Posttraumatic stress disorder (PTSD) is an anxiety condition that can result from experiencing an event involving direct or indirect threat of death, serious injury or a physical threat. Such a life-threatening incident could be a car accident, a sexual assault, a natural disaster, physical assault or military combat.
Over the course of a lifetime, about 60 percent of men and 50 percent of women will experience a traumatic event. Most do not get PTSD. It’s estimated that about 8 percent of the U.S. population will have PTSD symptoms at some point in their lives.
Causes and Effects
The exact causes of PTSD are not known. When a traumatic event occurs, the brain gets revved up and is flooded with stress hormones. In PTSD sufferers, the brain’s metabolism has been altered by the rush of hormones, and memories of the event are stored in a different way.
PTSD symptoms include:
- flashbacks of the event
- inability to feel a range of emotions
- insomnia, difficulty concentrating
- persistent anxiety
- being easily startled
Signs of PTSD appear more severe and long-lasting if the traumatic event is man-made, such as in combat or with a violent crime.
PTSD symptoms may occur soon after the trauma, or it may be months or years before they develop. They might also reoccur over the years.
A major study published in 2004 estimated the risk for PTSD from service in the Iraq War at 18 percent and the estimated risk for PTSD from the Afghanistan War at 11 percent.
But research also shows that early symptoms of PTSD are not very good predictors of a long-term prognosis, according to a report from the National Center for Post-Traumatic Stress Disorder, which was established by Congress in 1989 and operates within the Department of Veteran Affairs.
“Studies suggest that in the face of severe military service demands, including combat, most men and women do remarkably well across [their] lifespan,” the report says, adding a caution:
“On the other hand, if the mission is experienced as a failure, if soldiers deploy more than once, if new veterans who need services do not get the support they need, or if post-deployment demands and stressors mount, the lasting mental health toll of the wars in Afghanistan and Iraq may increase over time.”
Why do some service members experience combat-related PTSD while most do not? According to the National Center for PTSD, a person is more likely to develop PTSD if he or she was injured during the event, the trauma was long-lasting or if the person felt helpless during the trauma.
The likelihood of the disorder also increases if a person has previously experienced a trauma, has been the victim of childhood physical abuse or neglect, has a pre-existing mental-health problem or is repeatedly exposed to intense combat experiences. Some preliminary studies suggest there might also be a genetic component.
Treatment and Prognosis
There are successful treatments for PTSD, including cognitive behavioral therapy, certain prescription medications or a combination of both. Treatments may require several weeks or months. The chances for success are greatly increased if treatment begins early after symptoms are experienced.
Most people who are likely to recover from PTSD will do so within the first two years, by which time more than half will have recovered. Another 20 percent will recover over the next five years.
Military Sexual Trauma and PTSD
Military sexual trauma, known as MST, is a serious concern for all branches of the armed forces. Just how widespread a problem it represents is hard to gauge for a variety of reasons.
In a report delivered to Congress in March 2009, the Pentagon says there were 2,908 reports of sexual assaults involving either a military victim or perpetrator in fiscal year 2008. This is an 8.18 percent increase from the previous year, according to the Pentagon. The offenses range from wrongful sexual contact to rape.
The latest number could indicate that sex offenses are on the rise, more reports of offenses are being filed as service members are encouraged to report them, or a combination of both.
The military definition of sexual trauma is more inclusive than the civilian term. MST refers to both sexual harassment and sexual assault that occurs in military settings. Both men and women can experience MST, and the perpetrator can be of the same or opposite gender.
MST is associated with higher rates of mental-health problems. A study from the Department of Veterans Affairs looked at healthcare screening data of about 90,000 vets of the Iraqi and Afghanistan wars who were treated at a VA health facility between October 2001 and October 2006. Of these, about 14.5 percent of the women and 0.6 percent of the men report experiencing MST.
Both women and men with a positive MST screen were three times more likely to be diagnosed with a mental-health condition than patients who did not report MST, the study says. The most frequently reported mental-health conditions among OEF and OIF veterans were depression, PTSD and other stress disorders, and substance abuse.