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PTSD: Not just a combat condition

June 25, 2020

Guest blog: Rebecca Cicha, PhD, Rehabilitation Psychologist
Clinical Expertise

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Post-Traumatic Stress Disorder (PTSD), a mental health condition that can occur in some individuals following a traumatic event, is commonly associated with veterans. But other traumatic events can lead to this diagnosis as well, including COVID-19.

PTSD Symptoms

PTSD can present in different shapes and forms, but there are four major categories of symptoms that someone must experience, at least to some degree:

  • Persistent or recurring re-experiencing of the traumatic event (e.g., nightmares, intrusive memories or thoughts, flashbacks).
  • Persistent avoidance of reminders of the event (e.g., refusing to think or talk about the event, actively avoiding certain places or things that remind you of it, or engaging in excessive behaviors that make you feel more safe or in control after the event).
  • Persistent and significant changes in mood and/or thought processes (e.g., guilt, shame, horror, believing more extreme things about yourself, others, or the world).
  • Symptoms of excessive nervous symptom activity (e.g., hypervigilance, sleep problems, anger, concentration problems).

Most people who experience a traumatic event actually do not develop PTSD and naturally recover over time. A diagnosis of PTSD often occurs when the natural recovery process gets “stuck” and needs more specific intervention.

Can a pandemic cause PTSD?

Technically, any type of trauma could cause PTSD (e.g., combat, assault, injurious accidents, natural disasters, refugees, etc.), but the definition of trauma matters most when we consider this diagnosis:  Exposure to an actual or threatened situation– including death, serious injury, or sexual violence (either directly to yourself, witnessing another person, or learning about a loved one).

A pandemic certainly could be considered a trauma event for developing PTSD; early studies support this in the case of COVID-19. This is especially true for:

  • Those who personally experienced severe illness or a near-death experience.
  • Witnessing or knowing of someone who became sick or died from the illness. Healthcare workers are at high risk because of repeatedly encountering sick, suffering, and dying patients as well as some providers who find themselves in positions of having to decide which patients get what treatments when resources are scarce.
  • Healthy people living with fear of contracting the virus.
  • The availability of continuous news coverage of other places hit by the pandemic, including videos, images, and media posts of front-line experiences, can create an environment of vicarious trauma.

Community lockdowns and social distancing also create an environment where coping resiliency is limited and challenged, making it more likely for a mental health disorder to take hold.

How do you know if it’s PTSD and not something else?

It can be easy and tempting to try to self-diagnose, but it’s better for a healthcare professional to diagnose – ideally one who has appropriate training and qualifications to make formal psychological diagnoses, and has experience with diagnosis and treatment of trauma. Many mental health diagnoses share similar symptoms (depression, anxiety disorders, bipolar disorder, insomnia, PTSD, and chronic pain syndrome all can cause significant problems with sleep), so it’s important to determine the actual condition in order to prescribe appropriate treatment.

How is PTSD treated?

PTSD can very effectively be treated with evidence-based treatment, that is, treatment that is scientifically supported and demonstrated to be effective. Three psychological treatment protocols currently meet this standard:  Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and Eye Movement Desensitization and Reprocessing Therapy (EMDR).

In general, the type of successful treatments include these major components:

  • Gradually exposing individuals to their trauma-related thoughts, memories, and emotions, as well as systematically reducing trauma-related avoidance.
  • Learning to identify, challenge, and change problematic thought patterns (created or worsened by the trauma) that lead to ongoing emotional distress.

PTSD, like most mental health conditions, can negatively affect nearly any aspect of a person’s life – and those around them. It is vital to maintain awareness of PTSD to validate the survivor’s experience (it’s not just a matter of “toughening up” or “getting over it”). Knowing about the condition and appropriate treatment protocols also helps reduce the stigma surrounding mental health treatment so individuals can get the help they need.