What causes PTSD?

by Suzanne Grosser

PTSD, post traumatic stress disorder, is a reaction to a traumatic event. In other words, something bad (traumatic) happens and months or years later, you’re still messed up (see symptoms) because of it.

First let’s agree on what trauma is. After all, if there is no trauma, there is no post traumatic stress to deal with and no PTSD.

The following events are generally accepted as traumatic:

domestic violence
witnessing violence
threats of violence
child abuse
sexual exploitation
natural disasters

This is not a complete list, but you get the idea. Nasty stuff. Devasting, humiliating, life threatening events. Whether it’s your life, the life of someone you love, or the life of a total stranger doesn’t matter.

Trauma is anything that flips your world upside down and makes you question your most deeply held beliefs. It challenges your worldview and how you think of  yourself.

Threats to survival are trauma. Post traumatic stress occurs because your survival is threatened. But it’s not just physical survival. Who we are and what we think of ourselves is as important to us as our physical life. We humans sometimes place a higher value on who we are than on how long we live. Destroying someone’s body is often less devastating than destroying their self-image.

Some people die for what they believe. We call them martyrs, soldiers, patriots, police officers, fire fighters, heroes. They fight and die for their god, their country, their family, their neighbors, for us. We respect them. Idolize them.

But that does not mean you have to make that same choice. You might choose to live, instead of die. You might choose not go into the burning building. And it might be the right choice – you might not get back out alive and you won’t be able to save anyone else, either. Problem is, you’ll never know that for certain. You will always wonder, and you might feel bad about yourself because of it.

Or you might not even get a choice. Not everyone gets the option to die like a hero. Sometimes, there are no good options – and you have to pick one anyway. There isn’t time to think it over, to wait for something better. No matter what you do, it’s going to be bad. Then you have to live with imperfect choices made under unthinkable circumstances.

You have to live with the judgment of other people who were never in that situation. And you have to live with your own self-judgment. You don’t like what you did – or didn’t do. You have a huge gap between who you thought you were and how you acted, or did not act. No wonder you have post traumatic stress disorder! You survived only to discover you don’t know exactly who it is that survived. When an event makes you think differently about yourself, that is trauma.

Why doesn't everyone get PTSD?

That’s the real question, isn’t it? You think there is something wrong with you because other people who went through the same experience as you did, seem to be fine. So you figure you must be weak, or crazy, or some other kind of wrong.

Or it could be:

Maybe those other people aren’t fine. Maybe they’re faking it, just like you are.

But what if they are fine? Probably it’s because the events had a different meaning for them.

Here’s an example:Your world was torn apart when the floodwaters took your home. Everything you worked for all your life was destroyed: your possessions, the baby pictures of your kids, your family Bible. For you, those pictures, that Bible, your home was a big part of who you are. And now it is all gone. If you haven’t accepted how important all of that was to you, you won’t ever move past it. You develop post traumatic stress disorder. You keep saying that it was only things, just stuff, but you know better. It was you that got washed away – a big part of you anyway.

Then there’s your neighbor, Missy Toogood. She lost everything in the same flood, but she’s fine. Which is really irritating. There are a couple of reasons why she’s okay when you’re not. Maybe it was just stuff to her. Her kids were ugly babies anyway. The family Bible wasn’t hers. It belonged to her mother-in-law, and they hated each other. So, unlike you, Missy didn’t lose a part of herself. And she got a big fat insurance check to go out and buy better stuff. Stuff she actually wants.

Risk factors for PTSD

You can have a predisposition to post traumatic stress disorder, which means your brain is wired in such a way that you are more likely to have difficulty getting over trauma than other people. It’s like having a predisposition to high cholesterol. You are just born with it. You could blame your parents, if it makes you feel better, but it really isn’t their fault. They were born with a predisposition to post traumatic stress disorder, too. If you’re thinking life just isn’t fair, you’re right. If no one ever told you that as a kid, I’m telling you now: life is not fair.

Also in the life isn’t fair category: Some people develop PTSD because they have been screwed over repeatedly. A little girl survives a violent family and a string of perverted step-dads. She moves away and makes a good life for herself. Then some lunatic starts stalking her. It’s not her fault. She will very likely have post traumatic stress disorder because she has a whole string of traumatic events that keep piling up on her. She’s not weak, or crazy, – she’s just been dumped on more than most people.

Nope, life is not fair.

But we are not going to give up because it isn’t fair. We are going to put on our big girl panties or our super hero underpants (your choice), and we are going to beat post traumatic stress disorder. Together.

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