Trauma and Developing PTSD

Most People Who Experience Trauma Do Not Develop PTSD

Depressed veteran meets with psychologist
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Post-traumatic stress disorder (PTSD) is state of extreme anxiety and hypervigilance which begins after some type of traumatic experiences such as a rape, military combat, or natural disaster. 

The symptoms of PTSD may include reliving the traumatic event over and over again, avoiding people or places that remind you of the trauma, or exhibiting symptoms of the flight or fight reaction.

PTSD may also occur following milder but ongoing problems and is increasingly being recognized in cancer survivors, those with rheumatoid arthritis, and those living with multiple sclerosis, among other conditions.

How Common Is Post-Traumatic Stress Disorder (PTSD) Overall?

It's thought that there are currently around 8 million people in the U.S. who are living with PTSD. These numbers vary significantly depending on gender, the emotional response to the trauma, and other factors. Altogether it's estimated that seven to eight percent of people will experience PTSD at some point during their lifetime. 

That being said, this number is a small portion of the total number of people who suffer a traumatic experience. Most people who experience a traumatic event will not develop PTSD.

What Are the Risk Factors for Developing PTSD?

Many people will experience a traumatic event at some point in their lives. However, not everyone who experiences a traumatic event will eventually go on to develop PTSD.

So, how can we know which people are more likely to get PTSD after experiencing a traumatic event? In other words, what factors increase a person's chance of developing PTSD?

Researchers have been working hard on this question as it is an important one to answer. If healthcare providers know which people might be more likely to develop PTSD following a traumatic event, steps can be taken to treat the individual before the PTSD develops.

These steps are called "prevention efforts" because they act to prevent or stop the development of PTSD and all that goes along with it, such as relationship problems or substance abuse.

Here are several risk factors that have been found to increase the likelihood of developing PTSD after a traumatic event:

Mental or Physical Health Condition

People who've already experienced one traumatic event are likely to develop PTSD, as are people who had psychological difficulties before the traumatic event (especially depression or bipolar disorder) or a family history of psychological problems.

In addition, people who have a medical condition such as heart disease, chronic pain, or cancer are more likely to develop PTSD in response to a traumatic event. (Heart disease or cancer may also be the traumatic event which leads to the development of PTSD.)

However, it is important to remember that just because you have experienced another traumatic event or come from a family with psychological problems doesn't mean you will develop PTSD. It just means that you are more vulnerable to developing the disorder.

Emotional Response During the Trauma

The person's emotional response to the traumatic event is also a factor. For example, did the person feel fear, helplessness, horror, guilt, or shame? Alternatively, did they experience dissociation during the traumatic event?

Dissociation is a particular type of response to a stressful experience in which individuals may actually feel separated or cut-off from themselves or their surroundings.

When in a "dissociative state," people may feel numb, lose track of time or feel as though they are floating outside of their bodies. In some cases, they may have no memories of the event at all.

Research suggests dissociation at the time of the traumatic event is a particularly strong predictor of who develops PTSD. This is because dissociation may limit the extent to which a person can fully process his emotions about a traumatic event, and therefore, his ability to cope with the event.

The Trauma Itself

The event itself plays a role. For example, if the traumatic event put the person's life in danger, it may be more likely to cause PTSD down the road rather than an event which was not life-threatening.

Gender

Men and women differ in their lifetime rates of PTSD. Surprisingly, women appear to be twice as likely as men to have a diagnosis of PTSD at some point in their lifetime. Specifically, 10 percent of women and 5 percent of men have been found to have PTSD at one time or another in their past.

Why might this be? This finding may partly be because women are more likely than men to have experienced traumatic events (such as rape or physical abuse) that have a high likelihood of leading to the development of PTSD. Some experts suggest that this gender difference may also be at least partially explained by hormonal changes.

Age and Marriage

Research suggests that the risk of developing PTSD decreases as a person ages. In addition, marital status may play a role, with PTSD being more common in men and women who were previously married (separated, divorced, or widowed) than in a person currently married.  

Emotional Support

The emotional support people receive after a traumatic event also plays a role. People who do not receive support from others may be more likely to develop PTSD after a trauma.

A Word From Verywell

If you have any of the risk factors discussed above, you may be more vulnerable to developing PTSD following a traumatic event.

Seeking help (whether in the form of social support from loved ones or psychotherapy from a mental health professional) soon after experiencing a traumatic event may "defuse" these risk factors, preventing the development of PTSD. 

Keep in mind that even if you develop PTSD, there are treatments available which can make a tremendous difference in your quality of life. So, if you or a loved one has symptoms that suggest posttraumatic stress, don't wait. Make an appointment to talk to someone today.

Sources

Atwoli, L., Stein, D., Koenen, K., and K. McLaughlin. Epidemiology of Posttraumatic Stress Disorder: Prevalence, Correlates, and Consequences. Current Opinion in Psychiatry. 2015. 28(4):307-311.

Boudoukha AH, Ouagazzal O, Goutaudier N. When traumatic event exposure characteristics matter: Impact of traumatic event exposure characteristics on posttraumatic and dissociative symptoms. Psychol Trauma. 2016 Dec 8.

Briscione MA, Michopoulos V, Jovanovic T, Norrholm SD. Neuroendocrine underpinnings of increased risk for posttraumatic stress disorder in women. Vitam Horm. 2017;103:53-83.

Chang JC et al. Comorbid diseases as risk factors for incident posttraumatic stress disorder (PTSD) in a large community cohort (KCIS no.PSY4). Sci Rep. 2017 Jan 27;7:41276.

U.S. Department of Veteran Affairs. (October 2016). National Center for PTSD. How Common is PTSD?

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