Category: Post Traumatic Stress Disorder

Tim Thomas portrays a character suffering from Post-Traumatic Stress Disorder throughout the Seven Pounds film. But what happens when someone with a real-life case of mental health issues watches this film? Does it accurately portray mental illness to the watcher? While the heart within this movie is correct place, the special effects in the movie might not portray what real PTSD is like. Tim Thomas carelessly sends a text message while driving, causing a multi-car accident. Six strangers and his fiancee Sarah were all killed in the crash, leaving Tim the only survivor. After two years, Tim searches for redemption, unable to live with what he had done.

After donating a lung lobe to his brother, he finds a way to redeem himself. Donations. He decides to donate his vital organs to six “good” people in need. To find his candidates, he steals his brother’s, IRS agent credentials and ID. Using his brother Ben’s privileges, he further researches and interviews each donation candidates. He then deems them, worthy or unworthy. The first candidate, a young boy, received Tim’s bone marrow after Tim undergoes the procedure with no anesthesia. For his second candidate, he donates part of his liver to a CPS worker. A kidney was given to a junior hockey coach as a third candidate, but yet he still does not feel the atonement that he searches for. He then gives his home to his fourth candidate, a woman, and her children, so that they can leave the abusive household they were in. He refuses to explain why he is doing what he is doing despite being asked many times. His wishes were for no one to know why, as it would bring up his memories of the accident.

Still drowning in guilt, he moves into a motel with his box jellyfish to continue his formulated plan and takes his pet box jellyfish with him. His sixth potential donation is a blind telemarketer, of which he is looking to donate his eyes to. To test the man, Tim calls to harass him, the blind man stays calm and teary-eyed, and Tim then decides that he is worthy of his eyes. His final and most important candidate, Emily Posa, a wedding card printer, has a congenital heart condition and a rare blood type that grants her only a few weeks left to live. He then becomes closer with her, spending time together often. He tries to fight his affection for her but eventually gives in. But despite that ray of genuine happiness, Tim’s brother then visits him to retrieve his credentials and ID badge and Ben tries to explain to Tim that he is a federal officer and that it is a felony for him to be doing what he is doing. Tim is more concerned about Emily at that point and runs to the hospital to find out if anything has changed with her chances to survive. When he hears that there her chances have gotten slimmer, he solidifies his fate and begins to enact his plan. He heads straight to the motel and calls the blind man to tell him that he is receiving a gift and that someone will be contacting him. He then calls 911 and confirms his address with the operator and tells them that he is the suicide victim. Tim fills the bathtub with ice and releases the box jellyfish into the bath water. He is slowly electrocuted to death.

In the last few moments in the movie, Emily is given surgery for her new heart and Ben explains to her who Tim was. The ending of the movie is composed of the blind man and Emily meeting, and finding a sense of peace in the gifts that Tim had given them. A strangely happy ending after a gruesome suicide scene. Tim Thomas exhibited symptoms of PTSD throughout the movie, especially leading up to his death. Post-Traumatic Stress is a disorder common among those involved with a traumatic experience. Post-Traumatic Stress Disorder often have four categories: behavioral, psychological, mood, and sleep (as shown in the graph below)(Amatruda). Hollywood can glamorize and exaggerate the symptoms listed above through cinematography. The creators of the film have the ability to change the colors, distort music and sounds, change time, and switch viewpoints. They can manipulate the perception of incidents and emotions through carefully written scripts and emphasize reactions. Subconsciously as humans, we conclude what is real and what is strictly Hollywood.

While we may consciously tell ourselves that what we watched isn’t life, we subconsciously create stereotypes and fake solutions to people and problems (Beachum). This makes perfect sense because when we see someone with dark clothes, messy hair, and a sad expression we assume they are depressed. Media, especially movies, create a vision of what mental illness looks like and tries to create clarity into the viewer’s hearts to portray illness. This can be where portrayal and perception can become dangerous. The creator never knows who will see it and if it will impact or offend them negatively. The heavy special effects on the dramatic scenes growing closer and closer to his suicide escalate the emotion in the ending. It begins to escalate with a flashback of his fiancee, Sarah. Tim is in the shower when an unwanted memory passes through his head of Sarah after the accident and seeing her lifeless body (1:19:24-1:20:21).

During this scene, there are multiple factors being manipulated. It is a dull filter and cast on the imaging, there is a crescendoing drumming sound, as well as an eerie feel with the quick transitions between the present and the memory. This is a reoccurring theme among many important emotional scenes in the film such as: When Tim runs to the hospital to find out if Emily’s chances had improved at all (1:41:06-1:43:12). During the running and visit to the hospital, not only are all of the previously mentioned effects occurring but they also made it rain during that particular part, foreshadowing and giving the viewer a feeling that something bad is about to happen. The most important and final example is throughout his suicide scene (1:45:24-1:49:54). The lighting is dim throughout the entire scene before, during, and after his death. Music gets louder as memories of the crash are shown. He looks more and more tired after every scene change. These seemingly minor alterations are what make the scenes inaccurate and dramatized. Showing thoughts, hyperventilation, silence, and/or sobs can help bring the human factor into it. Mental illness is not beautiful or planned like in this movie. It is messy.

After watching Seven Pounds, a viewer has to process everything that occurred and make sense of it. While some movies can accurately depict real-life symptoms and genuine drama, others can fail horribly. Seven Pounds is somewhere in between that spectrum of realistic and fake. The guilt that causes the symptoms that are shown are logical, but they are edited to exaggerate the emotions and reactions of a real disorder. Based on the viewer, their knowledge of the disorder, and the symptoms belong to can change the viewpoint on whether it was depicted well or poorly. The most important concept in this analysis is that movies and media are completely subjective. The stance taken on this subject is very dependent on the viewer’s experience, sensitivity, state of mind, and moral views. This can change completely among different audiences which can make mental illness in a film so controversial, especially when they add special effects that make it seem more glamorous than it truly is.

There are many different types of PTSD cases and how people get this mental disorder, from traumatic events that have occurred in one’s life, to a situation that makes them remember the trauma. Millions of people around the world have suffered or are suffering from PTSD. In this paper I would like to highlight veterans throughout history that have suffered greatly from this disorder, but, unfortunately have never had the means to get treated. They had to hide their pain and be tormented by this illness throughout their entire lives, while never knowing what was the cause of it all. I hope to shed light on what these veterans have had to go through, and make people more aware of this disorder.

Literature Review

An article by Langer (2011) explains that World War II was not the first war that veterans suffered greatly from PTSD, but it was the first time when people began to notice that veterans after the war (midlife) would, at random, experience PTSD symptoms again. Once a young man would get back from war, he would experience horrific trauma from what he had seen, though it was not recognized as PTSD in that time, but rather ‘battle fatigue’. It was thought that just sending the military personal home and out of combat areas, they would ‘get over it’. It wasn’t seen as very serious, or something that needed intensive care. In some cases, after a few years, their PTSD symptoms would subside, but in almost every case it would reappear again when left untreated. The majority of combat vets, though, from World War II did not get any PTSD symptoms until they were in midlife, this affected their family, work, and everyday situations in life. Langer explains that the diagnostic criteria was not determined until 35 years after the war, many veterans with PTSD were actually given a wrong diagnosis such as having anxiety neurosis or an anti-social personality disorder.

Alcohol misuse among veterans has been a horrific problem throughout history, according to an article by Walton, Raines, Cuccurullo, Vidaurri, Villarosa, and Franklin (2018). Since veterans in the past did not know what PTSD was or how to combat it and many of them resorted to alcohol. These studies have shown that PTSD is, of course, the main issue, but alcohol misuse makes the individuals, perhaps, angrier, depressed, suicidal, and causes their process to recovery more difficult. It hinders their reality and maybe even numbs their pain for a while, but this is only temporary, and in the end, they are still faced with the horrors that traumatize them. This article explains that veterans need to have as many options to get treated as possible, this way so they don’t feel as though they have to resort to over drinking.

According to an article by Koven (2017), post-traumatic stress disorders are the cause of crippling depression, anger, and the rise of suicide in veterans that have been in combat. In his research, he concluded that people that claimed they had PTSD had increased dramatically between 1999 and 2004. Overall, it had grown at a staggering 79.5% of reported cases. It was obvious that PTSD was much more prevalent than was thought before, these veterans finally were able to come forward and reveal what had actually been going on for so long. Also, in Koven’s research he explained that in 2016, the statistics of a veteran committing suicide was over twice as likely as a man or women that hadn’t been in any combat. These veterans also admitted they used anger and internal hostility to numb the pain of suicide, night terrors, and flashbacks they were experiencing. It was very clear that PTSD was a link to the high suicide rate among active military and veterans that have gone through the traumas of war. The U.S Veterans Administration conducted that, overall, veterans committed suicide at incredibly higher rates than the average civilian. The mental health of an individual in the military returning from war is extremely important and should never be taken lightly, bringing these high rates of suicide down is the biggest concern.

Deeper Thinking

Thinking over how little people have spoken about veterans that have suffered with PTSD in the past, I believe now is the time we should spread awareness for it more than ever. We have come to a time that people should never feel ashamed or embarrassed to express how issues or distress they may be going through. These veterans that have had to hide their suffering, has finally come to an end. It is finally time for people with this illness to get the attention and help they deserve. Just as people are aware of depression and anxiety in today’s society, PTSD should be known just the same, since so many people are or have suffered from it. First and foremost, we should get these people the help and therapy they need in all parts of the world, big or small. In my personal opinion, in order for veterans to get the help and support they need, there should be access for them to get therapy anytime, anywhere. I believe online treatments should be available for them, more treatment centers in small towns and cities, and local support for these individuals. The online sessions could be very useful for a veteran that perhaps wants to stay in the comfort of his home, or if there are no available treatment centers in his or her neighborhood. In order for this mental illness to get recognized and for people to know how incredibly serious it is, I feel as though we should have benefits, fundraisers, and special days set aside for people to spread awareness. I personally volunteer at a veterans benefit once a month, we sing, have auctions, and serve food. I feel as though little steps like this can open people’s eyes on how significant veterans need to be recognized. Social media could also be a good source to get people’s attention in today’s world, since so many people interact with one another in that way. Perhaps Facebook fundraisers, support groups, and information being shared could get many people more involved with this issue. People are on their phones multiple times throughout the day, even as simple as a hashtag can get people interested quickly. In just a click of a button millions of people can become more aware of the struggles of veterans suffering from PTSD have had to live with. I believe many people would be shocked to realize how high the suicide rate among veterans is, and how we need to act immediately to get this issue taken care of. It would take a very large crowd of people to be dedicated to make this happen, and even more to help raise the money for treatment centers, cost is the main issue in this situation. With the money raised in the benefits and fundraisers, we could slowly buy buildings and get offices for the therapists. Over time I feel as though the money could be used to help other small towns and cities worldwide, to get their veterans the help they deserve.

Conclusion

Throughout history, veterans have undergone enormous amounts of trauma, pain, depression, and anxiety. It has always been overlooked until the last few decades as merely ‘battle fatigue’, but now we are finally taking the steps to help these men and women combat their PTSD. Before they were given many wrong diagnoses and in turn, resorted to the misuse of alcohol in many cases, which lead to even more issues. Suicide rates in combat veterans is incredibly high, and we should do all we can to stop this horrific path that’s been taken and let them know that there is a way out. I believe more can be done to get them the help, wherever it may be, and they will not have to pay a dime. With help primarily from social media, fundraisers, and more treatment facilities, awareness can be spread throughout every neighborhood, city, town, and country. No one should ever have to go through recovery alone.

PTSD, or post-traumatic stress disorder, is a mental health disorder that affects a vast amount of people in the united states. PTSD likely goes back as far as humanity itself, given that it is a mental disorder that stems from any type of traumatic or significant event in ones life. PTSD is very serious and commonly misunderstood due to the fact that it is a mental disorder. Mental disorders are especially tricky, sometimes they can have an unknown origin in a specific patient, and most don’t have any consistently successful treatments. There is almost never a set way to deal with a victim of a mental disorder, due to the fact that any patients with the same diagnosis will still have vastly different experiences than on another. PTSD is very unique in that way, a patient suffering from post-traumatic stress disorder, would have to be dealt with in a very different way than most, even if they are all suffering from the same disorder. Post-traumatic stress disorder is a very malicious disease, thousands upon thousands of people are affected by it each day with no signs of slowing down and no clear ways to treat it. Our best hope in treating PTSD is understanding it.

Post-traumatic stress disorder is a mental health condition that is triggered by a traumatic past experience in one’s life or even in the life of people around them. This condition is commonly found in, but most certainly not limited to military veterans. This is due to the fact that of all the people in most civilizations, those who fight in wars often see things that most people only see in glorified movies or stories. Most experiences that lead to PTSD are moments of great fear or helplessness, like the feeling of impending doom, being trapped in a spot where death feels imminent, or in a position where death was almost guaranteed. But not all cases of PTSD can be traced back to a single moment, these experiences can be moments that last days or even months. Drivers of military vehicles in war zones are constantly vigilant and looking out for IEDs, then when they get home they cause an accident because they swerved away from a plastic bag on the freeway. Post-traumatic stress disorder often includes symptoms such as flashbacks, nightmares, or severe anxiety. All of which is due to the brain bringing people back to that feeling of impending doom. It’s mainly caused by the lack of ability humans have to cope with things they’ve seen or done.

As evolution occurred in our species, at one point we developed highly functioning brains, and though our brains continue to evolve, we are still met with things that cannot be fully understood or explained. Post-traumatic stress disorder is one of the many conditions of the brain that still reign terror on humanity. WW1 soldiers were the first known victims of PTSD, but back then it was referred to as “shell shock”. As men would return from the war, some with obvious physical injuries and some without, a commonality between all of them were symptoms that were similar to those which had been associated with “hysterical women”. English physician Charles Myers wrote the first paper on “Shell Shock” in 1915. He theorized that these symptoms shown by soldiers were results of physical injury to the brain. Assuming that it was due to the blast from bombs. After testing his theory, it didn’t hold up. Even soldiers who hadn’t been exposed to blasts from bombs still showed symptoms of shell shock, and on top of that, not all soldiers who were exposed showed any symptoms of shell shock. Today we are able to realize that these soldiers were experiencing post-traumatic stress disorder. However, even though WW1 soldiers were the first recorded victims of PTSD, with an understanding of what post-traumatic stress disorder is, it’s obvious that it goes back much, much further than the “first documented case”. Wars go back as far as humanity itself, and on top of that, traumatic experiences are not limited to time as far back as we can record. For thousands of years, man has had to survive without the help of the luxuries we have today. Man had to fight to survive, and though we have been at the top of the food chain for a very, very long time, it was not always as easy as it is today. Today we can go to the grocery store and buy an already cut piece of meat with no issue, however back then there were very powerful predators that would need to be fought off just to hunt a single animal, and an encounter with one of those predators would likely be very traumatic. And just because it wasn’t recorded, doesn’t mean those men didn’t go through what we call today as post-traumatic stress disorder. Although it was highly controversial, In 1980, the APA (American Psychiatric Association) added Post-traumatic stress disorder to the third edition of the diagnostic and statistical manual of mental disorders. Despite the fact that many did not agree or recognize PTSD as a mental disorder, it went a long way in helping to understand the psychology behind many recorded cases of what we know today as PTSD.

PTSD is a mental condition that occurs when someone experiences or witnesses a traumatic incident. This can be a wide variety of things such as war, terrorism, natural disasters, or even sexual assault. People who suffer from this disease often have many different types of symptoms. These people often feel immense fear, stress, or anxiety. Some may even relive the event constantly through vivid flashbacks or nightmares. In most cases, people suffering from PTSD tend to be very irritable and appear to be more angry than usual. They may even tend to keep to themselves and appear to be shutting the rest of the world out, and in severe cases, you may notice very self-destructive or dangerous behavior. Victims of PTSD tend to close themselves off and not interact with others as much as they’ve been known to in the past, and interacting with them can be dangerous due to the fact that they are jumpy and more easily startled. Having a loved one suffering from PTSD can be especially difficult because they may not seem like the person you once knew. Unfortunately, this is where the people around a person suffering from PTSD can actually make it worse. We as people tend to do what everything that can, thinking it is helpful when in reality we’re only making it worse. Constantly hovering over a loved one and asking them what’s wrong may feel beneficial to you but all you’re doing for them is triggering their anxiety. The only way to care for someone dealing with PTSD is to stay by them and help with whatever you can at their pace, possibly even encouraging them to seek help if that’s what they want.

One of the hardest parts of PTSD is who it affects. Many people think the only person affected is the victim, however, that is not the case. Though the victim is the one who is hurt the most, the people around them are also suffering. PTSD can tear families apart, families who send loved ones off to war, suffering in sorrow, wondering if they will ever see them again, only to be met with this shell of the person they once knew. Studies have shown that Veterans suffering from PTSD tend to have more family-related issues than veterans who do not. This is due to the emotional detachment loved ones feel when their spouse lives through such a traumatic incident, the children of the family have also been known to have more behavioral issues than normal. 38% of marriages between Vietnam Veterans and their spouses failed within six months of the soldiers coming home. This disorder has been infamously known to tear families apart, it changes the overall behavior of the people suffering from it, thus changing who they are as a whole. People who suffer from PTSD often develop unhealthy coping mechanisms, such as drug use, drinking, or gambling. The reason behind this is because those suffering from PTSD don’t want to think about what happened anymore, so substances and habits are what help them forget, even if just for a moment. But after awhile these vices turn to addictions, and before they know it they’ve already lost the ones they love and care about.

Because post-traumatic stress disorder is a mental condition, there is no known cure. The disorder affects the brain, and since each person’s brain and experience are different, a method of treating one person’s PTSD may not be the same as treating others. PTSD stems from our inability to cope with a traumatic incident, this is always specific to the individual, some people may be more equipped to handle a certain experience than others. Taking 9/11 for example, everyone was affected by that horrible event in different ways. Weather they were near the towers, in the towers, or they knew someone that was there, all these people are prone to dealing with PTSD, but not all of them can be treated the same. Therapy is often recommended to someone dealing with PTSD, this gives them a chance to let out the feelings they’re trapping inside, it also gives others an opportunity to understand where all of it started. There are three main goals when it comes to PTSD therapy. Improving symptoms, teaching skills to cope with it, and restoring self-esteem. No matter the type of therapy, these are the goals that each therapist will help to accomplish. A therapy that has been known to help is cognitive behavioral therapy, this has to do with changing the thought patterns and how they’ve been affecting ones life. Typically this is done through discussing what happened in order to get a grasp on where the fear is coming from. Another common type of therapy for PTSD is cognitive processing therapy, this is a 12 week course with weekly sessions, it deals with talking about the event and analyzing it with a therapist to process why it is making the affected person feel the way they do so that they can work around it. There are also several medications that may help with the healing process of PTSD. The brain of people dealing with PTSD don’t work the same as of those who aren’t, people dealing with PTSD have a very easily triggered “fight or flight” response. This is because people who have dealt with real life or death experiences have had to us their “fight or flight” response to actually keep them alive, this is not an easy thing to recover from, it’s almost as if their mind is in a constant state of fight or flight, this is what makes them so jumpy. Medications, however, can actually can assist in helping to stop thinking about what happened. These drugs affect the chemistry in your brain that deal with fear and anxiety, these drugs include Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), and Venlafaxine (Effexor). However, Paroxetine is the only drug that’s been approved by the FDA to treat PTSD. But because not everyone reacts to medication in the same way, and not everyone’s PTSD is the exact same, doctors may prescribe “off-label” medications. There is nothing wrong with taking off-label medications as long as a doctor thinks that is what is best. The medications patients with PTSD take or even combination of medications has to do with what part of their everyday life the PTSD is affecting. The tricky part is the time it takes to get the dosage and combination right for each patient, that part just takes time.

It may not be an obvious fact, but adults aren’t the only people who suffer from post-traumatic stress disorder. Children are often, if not more often diagnosed with the disorder, in some cases PTSD can actually be more dangerous for children than adults. In 1980 when post-traumatic stress disorder was recognized as a psychiatric diagnosis, there wasn’t much knowledge on what PTSD looked like in children. Throughout the years, studies and tests have been done in order to recognize and identify PTSD in children. There are many things that can cause PTSD in a child, things such as car accidents, a large contributing factor to PTSD is the feeling of helplessness, and in the event of a car crash where a child is in the backseat that feeling may be more amplified than in many adults. Unfortunately in today’s society, traumatic events are happening around children everywhere, one of the most major events that occur are school shootings. It is a tragedy that children have to be so afraid to go to school because of recent events, one of the worst parts is how hard it can be to console a child due to the fact that all these shootings are much more common in recent times. It’s almost impossible to understand what a child might be feeling after an event like that, but we do know that most of these children are going to show signs of PTSD soon after the incident. Studies have shown that 15 to 43% of girls and 14 to 43% of boys have experienced at least one traumatic incident in their lifetime. Of those children, 3 to 15% of girls and 1 to 6% of boys could very well be diagnosed with PTSD. Post Traumatic Stress disorder is much trickier to spot in children than it is to find in adults. Through studies, researchers and clinicians have determined that signs and symptoms vary depending on the age of the child. For example, it is much more difficult to find symptoms of PTSD in a child because many of the symptoms require a verbal description of one’s feelings. Whereas in adolescents and teens, symptoms are much more recognizable due to how similar they are to those of adults, with some minor differences.

Post-traumatic stress disorder is a very real and very serious condition that lives in the world of EMS. Not only does EMS deal with patients who suffer from it, but it is also common for EMS personnel to suffer from it themselves. For cases of PTSD in EMS, it’s a little bit more sensitive to talk about due to the level of knowledge within EMS. Workers in the medical field are exposed to many traumatic events, but many go without saying anything and burying it down. EMTs, Paramedics, Fire fighters, even doctors are often responsible for the life of the people they are caring for, and even if you give the best possible care, unfortunately, people still die. That kind of thing can weigh heavily on anyone, but with EMS it can be even for detrimental. If, as caregiver in EMS, you are suffering from PTSD, it can easily affect the way you do your job and possibly hurt even more people. It is likely that the increasing rate of suicide in EMS is due to the lack of ability to properly deal with the PTSD that occurs during the job. It is the responsibility of an EMS provider to learn how to properly handle situations that will inevitably occur during the job.

Post-traumatic stress disorder is possibly one of the most misunderstood mental health disorders, it is a widely believed thought that PTSD just goes away, when in reality it is very rare to completely eliminate any signs and symptoms of PTSD. One of the worst parts of PTSD is that there are almost always underlying feelings of fear or anxiety towards a specific incident, the only way to heal is to learn how to deal with those symptoms. One of the biggest issues facing any mental health disorder, but specifically PTSD is the way it is looked upon by the public. Many people see PTSD as a weakness or something to be ashamed of due to the lack of understanding about the disease. This is what makes it so hard for the victims of the mental condition to talk about it. According to recent studies, “70 percent of American adults (that’s over 200 million people) have experienced an event that could be classified as traumatic”. Of that 70% of Americans, 20% of them will go on to develop PTSD. That means that at any given time, 8% of Americans are living with PTSD. This is why it’s so important to fully understand this disorder instead of thinking of it as a character flaw. So many people suffer from post-traumatic stress disorder, people of all nationalities, ethnicities, age groups, and sexes. From people you see on the street to the people closest to you, most people have had a traumatic experience at least once in their life. This is a mental health condition that truly does not only ruin the lives of those who suffer from it but also the lives of the people around them. It is the responsibility of us as a people, to understand this condition so we can better help those who have been made to feel scared and ashamed. No one can know when something traumatic may happen, but what we can do, is try to better understand what everyone is going through.

The Vietnam War has many consequences and these consequences are either good or bad. The War occurred from November 1st, 1955 through April 30th, 1975. This war derived from the Cold war. It basically all started because Americans were trying to prevent the spread of communism throughout the world. Although Vietnam won the war, communism did not spread. After the war was over, many Vietnam War veterans were diagnosed with Post Traumatic stress disorder. Post Traumatic Stress Disorder was one of the consequences that was not great and that ruined veteran’s lives. Post Traumatic Stress Disorder is a disorder that can last for an uncertain amount of time. It can last months or years. With PTSD you can get memories from the trauma (in this case the Vietnam War). Getting these memories you get intense emotional and physical reactions. Post Traumatic Stress disorder affects veterans mentally, physically, and emotionally. Some symptoms that occur are nightmares, unwanted memories, avoidance, heightened reactions, and anxiety or depressed moods. These symptoms did not occur right away. It could take months or maybe even years after the trauma event to be diagnosed and certain the veteran has Post Traumatic Stress Disorder.

Veterans From the Vietnam War with Post Traumatic stress disorder are affected mentally. These veterans get unwanted distressing memories from the trauma, which is events from the Vietnam War. The memories are usually about them killing someone, the torture they recieved from the Vietcong or the torture they give, or the death of the partner from the war. They also relive the moment/trauma of the war. The way they relive this moment is by getting flashbacks. By getting flashbacks they believe they are reliving it and that they are there. When in reality it’s just like a daydream and that moment has already occurred. When this happens they respond in a completely different way. They can either scream, cry, or they can even run away. Their mentality has not passed the trauma. It is still processing everything that they went through and what they had seen. It doesn’t just process in one or two months. It processes in years. That’s how big this event was to them. These Vietnam veteran also get upsetting dreams and nightmares. While they sleep, instead of getting normal dreams like everyone who doesn’t have post-traumatic stress disorder they get dreams about the violence of the war and the horrifying events of the war. Avoiding things is already set in they mentality. The reason why is because they don’t want to be reminded of the trauma they went through. They avoid talking and thinking about the Vietnam War. They also avoid going to places, doing activities, and people that remind them of the unpleasant event. Every time the veterans think of this event they have negative thoughts about themselves. They think this and believe this because of the killing they did during the war. They also experience memory issues. They don’t remember about the important parts of the Vietnam War and they don’t remember some things they say. The only things that they remember are the traumatic parts of the war.

Vietnam Veterans with Post Traumatic Stress disorder have also been affected physically. People and veterans with Post-traumatic stress disorder have been diagnosed with physical problems such as arthritis, heart-related problems or disease, respiratory system-related problems or disease, digestive problems and disease, reproductive system-related problems, diabetes, and pain. These physical problems occur over time if they do not take care of themselves and try to prevent themselves from getting these physical problems. Post Traumatic stress disorder puts a large amount of physical and emotional strain on a PTSD person/veteran. People with this disorder take part in things that affect their physical health. Some things they take part in is abusing alcohol and drugs. They consistently get stressed and get lots of anxiety. And due to all of this stress and anxiety, it increases the risk for physical problems and illness. The reason they stress and get anxiety is because they remember all those traumas that they went through. Many people/veterans with Post Traumatic stress disorder also have experienced a variety of sleeping problems. A study of Vietnam veterans showed that half of the veterans with PTSD have trouble sleeping at night or overall. If the veterans do sleep it is usually not a good sleep. The reason it is not a good sleep is because they may move a lot, talk, and scream while sleeping. Because of these sleeping issues, PTSD people/ veterans develop fear to go to sleep. Once they are in bed they worry or stress about the unpleasant events they fear of reliving. Veterans with Post Traumatic stress disorder can also get Auditory processing disorder(APD). The reason why they can get this is because of all the gunshots, explosions, screaming, etc in the battlefield. All this affects their hearing because it is extremely loud and you hear it for a long period of time.

Veterans with Post Traumatic stress disorder have also been affected emotionally. A ceteran that has PTSD can experience many strong emotions such as anxiety, sadness, anger, guilt, or shame. There are many other emotions but those are a few common ones that happen. They feel sadness, anger, and shame all because of the terrible things that they have done in the Vietnam war. They mainly feel sad for killing many innocents, anger because of the partners that were killed by Vietkongs, and shame because they were proud of doing all those things for their country, The United States of America. They feel out of control with their emotions. They can’t control their emotions and they don’t know exactly what they really feel. They get anxious because they don’t know exactly what they are feeling. They can’t manage to control their emotions, all they can do is feel the way they are feeling at the moment. People with Post Traumatic stress disorder cant distinguish between fear, sadness, and anger. People with PTSD adjust by avoiding their feelings or giving themselves unmedicated medications. If those with this disorder knew what they were feeling, they would be able to know or figure out how to make themselves feel better again. These feelings can make these people feel like they are living in a nightmare. They feel like this because of all the things they are going through and all the things they went through. Sometimes people with this order start having suicidal thoughts because they can’t take it anymore. Their emotions can sometimes be unpleasant. They can feel happy in a time were it sad, devastating, and not appropriate. They can also feel sad when it is time to be happy and thankful. This can happen with many other emotions. It is something they can’t control. It’s simply unpredictable when you feel like that.

The Vietnam war was a long intensive battle with many dead and many injured. The war affected many veterans and have given them major trauma. Many coped with the trauma but others did not like the Troma one single bit. Post Traumatic stress disorder has affected many veterans mentally, physically, and emotionally. Veterans would get unwanted memories and they would have trouble remembering things such as important events. Veterans would also experience arthritis, auditory processing disorder, and other physical problems. Many veterans from the Vietnam war experienced changes of moods and emotions and would not know ehat they would feel. Going to this war and seeing things affected many veterans.

Works Cited

1. “Hearing Center of Excellence.” Hearing Center of Excellence, hearing.health.mil/Education/Conditions-and-Concerns/PTSD-and-APD.
2. Holland, Kimberly. “PTSD and Depression: Similarities, Differences & What If You Have Both.” Healthline, Healthline Media, 22 Mar. 2019, www.healthline.com/health/ptsd-and-depression#depression.
3. military benefits. “PTSD and Veteran’s Symptoms: Military Benefits.” MilitaryBenefits.info, 2 Dec. 2018, militarybenefits.info/ptsd-and-veterans-symptoms/.
4. US Department of Veterans Affairs, Veterans Health Administration. “Public Health.” Protect Your Health, 7 May 2015, www.publichealth.va.gov/exposures/publications/agent-orange/agent-orange-summer-2015/nvvls.asp.
5. “What Is Posttraumatic Stress Disorder?” What Is PTSD?, www.psychiatry.org/patients-families/ptsd/what-is-ptsd.
6. Post-Traumatic Stress Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml.

Post Traumatic Stress Disorder affects millions of people every day. It can affect everyone and anyone and they don’t have to have served time in the military. It can be a man, women, child, or elderly. In this paper, I will be going over the definition of PTSD, the classic symptoms, risk factors and causes, prevention methods, warning signs, treatments, look further into what is happening in the brain, how to help if you know someone who is going through it, and places to go for help.

According to Merriam Webster Dictionary, the definition of post-traumatic stress disorder is “a psychological reaction occurring after experiencing a highly stressing event (such as wartime combat, physical violence, or a natural disaster) that is usually characterized by depression, anxiety, flashbacks, recurrent nightmares, and avoidance of reminders of the event —abbreviation PTSD.” ** DSM DEFF

The three main classic symptoms that go along with post-traumatic stress disorder are re-experiencing the event, avoidance of reminders of the event, and hyperarousal. Once a person has been experiencing those three symptoms over and over again for at least a month it can be said that a person has post-traumatic stress disorder. To further explain the three main symptoms of post-traumatic stress disorder, re-experiencing refers to unwanted recollections of the incident in the form of a distressing images, nightmares, or flashbacks. Avoidance is exactly what it sounds like, they are consistent attempts to avoid reminders of the event, including people, places, and thoughts associated with the incident. Symptoms of hyperarousal are physiological manifestations such as insomnia, irritability, impaired concentration, hypervigilance, and increased startle reactions. Those are the three main symptoms of post-traumatic stress disorder.

The obvious main cause to post-traumatic stress disorder is going through a traumatic, experience. The experience has to invoke fear, hopelessness, or horror in response to death or injury. The experience is what starts all of the other symptoms. Not every person who experiences a traumatic event gets post-traumatic stress disorder. Experts are not totally sure why some people get post-traumatic stress disorder and others don’t. They believe the chance of getting post-traumatic stress disorder is increased if, they have had depression, anxiety, or substance abuse before the event and also if you do not have good base of support at home or if a person was abused as a child. Another factor that increases a person’s chance of getting post-traumatic stress disorder is if their family has a history of mental illness. According to the National Institute of Mental, Health women are more likely to get it than men. There are also certain gene differences that make people more likely to get it than another.

There is no fool proof way of preventing a person from getting post-traumatic stress disorder. There is only particular things that doctors have seen that seem to play somewhat of a role in the deciding factor if a person gets post-traumatic stress disorder or not. One situation that has been seen to help prevent post-traumatic stress disorder is if the person has early childhood events that caused them to go out of their comfort zone. Not the comfort zone like deciding to ride a ride at the amusement park that scares them, more like being it a situation that they have never been in before or seeing things haven’t and or shouldn’t see at that age. Because they were put into that situation, they were able to learn adaptability and coping strategies that would help them when they are older and go through a traumatic experience. Some personal characteristic that prevent post-traumatic stress disorder are, being goal-oriented, having a high self-esteem, adaptability, good social skills, and a good sense of humor. Some things that a person can do to prevent is are, seek out support from friends or family, find a support group, or learn to feel good about their action in the face of danger. In the military, soldiers are now exposed to hypothetical traumatic events during basic training to teach them coping mechanisms.

There are warning signs and symptoms for post-traumatic stress disorder. Not every single person with post-traumatic stress disorder will have every single one of the listed symptoms for PTSD but they will have a majority of them. Like I said earlier in this paper there is hyperarousal, re-experiencing the incident, and avoidance of reminder, but there are many more than just that. Some common symptoms are difficulty falling asleep, disturbed sleep/nightmares being easily startled, increased hostility, abnormal outbursts, and being ashamed of the situation. Another important warning sign to watch for is self-medication. Whether that is with misusing medication, alcohol, drugs, or many other things. These are all many signs that can collectively point towards someone having post-traumatic stress disorder.

There is no set in stone treatment to cure post-traumatic stress disorder. It is not totally curable because you never know what could trigger a person and have it happen all over again. There are many ways doctors try to treat post-traumatic stress disorder, like psychotherapy which is where they focus on the trauma itself. During therapy, they talk about the trauma and what happened while trying to make sense of it. There is also exposure therapy. Exposure therapy can be divided into two main types imaginal and in vivo exposures. In vivo take on the fears head on through direct confrontation. During imaginal exposure, therapists ask patients to imagine the places or people that they might fear because of the experience. Another one is stress inoculation therapy. SIT is a type of cognitive-behavioral therapy. Which is mostly talking based, they talk about the event, help patients recognize and change negative or wrong thoughts that they might be having. Lastly, there is eye movement desensitization and reprocessing therapy. It is exposure-based. Therapist and patient choose which memory to target first then the therapist moves their hand back and forth in front of their face. Then the patient follows it with their eyes. This creates movement similar to what happens in REM sleep. Then the thoughts and recollections begin to arise and they start to process the memories and feelings. During that they shift the thoughts to be more positive. Those are not the only treatment types for post-traumatic stress disorder. There are many many more than just the ones I have talked about. Even though they’re all different types of treatments for post-traumatic stress disorder it is not curable. The memory could spontaneously recover at any time.

Post-traumatic stress disorder is a very stressful disorder, as it has stress in the name. The stress response areas in the brain are the amygdala, hippocampus, and the prefrontal cortex. Post-traumatic stress disorder can cause changes in those areas. When a person experiences traumatic stress there is an increase in norepinephrine and cortisol, which are both produced from the adrenal cortex. Antidepressants have been seen to counteract the levels of the norepinephrine and cortisol. One of the most affected areas in the brain is the hippocampus, it goes through a serious reduction when someone gets PTSD. This causes them to have a hard time deciphering between the past and the present memories and correctly interpret environmental context. The neural mechanisms in that part of the brain and trigger extreme stress responses when it encounters something even a little bit similar to their traumatic experience. The prefrontal cortex is responsible for how you react to emotional stressors which is triggered by the amygdala. In particular, is reacts to negative emotions more than positive ones. An example would be fear. The functionality of the region is what is effected. That explains why people with PTSD become fearful, show anxiety, and lots of amounts of stress to something that might not even be related to their experience. When it come to the amygdala activity is increased in that area. This area is also associated with the processing of emotions. When people with PTSD see something that reminds them of their trauma the amygdala is hyperactive. Sometimes even if they see something not associated with their stressor they will begin to freak out an example would be, if they see a picture of people in fear they would also begin to then it would continue on from there. All three of these parts of the brain are associated with dealing with stress and conveniently, they are the three main area post-traumatic stress disorder effects.

Many people may know someone who is suffering from post-traumatic stress disorder. What they may not know is what to do about it or how to act. The first thing someone could do it learn about post-traumatic stress disorder and their trauma. Although, you do not want to ask them directly about their trauma. If they do talk to you about what they have gone through listen, be attentive. If you’re not able to give them your full attention then don’t talk to them at that time. If you are able to give them your full attention do not interrupt them, do not try to compare their experience with something that has happened to you, do not play the expert, do not judge them for their thoughts you actions, do not tell them what to do or what they need to do. Also don’t allow them to be inappropriate. Always report if they are having suicidal thoughts or actions no matter what the person suffering says, it is always helpful. As a friend, someone could make sure the person suffering knows that they have option and if they could show them that would be even better. The friend should set limits for themself about what they’re willing to help with and what they are not. The friend should also really make an effort to understand what they are going through. They also should not expect them to be better within any certain time frame, no one knows how long it will take to effectively manage a person’s post-traumatic stress disorder. One of the most important things is to be positive!

There are many places you can go for help and information. For veterans, there is the Wounded Warrior Project. There is also the National Center for PTSD, Gifts from WIthin, the Anxiety and Depression Association, The International Society for Traumatic Studies, and the PTSD Alliance. They are all very good places to go if someone is looking for help or information on PTSD. They are all very reliable and helpful.

30% of people in the military that have been in a war zone have post-traumatic stress disorder. 12-20% of soldiers serving in Iraq are estimated to have it. Almost half of everyone who served in Vietnam had experienced some type of PTSD. It was previously called shell shock during World War II.

During the essay I have gone over the definition of PTSD, the classic symptoms, risk factors and causes, prevention methods, warning signs, treatments, look further into what is happening in the brain, how to help if you know someone who is going through it, and places to go for help. Post-traumatic stress disorder affects millions everyday and will continue to for a long time to come. There is continuing research going on to truly understand what is going on inside. Hopefully once that is totally understood a cure will be shortly followed behind it.

Introduction

Charlie is the high school student that will be assessed and there will be a hypothesized diagnosis for him. There are many things that will be described about his behavior, social interactions, and previous mental health issues. When initially looking at Charlie, he seems as though he does not have any signs of mental health issues but as everything progresses, there are accounts from family and Charlie himself that brings light to what is actually going on.

Hypothesized Diagnosis

Post-traumatic stress disorder is described in simple terms by NIMH. They say, “PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” There are many situations that can affect someone’s mental state to cause this type of disorder. Some examples can be witnessing death or your own life being threatened, witnessing life-threatening injuries or being threatened with them, and being sexually assaulted or being threatened with sexual assault (Durand, Barlow, & Hofmann, 2019). The first and foremost aspect of diagnosing post-traumatic stress disorder is that there is that initial exposure to a very serious situation. The DSM-5 criteria shows that in order for a diagnosis, there will have to be a presence of intrusion symptoms, avoidance symptoms, and the changes in mood and cognition will be negative. These symptoms must be present for at least one month (Durand, Barlow, & Hofmann, 2019).

Charlie shows many of these symptoms throughout the time spent assessing him. He is shown during the entirety of his freshman year of high school, from day one until the last of the school year. During this time, he has very specific flashbacks about his aunt. He is also seen by those around him as a type of avoidant person. An example of avoidance would be how he sits alone at lunch during school to be alone and spend time reading.

Biopsychosocial Factors and Interactions of Factors

Biological Factors

When looking at the affects the disorder can have on a physiological level, there can be many factors involved. Durand, Barlow, and Hofmann talk about a generalized biological vulnerability being a part of many psychological disorders, post-traumatic stress disorder is no exception. This term of vulnerability shows that many people can be susceptible to stress or anxiety but when something traumatic happens, people will have a different biological reaction to the incident. In Charlie’s case, he shows signs that he has a high vulnerability. Since he has constant interaction with his aunt who was sexually assaulted by ex-boyfriends, he is exposed to her high-risk situations. This is not a parent with mental health issues but she was an influential person in Charlie’s life. This biological vulnerability made it much more likely for him to develop post-traumatic stress disorder after being sexually assaulted by a very close family member.

Charlie’s aunt is the main source of his trauma which is evident based on conversations and flashbacks that he has when he experiences any type of sexual interaction. She also exposes him to self-harm because it is shown that he sees her scars on her wrists which can leave damage as well since he was very young. It is known that he has already been in the hospital before but the reasons are not told.

Drinking and drugs can have a very large impact on anyone. Charlie does not become an alcoholic from the information that has been gathered but that does not go to say that he did not partake in drinking when at parties with his older friends. He also experimented with drugs, marijana was the most prevalent but hallucinogens were also ingested which caused the flashbacks to become more intense. The DSM-5 states that in some cases, the person will blame themselves for the trauma that happened to them. Charlie does not particularly blame himself for what his aunt did to him but she was killed on her way to get his birthday present which is another traumatic event for him. This is the trauma that he blames himself for and this is verbalized by Charlie himself when he calls his sister and tells her that he killed their aunt. This is an aspect of Charlie’s disorder that can severely affect those around him. When it is under control and he isn’t having very many flashbacks from the way the family interacts, it seems to not affect them as much but a drastic change can affect everyone.

Psychological Factors

There is a generalized psychological vulnerability when dealing with post-traumatic stress disorder. This is based on the patient’s view of their own world, do they see it as out of control and that trauma is inevitable or do they push on. Those who focus on the unstable aspects have a higher vulnerability to developing a psychological disorder (Durand, Barlow, & Hofmann, 2019). Memory problems are known to be an aspect of post-traumatic stress disorder. An example for Charlie is not related to his initial trauma but it is associated with a very brutal attack on his close friend by bullies in the school. What is known is that Charlie stepped in and defended his friend but has no memory of what he did to the bullies aside from an injury to his right hand consistent with punching. Something that was noted during the observation of Charlie is that he is very hopeful for his future for the majority of the time but when his flashbacks and thoughts begin to affect his functioning, that is when he does a complete turn and is hopeless.

Self-esteem can be difficult to judge since some people are more comfortable in different situations as compared to others. There are many who suffer from post-traumatic stress disorder who have negative feelings about themselves because of the trauma they experienced. Relationships are also difficult for sufferers which can then affect their self-esteem even more because they may feel abandoned. Charlie is confident when he is writing but when it comes to speaking out in class he becomes withdrawn. An example for Charlie’s negative feeling that were observed could be when he becomes ostracized from his group of friends for disrespecting one of the girls. This experience triggers his flashbacks and causes him to lose control of his emotions which is the cause of his aggression when defending his friend.

Personality is very important, especially when seeing the influences on someone’s psychological disorder. There are some aspects of a personality that are viewed as positive but they can then be turned to where it is detrimental. This is shown through Charlie, he is a very generous person and wants everyone in his life to be as happy as they can be. One specific time, one friend asks him what he wants since he never asked her on a date and his only answer was because he wanted her to be happy, not thinking about his own happiness. This can affect someone because they are never trying to take care of themselves which can lead to hurt and they can regress into a dark place like Charlie does.

Social Factors

It is shown in research, that if there is a strong support system in place for after someone experiences trauma, then they are less likely to develop a psychological disorder. When there are people who begin to place blame and create a negative environment, they are at a higher risk (Durand, Barlow, & Hofmann, 2019). There is, however, research that shows that if the trauma is coming from within what would be someone’s support group, that can deter them from feeling supported and they have a high risk of developing a disorder despite possibly having supportive people in their life (Charuvastra & Cloitre, 2008). This seems to be true with Charlie. His family is very supportive, they ask him how he is doing when there are particularly high-stress times in his life, such as the anniversary of his aunt’s death which also happens to be his birthday. When the trauma comes from within his “support”, there can be distorted memories. His aunt made it seem as though what she was doing was normal and that it just meant that she loved him. At such a young age, this can be very confusing and can then exacerbate the symptoms for the disorder.

Initially, it seems as though Charlie’s new friends are helping him stay distracted from his past and he gets to be a new person since they do not know what happened to him. There is a point where the friendship seems to crumble and it sends Charlie spiraling. When looking at whether or not the people around him help or hurt is not black and white. During the course of his freshman year, he experiences so many changes within himself and in his social interactions that it is difficult to say what exactly the friendships did to Charlie.

Interactions of Factors

Biological, psychological, and social factors are all weaved together in post-traumatic stress disorder. They can affect each other very easily. Charlie’s constant focus on everyone else’s happiness can affect his social interactions because some people may view it as dangerous or risky that he does not focus on taking care of himself. His aggression can affect this as well in almost the same way because it may cause people to withdraw from him fearing that he may lose control on them one day. The effects of each of these factors on both the person with the disorder and those around them can be drastic. There can be times when someone is in treatment and taking their medication and they are functioning almost normally and no one would even know they have a disorder. On the opposite side, they can be exhibiting all the negative symptoms of post-traumatic stress disorder and can cause many problems within their life.

Treatment

Medication and psychotherapy are the two main forms of treatment. Charlie is seen taking medication, it is most likely an antidepressant because they are the most common for post-traumatic stress disorder. People are all different so their treatment may vary depending on whether they respond best to medication, psychotherapy, or a combination of the two (Post-Traumatic Stress Disorder, n.d.).

Prognosis

There is not a set course for post-traumatic stress disorder. This varies from person to person and can last anywhere from a few months to someone’s full life (Post-Traumatic Stress Disorder, n.d.).

Conclusion

The interaction of the biopsychosocial factors is the main contributor for the diagnosis being proposed for Charlie. The evidence provided shows that he is exhibiting many major signs of post-traumatic stress disorder. These factors include, family member with mental health issues, partakes in drinking and drugs, vulnerability to develop a psychological disorder, and many more. The original trauma comes from a close family member who is the one with mental health issues. There is a strong support system for Charlie but as was observed, it was not enough for him.

References

1. Durand, V. Mark, Barlow, D. H., & Hofmann, S. G. (2019). Essentials of abnormal psychology. Available from https://ng.cengage.com/static/nb/ui/evo/index.html?eISBN=9780357164853&id=345099254&nbId=889322&snapshotId=889322&
2. Post-Traumatic Stress Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
3. Charuvastra, A., & Cloitre, M. (2008). Social bonds and posttraumatic stress disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722782/

PTSD, or post-traumatic stress disorder, is a mental health disorder that affects a vast amount of people in the united states. PTSD likely goes back as far as humanity itself, given that it is a mental disorder that stems from any type of traumatic or significant event in ones life. PTSD is very serious and commonly misunderstood due to the fact that it is a mental disorder. Mental disorders are especially tricky, sometimes they can have an unknown origin in a specific patient, and most don’t have any consistently successful treatments. There is almost never a set way to deal with a victim of a mental disorder, due to the fact that any patients with the same diagnosis will still have vastly different experiences than on another. PTSD is very unique in that way, a patient suffering from post-traumatic stress disorder, would have to be dealt with in a very different way than most, even if they are all suffering from the same disorder. Post-traumatic stress disorder is a very malicious disease, thousands upon thousands of people are affected by it each day with no signs of slowing down and no clear ways to treat it. Our best hope in treating PTSD is understanding it.

Post-traumatic stress disorder is a mental health condition that is triggered by a traumatic past experience in one’s life or even in the life of people around them. This condition is commonly found in, but most certainly not limited to military veterans. This is due to the fact that of all the people in most civilizations, those who fight in wars often see things that most people only see in glorified movies or stories. Most experiences that lead to PTSD are moments of great fear or helplessness, like the feeling of impending doom, being trapped in a spot where death feels imminent, or in a position where death was almost guaranteed. But not all cases of PTSD can be traced back to a single moment, these experiences can be moments that last days or even months. Drivers of military vehicles in war zones are constantly vigilant and looking out for IEDs, then when they get home they cause an accident because they swerved away from a plastic bag on the freeway. Post-traumatic stress disorder often includes symptoms such as flashbacks, nightmares, or severe anxiety. All of which is due to the brain bringing people back to that feeling of impending doom. It’s mainly caused by the lack of ability humans have to cope with things they’ve seen or done.

As evolution occurred in our species, at one point we developed highly functioning brains, and though our brains continue to evolve, we are still met with things that cannot be fully understood or explained. Post-traumatic stress disorder is one of the many conditions of the brain that still reign terror on humanity. WW1 soldiers were the first known victims of PTSD, but back then it was referred to as “shell shock”. As men would return from the war, some with obvious physical injuries and some without, a commonality between all of them were symptoms that were similar to those which had been associated with “hysterical women”. English physician Charles Myers wrote the first paper on “Shell Shock” in 1915. He theorized that these symptoms shown by soldiers were results of physical injury to the brain. Assuming that it was due to the blast from bombs. After testing his theory, it didn’t hold up. Even soldiers who hadn’t been exposed to blasts from bombs still showed symptoms of shell shock, and on top of that, not all soldiers who were exposed showed any symptoms of shell shock. Today we are able to realize that these soldiers were experiencing post-traumatic stress disorder. However, even though WW1 soldiers were the first recorded victims of PTSD, with an understanding of what post-traumatic stress disorder is, it’s obvious that it goes back much, much further than the “first documented case”. Wars go back as far as humanity itself, and on top of that, traumatic experiences are not limited to time as far back as we can record. For thousands of years, man has had to survive without the help of the luxuries we have today. Man had to fight to survive, and though we have been at the top of the food chain for a very, very long time, it was not always as easy as it is today. Today we can go to the grocery store and buy an already cut piece of meat with no issue, however back then there were very powerful predators that would need to be fought off just to hunt a single animal, and an encounter with one of those predators would likely be very traumatic. And just because it wasn’t recorded, doesn’t mean those men didn’t go through what we call today as post-traumatic stress disorder. Although it was highly controversial, In 1980, the APA (American Psychiatric Association) added Post-traumatic stress disorder to the third edition of the diagnostic and statistical manual of mental disorders. Despite the fact that many did not agree or recognize PTSD as a mental disorder, it went a long way in helping to understand the psychology behind many recorded cases of what we know today as PTSD.

PTSD is a mental condition that occurs when someone experiences or witnesses a traumatic incident. This can be a wide variety of things such as war, terrorism, natural disasters, or even sexual assault. People who suffer from this disease often have many different types of symptoms. These people often feel immense fear, stress, or anxiety. Some may even relive the event constantly through vivid flashbacks or nightmares. In most cases, people suffering from PTSD tend to be very irritable and appear to be more angry than usual. They may even tend to keep to themselves and appear to be shutting the rest of the world out, and in severe cases, you may notice very self-destructive or dangerous behavior. Victims of PTSD tend to close themselves off and not interact with others as much as they’ve been known to in the past, and interacting with them can be dangerous due to the fact that they are jumpy and more easily startled. Having a loved one suffering from PTSD can be especially difficult because they may not seem like the person you once knew. Unfortunately, this is where the people around a person suffering from PTSD can actually make it worse. We as people tend to do what everything that can, thinking it is helpful when in reality we’re only making it worse. Constantly hovering over a loved one and asking them what’s wrong may feel beneficial to you but all you’re doing for them is triggering their anxiety. The only way to care for someone dealing with PTSD is to stay by them and help with whatever you can at their pace, possibly even encouraging them to seek help if that’s what they want.

One of the hardest parts of PTSD is who it affects. Many people think the only person affected is the victim, however, that is not the case. Though the victim is the one who is hurt the most, the people around them are also suffering. PTSD can tear families apart, families who send loved ones off to war, suffering in sorrow, wondering if they will ever see them again, only to be met with this shell of the person they once knew. Studies have shown that Veterans suffering from PTSD tend to have more family-related issues than veterans who do not. This is due to the emotional detachment loved ones feel when their spouse lives through such a traumatic incident, the children of the family have also been known to have more behavioral issues than normal. 38% of marriages between Vietnam Veterans and their spouses failed within six months of the soldiers coming home. This disorder has been infamously known to tear families apart, it changes the overall behavior of the people suffering from it, thus changing who they are as a whole. People who suffer from PTSD often develop unhealthy coping mechanisms, such as drug use, drinking, or gambling. The reason behind this is because those suffering from PTSD don’t want to think about what happened anymore, so substances and habits are what help them forget, even if just for a moment. But after awhile these vices turn to addictions, and before they know it they’ve already lost the ones they love and care about.

Because post-traumatic stress disorder is a mental condition, there is no known cure. The disorder affects the brain, and since each person’s brain and experience are different, a method of treating one person’s PTSD may not be the same as treating others. PTSD stems from our inability to cope with a traumatic incident, this is always specific to the individual, some people may be more equipped to handle a certain experience than others. Taking 9/11 for example, everyone was affected by that horrible event in different ways. Weather they were near the towers, in the towers, or they knew someone that was there, all these people are prone to dealing with PTSD, but not all of them can be treated the same. Therapy is often recommended to someone dealing with PTSD, this gives them a chance to let out the feelings they’re trapping inside, it also gives others an opportunity to understand where all of it started. There are three main goals when it comes to PTSD therapy. Improving symptoms, teaching skills to cope with it, and restoring self-esteem. No matter the type of therapy, these are the goals that each therapist will help to accomplish. A therapy that has been known to help is cognitive behavioral therapy, this has to do with changing the thought patterns and how they’ve been affecting ones life. Typically this is done through discussing what happened in order to get a grasp on where the fear is coming from. Another common type of therapy for PTSD is cognitive processing therapy, this is a 12 week course with weekly sessions, it deals with talking about the event and analyzing it with a therapist to process why it is making the affected person feel the way they do so that they can work around it. There are also several medications that may help with the healing process of PTSD. The brain of people dealing with PTSD don’t work the same as of those who aren’t, people dealing with PTSD have a very easily triggered “fight or flight” response. This is because people who have dealt with real life or death experiences have had to us their “fight or flight” response to actually keep them alive, this is not an easy thing to recover from, it’s almost as if their mind is in a constant state of fight or flight, this is what makes them so jumpy. Medications, however, can actually can assist in helping to stop thinking about what happened. These drugs affect the chemistry in your brain that deal with fear and anxiety, these drugs include Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), and Venlafaxine (Effexor). However, Paroxetine is the only drug that’s been approved by the FDA to treat PTSD. But because not everyone reacts to medication in the same way, and not everyone’s PTSD is the exact same, doctors may prescribe “off-label” medications. There is nothing wrong with taking off-label medications as long as a doctor thinks that is what is best. The medications patients with PTSD take or even combination of medications has to do with what part of their everyday life the PTSD is affecting. The tricky part is the time it takes to get the dosage and combination right for each patient, that part just takes time.

It may not be an obvious fact, but adults aren’t the only people who suffer from post-traumatic stress disorder. Children are often, if not more often diagnosed with the disorder, in some cases PTSD can actually be more dangerous for children than adults. In 1980 when post-traumatic stress disorder was recognized as a psychiatric diagnosis, there wasn’t much knowledge on what PTSD looked like in children. Throughout the years, studies and tests have been done in order to recognize and identify PTSD in children. There are many things that can cause PTSD in a child, things such as car accidents, a large contributing factor to PTSD is the feeling of helplessness, and in the event of a car crash where a child is in the backseat that feeling may be more amplified than in many adults. Unfortunately in today’s society, traumatic events are happening around children everywhere, one of the most major events that occur are school shootings. It is a tragedy that children have to be so afraid to go to school because of recent events, one of the worst parts is how hard it can be to console a child due to the fact that all these shootings are much more common in recent times. It’s almost impossible to understand what a child might be feeling after an event like that, but we do know that most of these children are going to show signs of PTSD soon after the incident. Studies have shown that 15 to 43% of girls and 14 to 43% of boys have experienced at least one traumatic incident in their lifetime. Of those children, 3 to 15% of girls and 1 to 6% of boys could very well be diagnosed with PTSD. Post Traumatic Stress disorder is much trickier to spot in children than it is to find in adults. Through studies, researchers and clinicians have determined that signs and symptoms vary depending on the age of the child. For example, it is much more difficult to find symptoms of PTSD in a child because many of the symptoms require a verbal description of one’s feelings. Whereas in adolescents and teens, symptoms are much more recognizable due to how similar they are to those of adults, with some minor differences.

Post-traumatic stress disorder is a very real and very serious condition that lives in the world of EMS. Not only does EMS deal with patients who suffer from it, but it is also common for EMS personnel to suffer from it themselves. For cases of PTSD in EMS, it’s a little bit more sensitive to talk about due to the level of knowledge within EMS. Workers in the medical field are exposed to many traumatic events, but many go without saying anything and burying it down. EMTs, Paramedics, Fire fighters, even doctors are often responsible for the life of the people they are caring for, and even if you give the best possible care, unfortunately, people still die. That kind of thing can weigh heavily on anyone, but with EMS it can be even for detrimental. If, as caregiver in EMS, you are suffering from PTSD, it can easily affect the way you do your job and possibly hurt even more people. It is likely that the increasing rate of suicide in EMS is due to the lack of ability to properly deal with the PTSD that occurs during the job. It is the responsibility of an EMS provider to learn how to properly handle situations that will inevitably occur during the job.

Post-traumatic stress disorder is possibly one of the most misunderstood mental health disorders, it is a widely believed thought that PTSD just goes away, when in reality it is very rare to completely eliminate any signs and symptoms of PTSD. One of the worst parts of PTSD is that there are almost always underlying feelings of fear or anxiety towards a specific incident, the only way to heal is to learn how to deal with those symptoms. One of the biggest issues facing any mental health disorder, but specifically PTSD is the way it is looked upon by the public. Many people see PTSD as a weakness or something to be ashamed of due to the lack of understanding about the disease. This is what makes it so hard for the victims of the mental condition to talk about it. According to recent studies, “70 percent of American adults (that’s over 200 million people) have experienced an event that could be classified as traumatic”. Of that 70% of Americans, 20% of them will go on to develop PTSD. That means that at any given time, 8% of Americans are living with PTSD. This is why it’s so important to fully understand this disorder instead of thinking of it as a character flaw. So many people suffer from post-traumatic stress disorder, people of all nationalities, ethnicities, age groups, and sexes. From people you see on the street to the people closest to you, most people have had a traumatic experience at least once in their life. This is a mental health condition that truly does not only ruin the lives of those who suffer from it but also the lives of the people around them. It is the responsibility of us as a people, to understand this condition so we can better help those who have been made to feel scared and ashamed. No one can know when something traumatic may happen, but what we can do, is try to better understand what everyone is going through.

The Vietnam War has many consequences and these consequences are either good or bad. The War occurred from November 1st, 1955 through April 30th, 1975. This war derived from the Cold war. It basically all started because Americans were trying to prevent the spread of communism throughout the world. Although Vietnam won the war, communism did not spread. After the war was over, many Vietnam War veterans were diagnosed with Post Traumatic stress disorder. Post Traumatic Stress Disorder was one of the consequences that was not great and that ruined veteran’s lives. Post Traumatic Stress Disorder is a disorder that can last for an uncertain amount of time. It can last months or years. With PTSD you can get memories from the trauma (in this case the Vietnam War). Getting these memories you get intense emotional and physical reactions. Post Traumatic Stress disorder affects veterans mentally, physically, and emotionally. Some symptoms that occur are nightmares, unwanted memories, avoidance, heightened reactions, and anxiety or depressed moods. These symptoms did not occur right away. It could take months or maybe even years after the trauma event to be diagnosed and certain the veteran has Post Traumatic Stress Disorder.

Veterans From the Vietnam War with Post Traumatic stress disorder are affected mentally. These veterans get unwanted distressing memories from the trauma, which is events from the Vietnam War. The memories are usually about them killing someone, the torture they recieved from the Vietcong or the torture they give, or the death of the partner from the war. They also relive the moment/trauma of the war. The way they relive this moment is by getting flashbacks. By getting flashbacks they believe they are reliving it and that they are there. When in reality it’s just like a daydream and that moment has already occurred. When this happens they respond in a completely different way. They can either scream, cry, or they can even run away. Their mentality has not passed the trauma. It is still processing everything that they went through and what they had seen. It doesn’t just process in one or two months. It processes in years. That’s how big this event was to them. These Vietnam veteran also get upsetting dreams and nightmares. While they sleep, instead of getting normal dreams like everyone who doesn’t have post-traumatic stress disorder they get dreams about the violence of the war and the horrifying events of the war. Avoiding things is already set in they mentality. The reason why is because they don’t want to be reminded of the trauma they went through. They avoid talking and thinking about the Vietnam War. They also avoid going to places, doing activities, and people that remind them of the unpleasant event. Every time the veterans think of this event they have negative thoughts about themselves. They think this and believe this because of the killing they did during the war. They also experience memory issues. They don’t remember about the important parts of the Vietnam War and they don’t remember some things they say. The only things that they remember are the traumatic parts of the war.

Vietnam Veterans with Post Traumatic Stress disorder have also been affected physically. People and veterans with Post-traumatic stress disorder have been diagnosed with physical problems such as arthritis, heart-related problems or disease, respiratory system-related problems or disease, digestive problems and disease, reproductive system-related problems, diabetes, and pain. These physical problems occur over time if they do not take care of themselves and try to prevent themselves from getting these physical problems. Post Traumatic stress disorder puts a large amount of physical and emotional strain on a PTSD person/veteran. People with this disorder take part in things that affect their physical health. Some things they take part in is abusing alcohol and drugs. They consistently get stressed and get lots of anxiety. And due to all of this stress and anxiety, it increases the risk for physical problems and illness. The reason they stress and get anxiety is because they remember all those traumas that they went through. Many people/veterans with Post Traumatic stress disorder also have experienced a variety of sleeping problems. A study of Vietnam veterans showed that half of the veterans with PTSD have trouble sleeping at night or overall. If the veterans do sleep it is usually not a good sleep. The reason it is not a good sleep is because they may move a lot, talk, and scream while sleeping. Because of these sleeping issues, PTSD people/ veterans develop fear to go to sleep. Once they are in bed they worry or stress about the unpleasant events they fear of reliving. Veterans with Post Traumatic stress disorder can also get Auditory processing disorder(APD). The reason why they can get this is because of all the gunshots, explosions, screaming, etc in the battlefield. All this affects their hearing because it is extremely loud and you hear it for a long period of time.

Veterans with Post Traumatic stress disorder have also been affected emotionally. A ceteran that has PTSD can experience many strong emotions such as anxiety, sadness, anger, guilt, or shame. There are many other emotions but those are a few common ones that happen. They feel sadness, anger, and shame all because of the terrible things that they have done in the Vietnam war. They mainly feel sad for killing many innocents, anger because of the partners that were killed by Vietkongs, and shame because they were proud of doing all those things for their country, The United States of America. They feel out of control with their emotions. They can’t control their emotions and they don’t know exactly what they really feel. They get anxious because they don’t know exactly what they are feeling. They can’t manage to control their emotions, all they can do is feel the way they are feeling at the moment. People with Post Traumatic stress disorder cant distinguish between fear, sadness, and anger. People with PTSD adjust by avoiding their feelings or giving themselves unmedicated medications. If those with this disorder knew what they were feeling, they would be able to know or figure out how to make themselves feel better again. These feelings can make these people feel like they are living in a nightmare. They feel like this because of all the things they are going through and all the things they went through. Sometimes people with this order start having suicidal thoughts because they can’t take it anymore. Their emotions can sometimes be unpleasant. They can feel happy in a time were it sad, devastating, and not appropriate. They can also feel sad when it is time to be happy and thankful. This can happen with many other emotions. It is something they can’t control. It’s simply unpredictable when you feel like that.

The Vietnam war was a long intensive battle with many dead and many injured. The war affected many veterans and have given them major trauma. Many coped with the trauma but others did not like the Troma one single bit. Post Traumatic stress disorder has affected many veterans mentally, physically, and emotionally. Veterans would get unwanted memories and they would have trouble remembering things such as important events. Veterans would also experience arthritis, auditory processing disorder, and other physical problems. Many veterans from the Vietnam war experienced changes of moods and emotions and would not know ehat they would feel. Going to this war and seeing things affected many veterans.

Works Cited

1. “Hearing Center of Excellence.” Hearing Center of Excellence, hearing.health.mil/Education/Conditions-and-Concerns/PTSD-and-APD.
2. Holland, Kimberly. “PTSD and Depression: Similarities, Differences & What If You Have Both.” Healthline, Healthline Media, 22 Mar. 2019, www.healthline.com/health/ptsd-and-depression#depression.
3. military benefits. “PTSD and Veteran’s Symptoms: Military Benefits.” MilitaryBenefits.info, 2 Dec. 2018, militarybenefits.info/ptsd-and-veterans-symptoms/.
4. US Department of Veterans Affairs, Veterans Health Administration. “Public Health.” Protect Your Health, 7 May 2015, www.publichealth.va.gov/exposures/publications/agent-orange/agent-orange-summer-2015/nvvls.asp.
5. “What Is Posttraumatic Stress Disorder?” What Is PTSD?, www.psychiatry.org/patients-families/ptsd/what-is-ptsd.
6. Post-Traumatic Stress Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml.

Post Traumatic Stress Disorder affects millions of people every day. It can affect everyone and anyone and they don’t have to have served time in the military. It can be a man, women, child, or elderly. In this paper, I will be going over the definition of PTSD, the classic symptoms, risk factors and causes, prevention methods, warning signs, treatments, look further into what is happening in the brain, how to help if you know someone who is going through it, and places to go for help.

According to Merriam Webster Dictionary, the definition of post-traumatic stress disorder is “a psychological reaction occurring after experiencing a highly stressing event (such as wartime combat, physical violence, or a natural disaster) that is usually characterized by depression, anxiety, flashbacks, recurrent nightmares, and avoidance of reminders of the event —abbreviation PTSD.” ** DSM DEFF

The three main classic symptoms that go along with post-traumatic stress disorder are re-experiencing the event, avoidance of reminders of the event, and hyperarousal. Once a person has been experiencing those three symptoms over and over again for at least a month it can be said that a person has post-traumatic stress disorder. To further explain the three main symptoms of post-traumatic stress disorder, re-experiencing refers to unwanted recollections of the incident in the form of a distressing images, nightmares, or flashbacks. Avoidance is exactly what it sounds like, they are consistent attempts to avoid reminders of the event, including people, places, and thoughts associated with the incident. Symptoms of hyperarousal are physiological manifestations such as insomnia, irritability, impaired concentration, hypervigilance, and increased startle reactions. Those are the three main symptoms of post-traumatic stress disorder.

The obvious main cause to post-traumatic stress disorder is going through a traumatic, experience. The experience has to invoke fear, hopelessness, or horror in response to death or injury. The experience is what starts all of the other symptoms. Not every person who experiences a traumatic event gets post-traumatic stress disorder. Experts are not totally sure why some people get post-traumatic stress disorder and others don’t. They believe the chance of getting post-traumatic stress disorder is increased if, they have had depression, anxiety, or substance abuse before the event and also if you do not have good base of support at home or if a person was abused as a child. Another factor that increases a person’s chance of getting post-traumatic stress disorder is if their family has a history of mental illness. According to the National Institute of Mental, Health women are more likely to get it than men. There are also certain gene differences that make people more likely to get it than another.

There is no fool proof way of preventing a person from getting post-traumatic stress disorder. There is only particular things that doctors have seen that seem to play somewhat of a role in the deciding factor if a person gets post-traumatic stress disorder or not. One situation that has been seen to help prevent post-traumatic stress disorder is if the person has early childhood events that caused them to go out of their comfort zone. Not the comfort zone like deciding to ride a ride at the amusement park that scares them, more like being it a situation that they have never been in before or seeing things haven’t and or shouldn’t see at that age. Because they were put into that situation, they were able to learn adaptability and coping strategies that would help them when they are older and go through a traumatic experience. Some personal characteristic that prevent post-traumatic stress disorder are, being goal-oriented, having a high self-esteem, adaptability, good social skills, and a good sense of humor. Some things that a person can do to prevent is are, seek out support from friends or family, find a support group, or learn to feel good about their action in the face of danger. In the military, soldiers are now exposed to hypothetical traumatic events during basic training to teach them coping mechanisms.

There are warning signs and symptoms for post-traumatic stress disorder. Not every single person with post-traumatic stress disorder will have every single one of the listed symptoms for PTSD but they will have a majority of them. Like I said earlier in this paper there is hyperarousal, re-experiencing the incident, and avoidance of reminder, but there are many more than just that. Some common symptoms are difficulty falling asleep, disturbed sleep/nightmares being easily startled, increased hostility, abnormal outbursts, and being ashamed of the situation. Another important warning sign to watch for is self-medication. Whether that is with misusing medication, alcohol, drugs, or many other things. These are all many signs that can collectively point towards someone having post-traumatic stress disorder.

There is no set in stone treatment to cure post-traumatic stress disorder. It is not totally curable because you never know what could trigger a person and have it happen all over again. There are many ways doctors try to treat post-traumatic stress disorder, like psychotherapy which is where they focus on the trauma itself. During therapy, they talk about the trauma and what happened while trying to make sense of it. There is also exposure therapy. Exposure therapy can be divided into two main types imaginal and in vivo exposures. In vivo take on the fears head on through direct confrontation. During imaginal exposure, therapists ask patients to imagine the places or people that they might fear because of the experience. Another one is stress inoculation therapy. SIT is a type of cognitive-behavioral therapy. Which is mostly talking based, they talk about the event, help patients recognize and change negative or wrong thoughts that they might be having. Lastly, there is eye movement desensitization and reprocessing therapy. It is exposure-based. Therapist and patient choose which memory to target first then the therapist moves their hand back and forth in front of their face. Then the patient follows it with their eyes. This creates movement similar to what happens in REM sleep. Then the thoughts and recollections begin to arise and they start to process the memories and feelings. During that they shift the thoughts to be more positive. Those are not the only treatment types for post-traumatic stress disorder. There are many many more than just the ones I have talked about. Even though they’re all different types of treatments for post-traumatic stress disorder it is not curable. The memory could spontaneously recover at any time.

Post-traumatic stress disorder is a very stressful disorder, as it has stress in the name. The stress response areas in the brain are the amygdala, hippocampus, and the prefrontal cortex. Post-traumatic stress disorder can cause changes in those areas. When a person experiences traumatic stress there is an increase in norepinephrine and cortisol, which are both produced from the adrenal cortex. Antidepressants have been seen to counteract the levels of the norepinephrine and cortisol. One of the most affected areas in the brain is the hippocampus, it goes through a serious reduction when someone gets PTSD. This causes them to have a hard time deciphering between the past and the present memories and correctly interpret environmental context. The neural mechanisms in that part of the brain and trigger extreme stress responses when it encounters something even a little bit similar to their traumatic experience. The prefrontal cortex is responsible for how you react to emotional stressors which is triggered by the amygdala. In particular, is reacts to negative emotions more than positive ones. An example would be fear. The functionality of the region is what is effected. That explains why people with PTSD become fearful, show anxiety, and lots of amounts of stress to something that might not even be related to their experience. When it come to the amygdala activity is increased in that area. This area is also associated with the processing of emotions. When people with PTSD see something that reminds them of their trauma the amygdala is hyperactive. Sometimes even if they see something not associated with their stressor they will begin to freak out an example would be, if they see a picture of people in fear they would also begin to then it would continue on from there. All three of these parts of the brain are associated with dealing with stress and conveniently, they are the three main area post-traumatic stress disorder effects.

Many people may know someone who is suffering from post-traumatic stress disorder. What they may not know is what to do about it or how to act. The first thing someone could do it learn about post-traumatic stress disorder and their trauma. Although, you do not want to ask them directly about their trauma. If they do talk to you about what they have gone through listen, be attentive. If you’re not able to give them your full attention then don’t talk to them at that time. If you are able to give them your full attention do not interrupt them, do not try to compare their experience with something that has happened to you, do not play the expert, do not judge them for their thoughts you actions, do not tell them what to do or what they need to do. Also don’t allow them to be inappropriate. Always report if they are having suicidal thoughts or actions no matter what the person suffering says, it is always helpful. As a friend, someone could make sure the person suffering knows that they have option and if they could show them that would be even better. The friend should set limits for themself about what they’re willing to help with and what they are not. The friend should also really make an effort to understand what they are going through. They also should not expect them to be better within any certain time frame, no one knows how long it will take to effectively manage a person’s post-traumatic stress disorder. One of the most important things is to be positive!

There are many places you can go for help and information. For veterans, there is the Wounded Warrior Project. There is also the National Center for PTSD, Gifts from WIthin, the Anxiety and Depression Association, The International Society for Traumatic Studies, and the PTSD Alliance. They are all very good places to go if someone is looking for help or information on PTSD. They are all very reliable and helpful.

30% of people in the military that have been in a war zone have post-traumatic stress disorder. 12-20% of soldiers serving in Iraq are estimated to have it. Almost half of everyone who served in Vietnam had experienced some type of PTSD. It was previously called shell shock during World War II.

During the essay I have gone over the definition of PTSD, the classic symptoms, risk factors and causes, prevention methods, warning signs, treatments, look further into what is happening in the brain, how to help if you know someone who is going through it, and places to go for help. Post-traumatic stress disorder affects millions everyday and will continue to for a long time to come. There is continuing research going on to truly understand what is going on inside. Hopefully once that is totally understood a cure will be shortly followed behind it.

Introduction

Charlie is the high school student that will be assessed and there will be a hypothesized diagnosis for him. There are many things that will be described about his behavior, social interactions, and previous mental health issues. When initially looking at Charlie, he seems as though he does not have any signs of mental health issues but as everything progresses, there are accounts from family and Charlie himself that brings light to what is actually going on.

Hypothesized Diagnosis

Post-traumatic stress disorder is described in simple terms by NIMH. They say, “PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” There are many situations that can affect someone’s mental state to cause this type of disorder. Some examples can be witnessing death or your own life being threatened, witnessing life-threatening injuries or being threatened with them, and being sexually assaulted or being threatened with sexual assault (Durand, Barlow, & Hofmann, 2019). The first and foremost aspect of diagnosing post-traumatic stress disorder is that there is that initial exposure to a very serious situation. The DSM-5 criteria shows that in order for a diagnosis, there will have to be a presence of intrusion symptoms, avoidance symptoms, and the changes in mood and cognition will be negative. These symptoms must be present for at least one month (Durand, Barlow, & Hofmann, 2019).

Charlie shows many of these symptoms throughout the time spent assessing him. He is shown during the entirety of his freshman year of high school, from day one until the last of the school year. During this time, he has very specific flashbacks about his aunt. He is also seen by those around him as a type of avoidant person. An example of avoidance would be how he sits alone at lunch during school to be alone and spend time reading.

Biopsychosocial Factors and Interactions of Factors

Biological Factors

When looking at the affects the disorder can have on a physiological level, there can be many factors involved. Durand, Barlow, and Hofmann talk about a generalized biological vulnerability being a part of many psychological disorders, post-traumatic stress disorder is no exception. This term of vulnerability shows that many people can be susceptible to stress or anxiety but when something traumatic happens, people will have a different biological reaction to the incident. In Charlie’s case, he shows signs that he has a high vulnerability. Since he has constant interaction with his aunt who was sexually assaulted by ex-boyfriends, he is exposed to her high-risk situations. This is not a parent with mental health issues but she was an influential person in Charlie’s life. This biological vulnerability made it much more likely for him to develop post-traumatic stress disorder after being sexually assaulted by a very close family member.

Charlie’s aunt is the main source of his trauma which is evident based on conversations and flashbacks that he has when he experiences any type of sexual interaction. She also exposes him to self-harm because it is shown that he sees her scars on her wrists which can leave damage as well since he was very young. It is known that he has already been in the hospital before but the reasons are not told.

Drinking and drugs can have a very large impact on anyone. Charlie does not become an alcoholic from the information that has been gathered but that does not go to say that he did not partake in drinking when at parties with his older friends. He also experimented with drugs, marijana was the most prevalent but hallucinogens were also ingested which caused the flashbacks to become more intense. The DSM-5 states that in some cases, the person will blame themselves for the trauma that happened to them. Charlie does not particularly blame himself for what his aunt did to him but she was killed on her way to get his birthday present which is another traumatic event for him. This is the trauma that he blames himself for and this is verbalized by Charlie himself when he calls his sister and tells her that he killed their aunt. This is an aspect of Charlie’s disorder that can severely affect those around him. When it is under control and he isn’t having very many flashbacks from the way the family interacts, it seems to not affect them as much but a drastic change can affect everyone.

Psychological Factors

There is a generalized psychological vulnerability when dealing with post-traumatic stress disorder. This is based on the patient’s view of their own world, do they see it as out of control and that trauma is inevitable or do they push on. Those who focus on the unstable aspects have a higher vulnerability to developing a psychological disorder (Durand, Barlow, & Hofmann, 2019). Memory problems are known to be an aspect of post-traumatic stress disorder. An example for Charlie is not related to his initial trauma but it is associated with a very brutal attack on his close friend by bullies in the school. What is known is that Charlie stepped in and defended his friend but has no memory of what he did to the bullies aside from an injury to his right hand consistent with punching. Something that was noted during the observation of Charlie is that he is very hopeful for his future for the majority of the time but when his flashbacks and thoughts begin to affect his functioning, that is when he does a complete turn and is hopeless.

Self-esteem can be difficult to judge since some people are more comfortable in different situations as compared to others. There are many who suffer from post-traumatic stress disorder who have negative feelings about themselves because of the trauma they experienced. Relationships are also difficult for sufferers which can then affect their self-esteem even more because they may feel abandoned. Charlie is confident when he is writing but when it comes to speaking out in class he becomes withdrawn. An example for Charlie’s negative feeling that were observed could be when he becomes ostracized from his group of friends for disrespecting one of the girls. This experience triggers his flashbacks and causes him to lose control of his emotions which is the cause of his aggression when defending his friend.

Personality is very important, especially when seeing the influences on someone’s psychological disorder. There are some aspects of a personality that are viewed as positive but they can then be turned to where it is detrimental. This is shown through Charlie, he is a very generous person and wants everyone in his life to be as happy as they can be. One specific time, one friend asks him what he wants since he never asked her on a date and his only answer was because he wanted her to be happy, not thinking about his own happiness. This can affect someone because they are never trying to take care of themselves which can lead to hurt and they can regress into a dark place like Charlie does.

Social Factors

It is shown in research, that if there is a strong support system in place for after someone experiences trauma, then they are less likely to develop a psychological disorder. When there are people who begin to place blame and create a negative environment, they are at a higher risk (Durand, Barlow, & Hofmann, 2019). There is, however, research that shows that if the trauma is coming from within what would be someone’s support group, that can deter them from feeling supported and they have a high risk of developing a disorder despite possibly having supportive people in their life (Charuvastra & Cloitre, 2008). This seems to be true with Charlie. His family is very supportive, they ask him how he is doing when there are particularly high-stress times in his life, such as the anniversary of his aunt’s death which also happens to be his birthday. When the trauma comes from within his “support”, there can be distorted memories. His aunt made it seem as though what she was doing was normal and that it just meant that she loved him. At such a young age, this can be very confusing and can then exacerbate the symptoms for the disorder.

Initially, it seems as though Charlie’s new friends are helping him stay distracted from his past and he gets to be a new person since they do not know what happened to him. There is a point where the friendship seems to crumble and it sends Charlie spiraling. When looking at whether or not the people around him help or hurt is not black and white. During the course of his freshman year, he experiences so many changes within himself and in his social interactions that it is difficult to say what exactly the friendships did to Charlie.

Interactions of Factors

Biological, psychological, and social factors are all weaved together in post-traumatic stress disorder. They can affect each other very easily. Charlie’s constant focus on everyone else’s happiness can affect his social interactions because some people may view it as dangerous or risky that he does not focus on taking care of himself. His aggression can affect this as well in almost the same way because it may cause people to withdraw from him fearing that he may lose control on them one day. The effects of each of these factors on both the person with the disorder and those around them can be drastic. There can be times when someone is in treatment and taking their medication and they are functioning almost normally and no one would even know they have a disorder. On the opposite side, they can be exhibiting all the negative symptoms of post-traumatic stress disorder and can cause many problems within their life.

Treatment

Medication and psychotherapy are the two main forms of treatment. Charlie is seen taking medication, it is most likely an antidepressant because they are the most common for post-traumatic stress disorder. People are all different so their treatment may vary depending on whether they respond best to medication, psychotherapy, or a combination of the two (Post-Traumatic Stress Disorder, n.d.).

Prognosis

There is not a set course for post-traumatic stress disorder. This varies from person to person and can last anywhere from a few months to someone’s full life (Post-Traumatic Stress Disorder, n.d.).

Conclusion

The interaction of the biopsychosocial factors is the main contributor for the diagnosis being proposed for Charlie. The evidence provided shows that he is exhibiting many major signs of post-traumatic stress disorder. These factors include, family member with mental health issues, partakes in drinking and drugs, vulnerability to develop a psychological disorder, and many more. The original trauma comes from a close family member who is the one with mental health issues. There is a strong support system for Charlie but as was observed, it was not enough for him.

References

1. Durand, V. Mark, Barlow, D. H., & Hofmann, S. G. (2019). Essentials of abnormal psychology. Available from https://ng.cengage.com/static/nb/ui/evo/index.html?eISBN=9780357164853&id=345099254&nbId=889322&snapshotId=889322&
2. Post-Traumatic Stress Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
3. Charuvastra, A., & Cloitre, M. (2008). Social bonds and posttraumatic stress disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722782/