PTSD can happen to anyone: How to get help and support a loved one

You’re probably familiar with post-traumatic stress disorder (PTSD) — this mental health condition is a frequent subject of movies, television shows and internet memes.

While these media portrayals can support awareness of PTSD, they can also fuel stigma and myths.

“One of the biggest misconceptions about PTSD is that there’s something inherently wrong with a person who develops it — that they are weak in some way,” says Lauren Baker, MS, LMHCA, a mental health therapist with the MultiCare Behavioral Health Network. “But the reality is that they are reacting normally to an abnormal situation. Anyone can develop PTSD after a traumatic event, and it’s a lot more common than people think.”

What is PTSD?

Descriptions of PTSD-like symptoms and illnesses date back centuries — they can be found in classical works of literature like “The Iliad.” Fast-forward through time, and for nearly every major war Americans have fought, a term has been coined to describe the collection of symptoms many veterans experience, from “soldier’s heart” to “shell shock” to “combat fatigue” and others.

It wasn’t until 1980 that the American Psychological Association (APA) added PTSD to its Diagnostic and Statistical Manual of Mental Disorders (DSM).

“I describe PTSD as a decrease in well-being — to the point where it impacts a person’s ability to function after being exposed to a traumatic event,” says Joseph Tomsic, ARNP, a psychiatric nurse practitioner and outpatient medical director for the MultiCare Behavioral Health Network.

This means that a person may have PTSD if their symptoms are interfering with their relationships or their ability to work, attend school or pursue daily activities.

“What people might not know is that you don’t even have to directly experience the traumatic event — people can develop PTSD after witnessing a traumatic event happening to someone else or hearing about it happening to someone close to them,” Tomsic says.

While the history of PTSD is rooted in combat exposure, it’s a myth that this condition only affects military veterans. There are a variety of traumatic events that can lead to PTSD. Some of the most common include sexual and physical assault, rape, motor vehicle accidents, natural disasters and bullying. Even trauma related to medical illnesses or events, such as ectopic pregnancies or stillbirths, can cause PTSD.

What these events have in common is that they are life-threatening or have the potential to cause serious harm or injury.

“The National Institutes of Health shares that, over the past year, between nine and 10 million adults in the U.S. met the criteria for a PTSD diagnosis,” Tomsic says. “That’s more than the entire population of Washington state.”

Who’s at risk for PTSD?

Not everyone who experiences a traumatic event goes on to develop PTSD, but there are some factors that may increase a person’s risk for this condition. One of those risks is pre-existing mental health challenges.

Another is repeated exposure to traumatic events over time. For example, people who are first responders, such as firefighters, emergency medical professionals or law enforcement officers, may be more susceptible to PTSD due to the frequency to which they are exposed to traumatic events.

However, it’s important to note that many people who develop PTSD have no known risk factors.

“We don’t fully understand why some people develop PTSD and others don’t,” Baker says. “Sometimes people with PTSD feel shame that they haven’t been able to ‘get over’ what has happened to them, but they are not flawed. Every person’s reaction to trauma is different, but recovery is possible for all.”

Common PTSD symptoms

PTSD symptoms fall into four categories. Here are common examples of each:

• Intrusive memories: These can include flashbacks or recurrent distressing dreams.
• Avoidance symptoms: People with PTSD may change their routines to avoid situations, places or objects that remind them of a traumatic event.
• Changes in how someone reacts or behaves: People with PTSD may constantly be on edge, have angry outbursts, startle easily, experience trouble sleeping or concentrating, or engage in reckless or destructive behavior.
• Changes in thinking or mood: These symptoms can include difficulty remembering the traumatic event, loss of interest in activities a person once enjoyed or inability to experience positive emotions.

Not everyone with PTSD will experience all these symptoms, and symptoms may vary in intensity. For more information about symptoms, visit the National Institute of Mental Health.

Recognizing and treating PTSD

Timely diagnosis and treatment of PTSD supports effective long-term recovery, but — as a New York Times article points out — it’s common for PTSD to be overlooked.

“Most mental health providers are well-equipped to recognize and diagnose PTSD,” Tomsic says. “But where it may get overlooked is in the primary care setting.”

For example, he says that patients may get treated for symptoms like anxiety, but the root cause of that anxiety — in some cases PTSD — may not be identified, which can delay or hamper recovery. Some medications — benzodiazepines such as Xanax, Valium and Ativan — are commonly prescribed for anxiety but not recommended for people with PTSD because they can actually make PTSD symptoms worse.

“One of the things I appreciate about MultiCare is that we incorporate mental health resources into many of our primary care clinics, which can help prevent PTSD and other mental health conditions from going undiagnosed,” Tomsic says.

Providers are not the only ones who may overlook PTSD. Baker shares that it’s often the symptoms associated with PTSD — insomnia, panic attacks and difficulty concentrating, for example — that bring people to her door, rather than an awareness or diagnosis of PTSD itself.

“It’s actually really common for patients to think they are struggling with attention-deficit hyperactivity disorder (ADHD) because they are having a hard time completing tasks or are highly distractible, when it turns out they are living with PTSD,” she says.

Once PTSD is identified, the good news is there are evidence-based treatments that can bring symptom relief and support recovery. The primary treatment is trauma-focused psychotherapy (also called talk therapy), where a person works one-on-one and/or in a group setting with a counselor.

In some cases, medications may also be used to treat symptoms associated with PTSD.

“Medications don’t heal trauma, but they can help with controlling symptoms, such as worry, anger and fear, as people work toward healing,” Baker says.

Tomsic emphasizes that recovery from PTSD is highly individual; there is no set amount of time it takes and it’s not a linear process.

“Sometimes people take two steps forward and one step back in the recovery process, and that’s OK because it’s still one step forward,” he says. “What I always tell people is that I like to see slow, steady progress.”

How to support someone with PTSD

Friends and family play an important part in helping people recover from PTSD. Here are some tips for how to support loved ones in a meaningful way:

Offer practical assistance. Sometimes taking that first step to get help is the hardest. Anything you can do to facilitate this journey, from offering to drive your loved one to an appointment to helping them search for an appropriate mental health provider, is beneficial.

Be a source of optimism and hope. Offering emotional support by listening to your loved one and validating their experiences and feelings is key. To validate means to acknowledge without passing judgment — for example, saying “I understand why you feel [restate the emotion they are expressing].”

Don’t pressure them to talk about what happened or what they’re feeling. If your loved one is in treatment for PTSD, check in with them about how it’s going and encourage them to stick with the treatment plan.

Play a role in suicide prevention. If you think your loved one might be in crisis, talk to them about it. Never be afraid to directly ask if they’re having thoughts of suicide. Getting someone to talk about their thoughts and feelings about suicide can save their life. If they are thinking about or planning suicide, it’s important to get help. Options include calling 911, contacting the 988 crisis line or visiting your local emergency department.

Where to get help

There are multiple routes to getting help for PTSD. One option is to ask your primary care provider for a referral to a licensed mental health therapist. Another option is to call your insurance company and ask them for a list of mental health providers that accept your coverage. When contacting these providers, ask about their training and experience in treating PTSD.

Many employers, including MultiCare, also have employee assistance programs, which offer free, confidential support. These programs can help assess your situation and provide referrals.