually assaulted as adults, and victims of domestic violence, they have more risk factors for PTSD.
What are the symptoms of Post-Traumatic Stress Disorder?
People with Post-Traumatic Stress Disorder stay in a state of mental, physical, and emotional crisis long after the actual crisis has passed:
What are remedies for Post-Traumatic Stress Disorder
Because Post-Traumatic Stress Disorder affects people in multiple ways, it often requires multiple types of treatment. Physical symptoms such as hyperarousal, anxiety, depression, and insomnia are often best treated with medication. Eye-Movement Desensitization & Reprocessing (EMDR) and neurofeedback have also been shown to be effective at relieving some physical symptoms of PTSD.
Medication alone, though, cannot address all the symptoms of PTSD. At their core, severe traumatic events cause us to question the world and our place in it. In order to resolve these existential questions, it is usually best to seek out some form of talk therapy. In the absence of individual or group psychotherapy, the support of kind, patient, empathetic loved ones can also be therapeutic.
What is Dissociative Identity Disorder?
Dissociative Identity Disorder (DID) is a condition in which a person exhibits the behaviors of two or more distinct identities. Often various identities display amnesia for the actions of other identities, making people with DID seem forgetful. Formerly called Multiple Personality Disorder, the condition was first popularized in the media by books the books The Three Faces of Eve and Sybil.
How common is Dissociative Identity Disorder?
There is a myth that Dissociative Identity Disorder is extremely rare, but that is not true. Approximately 1% of the general population suffers from DID, making it about as prevalent as schizophrenia. People think DID is rare, because many people with the condition don’t know they have it.
How does Dissociative Identity present?
Despite media portrayals of DID as a dramatic condition in which various alternate personalities announce their presence and act strangely, in truth the changes among identities are usually subtle. They are so subtle, in fact, that even those closest to someone with DID might not realize he or she has it.
It is the nature of DID for sufferers not to recognize when they have switched personalities. While they often forget the things they’ve done when they are a different identity, people with DID also have what is known as “amnesia for the amnesia”—meaning they do not recognize that they have forgotten time.
What causes Dissociative Identity Disorder?
It’s generally believed that Dissociative Identity Disorder is caused by severe and repeated abuse in early childhood. In order to cope with frightening and dangerous situations, the child dissociates (or “zones out”) during abuse. Over time, the repeated dissociation affects the child’s still forming personality, leading to abnormal development.
The so-called “controversy” surrounding Dissociative Identity Disorder
Many sites and articles claim that Dissociative Identity Disorder is a “controversial” diagnosis. This is not true. Dissociative Identity Disorder is recognized by the American Psychiatric Association and has been for decades. In addition, all mainstream organizations that study psychological trauma recognize the validity of DID.
What are remedies for Dissociative Identity Disorder?
Because people with Dissociative Identity Disorder usually don’t realize they have it, they rarely seek treatment for the disorder. Instead, people with DID often seek treatment for other conditions such as depression, anxiety, PTSD or suicidality. During the course of therapy, if the therapist has had training in dissociative disorders, he or she may be able to recognize a case of DID. However, because most therapists haven’t been trained to look for symptoms of DID and believe it to be extremely rare, the condition is routinely misdiagnosed—on average for seven years.
Once a person knows that they are suffering from DID, he or she should work with a competent therapist to treat the disorder. Treating Dissociative Identity Disorder usually takes many years of psychotherapy. In addition, medication is often needed to treat depression and anxiety, which are both common in people with DID.
With proper diagnosis and treatment, people with Dissociative Identity Disorder can improve immensely and go on to lead happy, fulfilling lives.
What is child sexual abuse?
Child sexual abuse describes any sexual behavior between an adult and someone under the age of eighteen. It can also describe sexual behavior between two underage people if there is a significant age difference between them or they are developmentally mismatched. While child sexual abuse includes obvious behaviors like touching and penetration, it also includes less obvious behaviors, such as looking at or showing body parts in a sexual manner, sharing pornography, or talking inappropriately about sex.
How common is child sexual abuse?
Unfortunately, child sexual abuse is incredibly common. Up to 40% of all women and 13% of all men in the United States report that they experienced at least one episode of sexual abuse in childhood. Internationally, some regions report that up to 60% of children are sexually abused, making it a problem of pandemic proportions.
Who commits child sexual abuse?
There is a general belief that most child molesters are strangers that take children by force, but this is not true. In actuality, 90% of all sexual abuse is committed by someone the child already knows—30% by family members (such as fathers, stepfathers, uncles and brothers) and 60% by acquaintances (such as teachers, coaches, neighbors, and clergymen). The vast majority of child molesters are heterosexual men.
While some perpetrators will use violence and force to commit child sexual abuse, many don’t. Instead, they groom children for abuse. Grooming is a process by which an abuser slowly and methodically wears down a child’s resistance so that the child actually believes she or he has consented to sexual activities with the adult.
Even though a child or adolescent may feel that she or he consented and was somehow complicit in the sexual behavior, this is never true. Someone under the age of eighteen is too immature, emotionally and legally, to provide consent. Child molesters use this immaturity to manipulate their victims.
What are the effects of child sexual abuse?
Child sexual abuse can have long-term consequences for victims. Adults who were abused as children are at increased risk for future sexual assaults, depression, anxiety, Post-Traumatic Stress Disorder, substance abuse, self-harm behaviors such as cutting, suicidality, Borderline Personality Disorder, and dissociative disorders. Because sexual abuse happens while a child is still developing, it can permanently alter the victim’s sense of self, as well as his or her ability to trust others, making it difficult to form healthy relationships or enjoy healthy sexuality later in life.
What are remedies for the effects of child sexual abuse?
Many adults who were sexually abused as children do not realize how it may have affected them, so they don’t seek help for the abuse. Instead, they eventually enter psychotherapy for secondary issues like anxiety, depression, substance abuse, and relationship problems. During the course of therapy, victims of child abuse often begin to see a link between their current problems and their past abuse. In remembering the abuse and mourning its damage, survivors can free themselves to lead more fulfilling lives.
Dr. Michelle Stevens is a psychologist, writer, and expert on trauma. She wrote the bestselling book, Scared Selfless: My Journey from Abuse and Madness to Surviving and Thriving (Putnam, 2017).