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Post-Traumatic Stress Disorder in Civilians
Post-traumatic Stress Disorder is a relatively new diagnosis, though the symptoms have been around for many years. In WWI, since it was shown to afflict men who had been in combat, it was given the name “shellshock” (PTSD Part I, 17.) In WWII, it was known as “battle fatigue”, to allow the men who suffered from it to keep their dignity. During the Vietnam War Era, the phenomenon began to be understood (Arlene, 2). Post-traumatic stress disorder is an anxiety disorder that stems from extreme stress over an event that the victim perceives as life-threatening or overwhelming. The event causes extreme fear in the victim. Post-traumatic Stress Disorder produces a specific set of symptoms that last at least a month (PTSD Part II, 73). It is now known that civilians also develop this disorder. Post-traumatic Stress Disorder is unique among all emotional and mental disorders, in that it can be linked directly to a specific event. It affects only 34% of adults (Feerick, 410). Although men are more likely to experience traumatic events, women are twice as likely to develop PTSD (Columbia Encyclopedia, 2). The gender of the victim influences the type of trauma experienced and how that trauma is encoded into memory (PTSD Part III, 113). Post-traumatic disorder in civilian women can be caused by many factors.
One reason some people develop this disorder is the trauma of natural disaster. This is seen in survivors of tornadoes, hurricanes, earthquakes, etc. People are injured and dealing with intense pain. They can be separated from those they care about. People who have never before experienced death or violence can be suddenly exposed to both. A year after Hurricane Katrina, 24% of survivors showed symptoms of PTSD (Edmonson, e134). Seeing and experiencing something so horrific falls under the category of “an overwhelming traumatic event” (Columbia Encyclopedia, 1).
The aftereffects of natural disasters, of course, can lead to the second cause of PTSD: loss of security and loss of a loved ones. After such events, they can lose their homes, their family members and friends, and their employment, all at once. Losing everything, losing the security of a future, losing someone you love when you are unprepared, causes prolonged depression and fear. Some may consider these to be mild events, but to the person suffering, it is overwhelming and life-threatening (PTSD Part II, 75). “Loss of resources has been linked to an increase in symptoms of mental illness and with PTSD symptoms in particular” (Schmidt, 255). This seems to most often affect single mothers on low-income assistance (Samuels-Dennis, 603). These women feel they have lost all power over their own lives, which makes it more overwhelming. This feeling over powerlessness puts them at high-risk for developing PTSD (Schmidt, 254).
Another cause of PTSD is violent crime. Violent crimes can include mugging, armed robbery, or burglary. These are considered assaultive traumas. The victims are quite often in fear for their lives. The most intense violent crime, which affects women the most, is sexual assault (Antai-Otong, 55). “Assaultive traumas include discreet and/or enduring offensive physical and sexual encounters that precipitate a state of intense fear, apprehension, loss of control, and powerlessness in victims” (Samuel-Dennis, 605).
One of the worst traumas for women is intimate partner violence, also known as domestic abuse or spousal abuse. This is a type of ongoing trauma. The victim is usually kept under control and not allowed to speak to others. The abuse tends to get worse over time. The avoidance symptoms, fear, depression, and nightmares that survivors of IPV experience was once called “Battered Woman’s Syndrome”. These women go through the feelings of powerlessness and hopelessness associated with “learned helplessness”. They feel isolated from others. They experience fear of losing everything and becoming destitute. Many also fear losing their children. Often, the abuser is the one with money, so is able to hire attorneys to take custody. It is only fairly recently that “Battered Woman’s Syndrome” is post-traumatic stress disorder (Schmidt, 253-255).
Often, IPV leads to the next cause of post-traumatic stress disorder, which is the lack of a social network. This contributes the most to Post-Traumatic Stress Disorder symptoms, in all of these situations, because it intensifies the isolation the victim already feels and enhances the depression. The survivor has no one to lean on for support and no one with whom to share her fears (Samuel-Dennis, 605).
The leading cause of post-traumatic stress disorder in females is childhood sexual abuse. This is another trauma which causes the victim to fall into learned helplessness, because it is also an ongoing trauma. The child must learn coping skills, most often dissociation and emotional numbing. Adult survivors of childhood sexual abuse exhibit the same types of PTSD symptoms as combat war veterans. Because the children are exposed to chronic abuse, they develop coping mechanisms that evolve into more severe problems in later life. Adult survivors of childhood sexual abuse have the most problems adjusting to society. The PTSD experienced by the abuse suffered impacts how the victim mentally processes future traumatic experiences. It has been shown that those who have had PTSD are more likely to develop it again. Those who are re-victimized by other traumas experience more sever effects than those who never experienced abuse. This is because the nervous system is primed for stress already. The more often the woman is re-victimized, the more severe the next bout of PTSD is. Women who were sexually abused as children have the highest risk of developing PTSD. Those who were fondled or dealt with simple exposure showed less symptoms than those who experienced full intercourse or attempted intercourse. Women who were sexually abused have more issues with social functioning and isolation (Feerick, 410-11).
Post-traumatic Stress Disorder is a serious problem. It leads to more health issues, less employment, more homelessness, and higher medical costs (PTSD Part II, 79). PTSD symptoms are categorized into four types: Intrusion symptoms, which causes unwanted memories to flood into the victim’s mind, recurring nightmares, and flashbacks; Avoidance Symptoms, avoiding any and all thoughts of the event, and avoiding people, places, and things that are reminders of the event; Negative Cognitions, which include lapses in memory about the event, constantly seeing only the bad in everything, the inability to experience love or any positive emotion, detaching from others, and feeling alone in the world; and Alterations in Arousal and Reactivity, which includes extreme irritability, self-destructive behavior – like self-mutilation, and heavy drinking and drug use, hypervigilance, difficulty concentrating, and sleep problems (Levine, 2). Memories related to the traumatic event tend to push the victim into more alcohol and drug use in order to numb the pain. This often leads to alcoholism and addiction. They have less ability to function in society, they have more physical symptoms, and more health-risk behaviors. They are also more at risk for stress-related disease, like heart-disease, DOPD, cancer, and liver disease. Women with PTSD are the most susceptible to suicidal thoughts and self-mutilation, and are most at risk for attempting suicide (PTSD Part III, 169). Studies seem to show that women develop PTSD more often than men because they have higher rates of experiencing the types of trauma that most often cause PTSD: interpersonal trauma. “Only prisoner-of-war experiences carry similar risk of PTSD…[P]owerlessness is central to the development of PTSD” (PTSD Part III, 165).
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© 2016 Melissa Lawson