Note: Article originally published on 6-April-15 on How to Get Up From An All-Time Low? And being moved over here to finish transferring everything to ID so I can delete my other blog (yeah I still didn’t finish doing that because I didn’t want to swamp reader too much). It is unedited.
What can cause Post Traumatic Stress Disorder?
Post Traumatic Stress Disorder is a complex illness that can cause the sufferer to have flashbacks, lose all emotion, have angry outbursts, anxiety, avoidance of people or places that remind them of the event. The feeling of being “on edge” (or, ready for action). The strong feeling that one can’t have a normal life. It causes significant mood disturbance and can cause specific psychoses (plural) as well as a collection of symptoms that occur less frequently such as gastrointestinal symptoms and substance abuse. PTSD really ticks all the boxes for being a very serious, severe disorder, and many sufferers appear to be angry that people who have watched TV coverage of traumatic events may be getting misdiagnosed. Source here.
It bars sufferers from serving in the military (so does bipolar in the US – stereotypes of gun toting maniacs, anyone???). But what causes it? When it was first established as a legitimate disorder, it was thought that only veterans could experience things that were severe enough to cause it. These days, they know better, and it wasn’t so long ago that victims of domestic violence were being told that they couldn’t possibly have PTSD because their domestic experiences could not compare to a war zone. Leaving the feminist analysis of this alone (it could fill another article), let’s look at what’s currently an “approved” cause of PTSD. The NHS lists the following as causes of post traumatic stress disorder: Causes.
Mostly, though, nobody can tell someone that what that person experienced wasn’t “bad enough” to be considered a cause of Post Traumatic Stress Disorder. The proof is in the pudding. If someone has the symptoms, after an event that they feel affected themselves deeply at the time (it doesn’t always develop straight away, it can take years) then that is a valid cause. Of course it is. Someone doesn’t need to read it on a list to know what affected them. Right? Let’s consider that for a minute:
The complication is that some people “block out” extremely traumatic memories and can’t actually remember what has happened. Then they can end up with a whole plethora of problems that can’t be pinned down as PTSD, because as far as they know, they never experienced a trigger event. This means that the footage they’ve viewed might be what they believe to be the cause, but it cannot be proven that this was definitely, without a shadow of a doubt, the cause. Just like nothing can ever be fully proven beyond the realm of certain branches of mathematics. That’s why they call it the theory of relativity.
Leaving that aside (it could also fill another article), there’s a further complication: There is a lot of evidence that suggests that people don’t need to be present at an event to be affected by it. An example is the recent article in the Huffington Post which discusses how war journalists, editors and other members of the media can get PTSD from their work covering gruesome events in graphic detail. Article here. The key point here is that the DSM appears to have defined this as valid only if it was a work-based exposure. Why would our brains care about the difference? Nope, you’ve got me on that one, too, I have no idea.
Perhaps it’s something to do with the fact that, in a work activity, they haven’t chosen to view the excessive amounts of footage, that they might feel that they have no control over what they are seeing. But what about if they’re stuck at home with someone who is insisting that they must watch coverage when the person doesn’t want to and is finding it severely distressing? Would that fall into “this person is probably abusive in other situations” and the abuse be identified as the real trigger, or would it fall into “work related activity” because the victim didn’t choose to do it? What if it was just something as simple as that the person making them watch it was usually a reasonable and nice person but was obsessed with something, and the victim wasn’t in a position to avoid repetitive viewing? Again, it would likely depend on the diagnosing psychologist or psychiatrist.
An example of this is the coverage of the Boston Marathon bombing, which was when a study was conducted to find out if people who had followed the footage of the event (which was pretty shocking) had been affected adversely: Article here. Original study here. The lead study author, Professor E. Alison Holman, said: “There is mounting evidence that live and video images of traumatic events can trigger flashbacks and encourage fear conditioning. If repeatedly viewing traumatic images reactivates fear or threat responses in the brain and promotes rumination, there could be serious health consequences.” It should be pointed out that this was based on viewing events which had really happened, not a horror film or a TV series.
There are no solid conclusions, like with anything in this ball park, because of individual differences; these are the things that cause one person to react to something completely differently to another. So 10,000 people could experience the same coverage of the same event, and they would all respond to it slightly differently. There’s no probability scale here, and anyway, it wouldn’t help decide who was going to get PTSD and who was not, because it’s entirely down to the individual, and it’s not a fair chance. The main criticism of work like this is that PTSD is always dragged out as the only trauma diagnosis, when there are plenty of others, but PTSD is perceived as the “most serious” of these. By labelling every trauma-related psychological disorder as PTSD, it’s effectively invalidating the experiences and diagnoses of the people who have “lesser” disorders such as complex trauma or trauma-related anxiety disorders, which can still be disabling they just present with different symptoms.
So what are the real causes of PTSD? Surely, the answer is as circular as “anything that causes PTSD is a cause of PTSD.” The debate over whether watching violent events on TV can cause PTSD or not seems to have missed the key points: If it has caused PTSD, then it is a cause of PTSD, although, again, it depends on the individual. It’s a very complex disorder to get a diagnosis for, it changes what it does to someone as time goes on, and there is no known cure (although some psychological treatments can help), so dwelling on the validity of any given cause seems moot, and the real question should be, “what can you do to help someone with PTSD or associated disorders?”