Posttraumatic Stress Disorder and 9-11 (cont.)

During World War I, PTSD was called shell shock, and during WW II, it was referred to as combat fatigue. After the Vietnam War, it was often mistakenly called the Post Vietnam Syndrome. Indeed, the understanding and effective treatment of PTSD were actually described in the psychiatric literature well before the Vietnam War. A psychiatrist from Harvard Medical School, Dr. Eric Lindemann at Massachusetts General Hospital in Boston, was the first to report on the systematic management of PTSD. He did this work after the Coconut Grove fire and tragedy in the 1940's.

Posttraumatic stress disorder is defined in terms of the trauma itself and the person's response to the trauma. Trauma occurs when a person has experienced, witnessed, or been confronted with a terrible event that is an actual occurrence. Alternatively, the person may have been threatened with a terrible event, perhaps injury (physical or psychological) or death to themselves or others. Then, the person's response to the event or to the threat involves intense fear, helplessness, and/or horror.

It is important to note, however, that having strong reactions to trauma is normal. What's more, there is a range (spectrum) of expected reactions depending on a person's prior exposure to trauma and even on hereditary (genetic) factors. Most importantly, you should understand that there are efficient and effective treatments for PTSD.

The scope of posttraumatic stress disorder

Sadly, the September 11th tragedy is only the most recent causative (precipitating) event for posttraumatic stress disorder. The scope of the PTSD problem in our society is actually substantial. For example, a current diagnosis of PTSD has been found in 15% of 500,000 men who were Vietnam veterans. Likewise, almost 18% of 10 million women who were victims of physical assault have PTSD. As a matter of fact, eight to 10% of the population will suffer from PTSD at sometime in their lives.

The consequences of PTSD for both the afflicted individual and society are significant. For example, studies have shown that patients with PTSD will have an increased number of suicides and hospitalizations. Also, patients with PTSD will have an increased frequency of alcohol abuse and drug dependency problems. In addition, we know that patients who have been victims of criminal acts subsequently have a much higher utilization of medical services in general. Most significantly, one third of PTSD patients will have related symptoms 10 years after the trauma. The majority of these people will also suffer from other psychiatric, marital, occupational, financial, and health problems.

The symptoms of PTSD

In general, posttraumatic stress disorder can be seen as an overwhelming of the body's normal psychological defenses against stress. Thus, after the trauma, there is abnormal function (dysfunction) of the normal defense systems, which results in certain symptoms. The symptoms are produced in three different ways:
  1. Re-experiencing the trauma
  2. Persistent avoidance
  3. Increased arousal