Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic experience typically involves the potential for death or serious injury resulting in feeling of intense fear, helplessness, or horror. The person may have either experienced, witnessed, or been confronted with an event that involved actual or threatened death or serious injury to the person or someone else.
How Common Is PTSD?
An estimated eight percent 8%) of Americans will experience PTSD at some point in their lives. Women are twice as likely as men to develop PTSD. Nearly seven million U.S adults (3.6%) have PTSD during the course of a given year. However, this represents a very small percentage compared to the statistics related to individuals who have experienced traumatic events that could have triggered PTSD. 61% of men and 52% of women have reported at least one significant traumatic event in their lifetimes. Although there are unique cultural and gender based aspects of PTSD, it occurs in men and women, adults and children, in all cultural groups, and all socioeconomic types. A national study of American civilians estimated that the lifetime prevalence of PTSD was 5% in men and 10% in women. Approximately 30% of the men and women who have spent time in war zones experience PTSD.
Every law enforcement officer has been or will be involved with a traumatic event, often an uncountable number of traumatic events, by the nature of the job. The details of these events would stagger the average citizen. PTSD statistics for law enforcement officers are hard to obtain, but range from 4-14%. The discrepancy in this range may be due to underreporting. Living through a traumatic event is hard enough for an officer, admitting that you are having problems related to that event is even harder. Law enforcement officers are at a much higher rate of developing a cumulative form of PTSD related to their exposure to multiple traumatic events.
What Types of Trauma Can Lead to PTSD?
Anyone who has gone through a life-threatening event can develop PTSD. These events can include: combat or military exposure, violent personal assault (rape, battery, robbery, mugging), being kidnapped or taken hostage, terrorist attacks, torture, incarceration (such as a prisoner of war), natural or manmade disasters, diagnosis of life threatening illness, childhood sexual or physical abuse, terrorist attacks, serious accidents, etc.
What Events Are Most Likely to Traumatize Law Enforcement Officers?
Psychologist Nancy Davis identified the following events as being the most potentially traumatic for law enforcement officers:
- Witnessing the death of a law enforcement officer or viewing their body at the scene.
- A reasonable belief that the officer's death or critical injury was imminent.
- Accidentally killing or wounding a bystander.
- The officer's inability to stop a suspect from injuring or killing another.
- Killing or wounding a child, teenager or mentally ill individual, even if the life of the officer had been threatened.
- Viewing the body of a child victim, particularly if the officer has children, or if the child had been assaulted, abused or tortured.
- When a dead victim becomes personalized, rather than just an unknown body.
- The terror of being caught in a violent riot.
- An officer is blamed or told he or she is responsible for the death of an innocent bystander, law enforcement officer, or a child victim.
- Exchanging shifts with another officer who is killed while working the exchanged shift.
- Responding to a call minutes after an officer is killed or critically injured.
- Particularly bloody or gruesome scenes that involve decay, dismemberment, or suffering.
- Observing an event involving violence or murder, but not being able to intervene.
- Feeling responsible for someone else’s life (hostage negotiators)
- Undercover assignments in which the officer is constantly "on-guard" because of the likelihood of being hurt, killed, or discovered.
- When an "informant" developed by an officer is murdered for providing information to law enforcement.
- Viable threats of violence by suspects towards an officer and/or his family.
- Being referred to as a "Hero" after being involved in an incident where other officers died or were critically wounded.
When there is exposure to multiple traumatic events, an officer in more vulnerable to developing more severe forms of PTSD, including cumulative and complex PTSD. Untreated PTSD can be disabling and/or deadly.
Who Is The Most Likely to Develop PTSD?
Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes. How likely you are to get PTSD depends on many things. These include: how intense the trauma was, how long it lasted, how close you were, how much control you felt, if you lost someone close, if you were injured, and how much support you received afterwards.
- The highest potential risk is the experience of a previous trauma, especially in childhood
- The individual who experiences the greatest traumas as measured by: magnitude, intensity, unpredictability, level of control, type of victimization, real/perceived personal responsibility, and feelings of betrayal.
- The individual who reports a greater perceived threat, suffering, terror, horror or fear Individuals who lack a support system or who are in a social environment that produces shame, guilt, or stigmatization
- Previous psychiatric disorder
- Family history
What Are The Symptoms of PTSD?
The components for the diagnosis of PTSD symptoms include: exposure to a traumatic incident with three resultant and specific symptoms: re-experiencing, avoidance and hyper-arousal. PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. These symptoms may be terrifying, disrupt an individual’s life, work, and relationships. How disabling these symptoms are depends on several factors including: the person's life experiences before the trauma, their own natural ability to cope with stress, how serious the trauma was, and what kind of support a person gets immediately following the trauma. The symptoms may come and go over many years.
Trauma survivors commonly re-experience their traumas. Re-experiencing symptoms involve a mental replay of the trauma accompanied by strong emotional, mental, and/or physical reactions. These symptoms are automatic and include: thinking about the trauma, seeing images of the event, feeling agitated, and having physical sensations like those that occurred during the trauma. This can happen when the person is awake or in nightmares during sleep. This feeling of being in the traumatic event again is called having flashbacks. Flashback symptoms are the most dramatic and are the focus of most media attention. Flashbacks may consist of images, sounds, smells, or feelings, and are often triggered by ordinary occurrences; the slamming of a door, a news report, seeing an accident, or a car backfiring on the street. A person having a flashback may lose touch with reality and believe that the traumatic incident is indeed happening all over again. Re-experiencing symptoms are indicators that the individual is actively struggling to cope with the traumatic experience, even trying to make sense of what has happened.
Avoidance symptoms are the most disabling and persistent; they fundamentally cause the most distress in an individual’s life. Avoidant symptoms are ways in which the person tries to avoid anything associated with the traumatic event; they are frequently exhibited by efforts to evade thoughts, activities, places, situations, or people that are reminders of the trauma. Additional avoidance symptoms include; not being able to recall important aspects of the traumatic event, having a sense of a shortened future, feeling emotionally dead, feeling disconnected from others, and losing interest in previously enjoyable activities. The individual may distance or detach himself from others and have difficulty experiencing any positive feeling. Symptoms may actually be physical: feelings of numbness or not feeling pain.
Hyper-arousal symptoms are usually what bring an individual into treatment. The person seeks treatment for his disabling and relentless symptoms of anxiety or panic attacks. Hyper-arousal symptoms are the most bothersome symptoms for both the individual and the family. Increased arousal symptoms include the following: hypervigilance, agitation, difficulty concentrating, feeling sweaty and shaky, shortness of breath, heart pounding, watchfulness, wariness, irritability, outbursts of anger, insomnia, and being easily startled.
What Are Other Common Problems Associated With PTSD?
PTSD is associated with a significantly increased risk of co-occurring psychiatric disorders.
Co-occurring Disorder Statistics with PTSD
- 88% will meet the criteria for another psychiatric disorder
- 52% will abuse or become dependent on alcohol
- 48% will experience major depressive episodes
- 43% will experience conduct disorders
- 35% will abuse or become dependent on drugs
- 79% will meet the criteria for another psychiatric disorder
- 49% will experience major depressive episodes
- 29% will experience simple phobias
- 29% will experience social phobias
- 28% will abuse or become dependent on alcohol
Individuals with PTSD frequently feel depressed, desperate, hopeless, helpless, and become suicidal. They may lose previously established important beliefs. They can become frequently angry and/or aggressive towards themselves or others. Many experience significant problems in regards to relationships, employment, and with law enforcement. Some may blame themselves for the traumatic event, and experience deep shame and/or guilt. Or they may retreat into complete social isolation, unable to feel close or trust anyone again.
How is PTSD Treated?
PTSD is generally treated by a variety of forms of psychotherapy and medication. Cognitive processing therapy involves writing about the event, and with the help of the therapist, trying to understand what happened and why the individual has reacted the way he has. Prolonged exposure therapy involves telling, retelling, and listening to accounts about the traumatic event. Eye-movement desensitization and reprocessing therapy (EMDR) involves exposure to mental images of the trauma while moving the individual’s eyes back and forth. Group therapy may also be beneficial. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Pazil and Zoloft. Benzodiazepines (Valium, Xanax, Ativan) are approved for the treatment of anxiety disorders, and are often useful adjuncts to antidepressants. Prazosin is helpful for treating nightmares. If there are psychotic symptoms (which happens in 30% of all individuals with PTSD) Risperdal, Seroquel, Zyprexa, Abilify or Geodone may be prescribed.
What is the Prognosis for People with PTSD?
Not every traumatized person develops full-blown or even minor PTSD. There is no definitive cure for PTSD. However, most people who develop PTSD do get better at some time. One half will have remission of their symptoms within three months to a year. But about 1/3rd of individuals with PTSD may continue to have some symptoms for years. In some cases the condition becomes chronic. Debriefing after a traumatic event can promote a better prognosis.
Even if you never develop PTSD, someone you know, or someone on some call will. Recognize the symptoms and encourage them to seek treatment. Early identification of PTSD and treatment is essential for the individual’s total physical, psychological, and social well-being.