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9 myths about PTSD

A patient with PTSD speaks with a therapist. Chris Hondros/Getty Images
A patient with PTSD speaks with a therapist. Chris Hondros/Getty Images
Chris Hondros/Getty Images

Myth #1: PTSD only affects veterans

Post-traumatic stress disorder, or PTSD, is a condition that affects people who've been through a significant trauma. Humans have long been haunted by trauma, but it wasn't until 1980 that psychologists made PTSD an official diagnosis. Civil War soldiers who were plagued by what we'd now call anxiety and panic attacks, symptoms of PTSD, were diagnosed with "irritable hearts." Troops in World War I had "shell shock" or "combat fatigue." The American Psychiatric Association added PTSD to its Diagnostic and Statistical Manual of Mental Disorders after soldiers came back from Vietnam exhibiting symptoms of the condition en masse.

The perception of the disorder has historically been centered on soldiers, but anyone can develop PTSD. Combat, child abuse, a physical assault, or a car crash can cause PTSD to develop. About 7 percent of the US population has PTSD some point in their lives, according to the National Center for PTSD. It's a small portion of the people who go through a trauma, because most people who experience some sort of significant distress don't develop PTSD. Women are more than twice as likely to develop PTSD as men, with 10 percent of women and about 4 percent of men having it some point in their lives.

Myth #2: People suffer symptoms of PTSD right after a trauma

Symptoms often show up in the first few months after a traumatic event, but sometimes symptoms don't appear until years after. It's different for everyone who develops PTSD.

Many people with PTSD re-experience their traumas through nightmares, flashbacks, or frightened or angry thoughts. They might make a concerted effort to avoid anything that might trigger those recurring feelings of trauma. People with PTSD might feel alienated or lose interest in things they enjoyed before a trauma. They might become more aggressive, self-destructive, or hypervigilant. PTSD is diagnosed when multiple symptoms have lasted for more than a month.

Myth #3: Everyone has some sort of PTSD

Certainly, most people will go through some sort of trauma in their lives. About 60 percent of men and 50 percent of women experience at least one trauma in their lives. But a much smaller percentage of people actually develop PTSD. About 10 percent of women and 4 percent of men develop PTSD at some point.

People who experience a trauma but don't develop PTSD might still develop a symptom of PTSD. But the American Psychological Association has a strict outline for what qualifies as PTSD. To be diagnosed with the disorder, a person has to have a combination of symptoms that last for over a month. So while it's common to experience a trauma, it's relatively rare to develop PTSD.

Myth #4: PTSD isn't treatable

It's actually quite treatable, even if it isn't completely curable in everyone. PTSD is frequently treated with drugs, behavioral therapy, and other approaches. Writer P.K. Phillips had PTSD that caused her terrible flashbacks and nightmares and left her unable to sleep alone in her own home. She started taking medication and going through behavioral therapy when she was diagnosed. Now, she says, she has control of her life again.

"For me there is no cure, no final healing. But there are things I can do to ensure that I never have to suffer as I did before being diagnosed with PTSD. I'm no longer at the mercy of my disorder," she writes.

Several forms of counseling have proven effective in treating PTSD, including talk therapy, exposure therapy, and behavioral therapy. The FDA has also approved two medications to treat PTSD: sertraline and paroxetine (Zoloft and Paxil). They're both antidepressants, and can help control emotional symptoms of PTSD like sadness, anger, and anxiety. There's evidence that meditation can help those with PTSD, as well. Treatments are different for everyone, and sometimes people need to try various combinations to find what works.

Myth #5: Symptoms of PTSD go away as a person heals from trauma

Symptoms of PTSD can come and go, and can vary in intensity over time. As with an anxiety disorder, stress can exacerbate a person's PTSD symptoms. Reminders of the trauma, even many years later, can cause long-dormant symptoms to reappear.

It's called re-experiencing a trauma, and it's common in people with PTSD. They might experience the same emotions or even physical sensations they felt during a trauma. People with PTSD commonly cannot control re-experiencing a trauma.

Myth #6: PTSD causes violent behavior

The majority of people with PTSD aren't dangerous. PTSD is associated with an increased risk of violence, but most people with it have never acted violently. Research shows that when risk factors correlated with PTSD are taken into account, the association between PTSD and violent behavior drops significantly. There's a wide variety of risk factors, like alcohol abuse, drug misuse, and other psychiatric disorders, that play into the relationship between PTSD and violence.

Myth #7: PTSD is all in a person's head

PTSD is a real condition that causes very real symptoms. Traumatic events can change how the brain functions. PTSD leads to measurable changes in the brain and body after a person has been exposed to a trauma.

Researchers have found three areas of the brain that are different in patients with PTSD than in patients without the disorder: the hippocampus, the amygdala, and the medial prefrontal cortex. The amygdala is where emotions meet reactions, and in people with PTSD, it overreacts to things that have to do with their trauma. In the hippocampus, which controls emotions, research shows that a PTSD patient's flashbacks might be due to a failure in the brain to control reactions to trauma-related stress.

Myth #8: PTSD only affects weak people

It's not a question of strength, or of emotional stamina. There are a number of factors that play into whether a person who's gone through a trauma develops PTSD. A person's risk of getting PTSD depends, in part, on a combination of risk factors and resilience factors, as researchers call them. Having a history of mental illness, for example, puts people at greater risk to develop PTSD. People with little to no support, such as those who don't tell anyone about what happened to them, are more likely to develop PTSD.

On the other hand, people who seek support from friends or family after a trauma (considered a resilience factor) are less likely to develop PTSD. Other resilience factors that might stop PTSD from developing include learning how to cope in a healthy way, joining a support group, and feeling good about one's reaction to the trauma.

Myth #9: It's not an injury, so it doesn't require medical attention

Trauma can be physically damaging, but isn't always. You don't have to be physically hurt or wounded to develop PTSD. Many disaster workers who volunteered as part of the rescue crews after 9/11 developed the disorder, though they weren't physically hurt in the disaster.

Even without a physical wound, PTSD is a sign of an injury, and one that often requires medical attention. Some PTSD symptoms might be acute and subside quickly on their own without help from a professional. But many people with PTSD find their lives disrupted by the symptoms, and require medical attention. It can cause people to lose function as their daily lives are interrupted by symptoms such as panic attacks and sleeplessness. PTSD isn't something people can necessarily get over by themselves. It often takes time, support, and directed treatment. Seeking medical attention can help people with PTSD regain control over their lives.

To bust this myth, there's a campaign to end the stigma around PTSD by dropping the D from its name. Army Staff Sergeant Ty Carter has led the movement to change the name to PTS, because he wants people to start seeing it as more of an injury and less of a disorder.