PTSD and Its Dopplegangers
- Michael Lacroix – Medical Director, The Hartford Ins. Co.
- Melina Griss – Medical Director, The Hartford
- Nikki Wilson – Senior Director of Clinical Pharmacy Services, Enlyte
- Tammy Bradly – Senior Director Clinical Product Marketing, Enlyte
The Four Stages of Trauma-Related Stress
34 US states have recognized “mental injury” as a workers’ compensation (WC) injury, often subjected to PTSD. The expectation among WC regulators is that compensation for PTSD will expand in the next few years.
Factors that drive the condition are linked to trauma-related stress, including:
- Immediate reaction (shock)
- In the following days (critical incident stress)
- Weeks that follow (Acute Stress Disorder)
- Later stages (Post-Traumatic Stress Disorder)
What Is PTSD?
Beginning with exposure to a traumatic or critical incident, PTSD is a condition that disrupts normal life patterns. Extending beyond a 30-day lifespan, PTSD is triggered by three long-standing symptom patterns, including:
- Intrusion
- Avoidance
- Arousal
Breaking Down the Symptoms
Intrusion
- Someone sees repeated aspects of life events
- Hearing familiar noises again and again
- Smelling familiar scents again and again
- Experiencing familiar tastes again and again
- Uncontrollable thoughts of traumatic events
- Recurring dreams and nightmares
Avoidance
- Avoiding places
- Avoiding people
- Avoiding conversations
- Avoiding Reminders
- Excessive sleeping
- Limited activities
- Indoor isolation
Arousal
- Sleepless and restlessness
- Loss of attention span
- Inability to concentrate
- Inability to relax
- Hyper alertness
Diagnostic Criteria
People experiencing PTSD often experience some form of exposure to threats of death, injury, or sexual violence. At least one intrusion symptom is typically present along with a persistent avoidance of stimuli associated with specific traumas.
Other critical factors include marked alterations in arousal and reactivity, as well as negative alterations in cognition and moods. Trauma durations must succeed a month of duration.
PTSD By the Numbers
We do not know the exact number of individuals suffering from PTSD. In fact, many statistics are likely underestimated to the true prevalence rates. Some individuals go undiagnosed and never discuss their symptoms with a medical provider.
In 2020, 13 million Americans were reported to have PTSD. Projections show that 6% of the US population will experience some form of the condition at some point of their lives. Although, many individuals may experience a traumatic event related to the diagnostic criteria, this does not mean they will develop PTSD.
PTSD or TBI?
PTSD is commonly diagnosed following a traumatic brain injury (TBI), the most common form being a concussion.
While, not the same, given their related neurocognitive symptoms, PTSD and TBI often overlap. When one endures a concussion, confusion and disorientation are triggered often leading to repeated avoidance found during stages of PTSD. Any event associated with a TBI can be traumatic and contribute to trauma-related symptoms garnered over time.
Additionally, TBIs can also exacerbate pre-existing PTSD, ultimately complicating cognitive recovery. Fortunately, treatments such as Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) work hand in hand to support both disorders.
Key Takeaways
PTSD is a real condition that can affect anyone. It is not limited to “weak-minded” individuals. Often associated with broader health concerns, PTSD can resolve on its own, however, if symptoms persist, treatment is strongly advisable, especially when other injuries play a factor.