
Does everyone who suffers trauma have PTSD? - drjohnson
http://aeon.co/magazine/living-together/does-everyone-who-suffers-trauma-have-ptsd/
======
gaoshan
I was diagnosed with PTSD after having spent my childhood being raised by a
child molester. Since the molester was my dad I could never escape him, could
never go to my parent for help. He kept it up for the first 12 years of my
life (he told me he started when I was 2 months old). He also did this to my
sister and forced us to engage in incestuous behavior to boot. The end result
was that we were utterly unprepared for normal, caring, relationships.

I, a shy, weak, easily intimidated young man, reacted very poorly and became
the opposite of my father. Unfortunately he is a hard charging, successful go-
getter that is considered "Mr. Capable" so I became a slacking, stress
avoiding "Mr. Loser". My sister, on the other hand, adopted all of his good
traits, earning 2 PhDs from top schools and forging a career as a very highly
paid scientist living a luxurious life in LA (and I was the "smart" one, lol).
Thing is, we were both damaged quite badly, both attempted suicide, both
suffering from debilitating depression, PTSD symptoms, etc.

My salvation, such as it is, came in the form of a loving wife who has
nurtured me when needed and helped me grow into a more normal mode of living
(this led to me teaching myself to program and finally, at age 45, earning a
pretty decent living doing it). She cushioned the things that trigger me,
guided me in making correct choices and basically taught me, over the almost
20 years we have been married, to be "normal" and I truly believe she saved my
life. Her kindness and understanding has allowed my PTSD symptoms to fade over
the years and minimized them when they do appear.

In three words, love saved me.

p.s. if you are a parent and have the sorts of feelings my father did towards
us I beg of you to seek help. Please understand that acting on those desires
will result in the harming and potential destruction of your children and the
utter obliteration of your parent/child relationship. Imagine yourself being
confronted by your broken and damaged adult children... do you really want to
endure that? Seek help... if you haven't acted on it, you can get it with no
consequences. If you have... stop now. On behalf of your children I beg you.

~~~
jacquesm
Holy crap. Both you and your sister have gone through hell, and you still have
so much grace. And your wife is an amazing person. I'm not sure if I'll ever
be able to write about my own childhood, especially so frank. And yet,
compared to yours it was a walk in the park. Thanks for sharing this.

~~~
gaoshan
Appreciate it, man. I've been confronting it for many years now and writing
about what happened gets easier the more often I do so. My wife is indeed
amazing. A tough yet gentle, kind yet firm completely reasonable, intelligent,
clear minded person. I feel like meeting her was my winning lottery ticket.
It's amazing what a kind, reasonable person can do for a disturbed but
otherwise "normal" mind.

~~~
fapjacks
I really hope that this MDMA-assisted psychotherapy study shows similar
results to the one conducted in Switzerland and that you have the option to
use MDMA to help you overcome this condition with the good support network you
have in your wife. Good luck to you.

------
Alex3917
> The rise of biological psychiatry and its focus on mental illnesses as
> ‘brain diseases’ had failed to remove the taint of moral and personal
> failing associated with the majority of psychiatric disorders. But here was
> a disorder that came packaged with a clear-cut cause that was obviously not
> the patient’s fault, and which set them in the sympathetic and dramatic
> light of victimhood.

Actually the original definition of PTSD was only supposed to apply to Vietnam
veterans who came back from the war, realized what they had done was morally
abhorrent, and were no longer able to function because of that realization.
However the committee that wrote the DSM ended up stripping out the all the
theory behind the disorder before publication. There is a summary of this
here:
[http://www.vva.org/archive/TheVeteran/2005_03/feature_Histor...](http://www.vva.org/archive/TheVeteran/2005_03/feature_HistoryPTSD.htm)

Although the history of PTSD in Ethan Watters book Crazy Like Us is better
written.

~~~
pmoriarty
The terminology may be different, but "shell shock"[1] was well known back as
early as World War One.

[1] -
[https://en.wikipedia.org/wiki/Shell_shock](https://en.wikipedia.org/wiki/Shell_shock)

~~~
robg
And many stories from even ancient times. War is hell.

------
h1karu
MDMA-assisted psychotherapy can be an effective treatment for people who do
not respond to traditional therapies for PTSD.

[https://www.youtube.com/watch?v=t-4L5vRZ_g8](https://www.youtube.com/watch?v=t-4L5vRZ_g8)
< three minute rundown that explains MDMA

[http://www.mdmaptsd.org/](http://www.mdmaptsd.org/)

[https://www.youtube.com/watch?v=BNxuRs6tTuw](https://www.youtube.com/watch?v=BNxuRs6tTuw)
< The Verge / Ecstatic states: treating PTSD with MDMA

[http://www.mdma.net/psychotherapy/ptsd.html](http://www.mdma.net/psychotherapy/ptsd.html)

~~~
Pitarou
Did you read the article?

~~~
h1karu
Yes, but I don't wish to discuss 'PTSD diagnosis politics' in this forum
instead I'd rather just add value by pointing people to a non-commerical
modality that actually works for treating those who suffer from the types of
symptoms commonly associated with PTSD.

~~~
fapjacks
I'm an Iraq veteran currently enrolled in this study.

~~~
h1karu
Wow that's so cool! I'm personally overjoyed that the suppression of this
promising area of research is beginning to lift. I hope it goes well for you.

~~~
fapjacks
I want to remain as unbiased as possible, but I am also enormously excited
about the so-far-promising results. This simple and beautiful substance may go
a long way in solving the problems my peers are facing, whether we went to war
in Iraq or in Vietnam. It's also showing improvement in the treatment of
sexual assault victims with PTSD, indicating both that PTSD is a genuine
condition (as some professionals still think the diagnosis is questionable),
and also treatable (and hopefully curable) in patients with varying degrees of
the condition.

------
graeme
PTSD gets a lot of press, but post-traumatic growth is widely ignored:

[http://en.wikipedia.org/wiki/Posttraumatic_growth](http://en.wikipedia.org/wiki/Posttraumatic_growth)

I had cancer, and experienced exactly this. I feel _better_ than before I was
diagnosed. I had a particularly low impact form of cancer (testicular, one-
side) and feel I'm actually improved for having gone through it.

Not sure how this applies to combat veterans. Some papers indicate post-
traumatic growth occurs in ex-POWs.

------
SoftwareMaven
It's hard to read about PTSD and not think of George Carlin: shell shock to
combat fatigue to PTSD. I have a mentally ill daughter, and it never ceases to
amaze me how poor our knowledge and treatment of mental illness really are. I
also can't help but wonder if the DSM is for physicians and pharmacists more
than patients. We seem to have gone from no knowledge due to stigma to no
knowledge due to symptom-masking drugs (a definite improvement but not
remotely near great).

~~~
vacri
Carlin threw out a lot of populist quotes, but that doesn't mean they
translate into actuality. While it's a funny skit, in real terms keeping on
calling it 'shell shock' would have been bad - because the PTSD hits you in
other situations too. Victim responding badly to a rape? "It's not like it's
shell-shock, get over it". That sort of thing. It was called PTSD because the
same symptoms were being seen in relation to all sorts of traumatic
experiences.

 _I also can 't help but wonder if the DSM is for physicians and pharmacists
more than patients._

I think you're overly concentrating on the failings of the DSM rather than the
successes. Without something like the DSM, there isn't anything canonical for
doctors to compare notes on given diseases, and that is definitely bad for
patients.

Also, mental illness is notoriously difficult to diagnose in the first place,
which is why it's the weakest area of the DSM, and why there's a lot of
overlap between mental illness diagnoses. Mental illness is one of the most
difficult areas of expertise in the human experience, if not the most
difficult.

~~~
mercer
I like to see much of the field of psychology as similar to 'early' medicine,
or perhaps even our current treatment methods for cancer.

The methods are often primitive, inaccurate, and, in hindsight, sometimes even
harmful. But we're doing the best we can, and the goal is (generally) good.
And often it's better than nothing.

This should not prevent us from criticizing what we deem to be bad or at least
faulty solutions, but it is also important to realize that this is an ongoing
process, and not to reject the efforts because they're not perfect.

------
USNetizen
The US Army has done a lot of studies in this area of late, and found that a
certain percentage of the population is somewhat resistant to PTSD after a
traumatic event, but there are upwards of 20% or so that are pre-disposed to
it as well ([http://www.ptsd.va.gov/professional/newsletters/research-
qua...](http://www.ptsd.va.gov/professional/newsletters/research-
quarterly/v24n2-3.pdf)). It's sad that it has taken centuries of warfare for
people to wake up to the realization of this and finally just start learning
how to identify and treat it.

A good friend of mine, an Iraq war combat veteran, runs a blog and non-profit
on this subject as well at
[http://www.combatveteranswithptsd.com](http://www.combatveteranswithptsd.com)

If only we could do away with the stigma associated with it now which is
falsely based much upon wild dramatizations in movies and elsewhere of
eccentric, crazy or violent veterans ([http://flcourier.com/2013/07/03/post-
traumatic-stress-disord...](http://flcourier.com/2013/07/03/post-traumatic-
stress-disorder-stigma-hurts-veterans-in-job-search/)).

~~~
001sky
_It is clear than only a fraction of people who are exposed to trauma develop
the full syndrome of PTSD. Thus despite the high prevalence of trauma exposure
around the world, the lifetime prevalence of PTSD is no more than 7%. At any
given point in time, 1 to 3% of the civilian population and higher proportions
of Veteran populations will have currently active cases._

re: Title-query of the submitted HN article.

~~~
USNetizen
OR, only that small fraction is adequately diagnosed. This is a relatively new
field, after all, and people fear what they don't understand. Given the stigma
associated with it today many people would rather deny it or self-medicate
than seek treatment unfortunately.

------
bane
We're really at the beginning of understanding PTSD I think.

Some anecdotes:

I spent a few months in a war zone years ago, it was beyond stressful. I
didn't participate in any combat, and other than a few close-ish calls, came
away relatively unscathed. But I was very "wired" for months and months
afterwards. The innocent sound of cars driving slowly on gravel, the popping
sound of the rocks under the tires, made me hunt for cover from incoming
gunfire for example. I was supremely agitated and on edge for maybe a good
year after I got back. But after a while, most of it went away and other than
the occasional night sweat but I don't have nightmares or anything else. I'm
pretty sure I was just very stressed and my adrenaline reaction was primed for
a while, but it's not anymore. I don't believe I have or had PTSD.

I once worked with a Vet, long after he had retired. He was textbook untreated
PTSD. Decades after he saw conflict, a loud noise, like a piece of equipment
falling on a concrete floor, would send him into immediate action mode, one
time diving out of his car at a stoplight when another car backfired. He was
highly stressed, argumentative over little things and had lots of trouble
keeping a job. I met him when I was working a low waged computer service job
in the mid 90s.

My father was in the Korean conflict, landed with MacArthur's forces at Inchon
and saw quite a bit of action North of the 38th. He was shot in the leg, spent
time in Japan recuperating, got hooked on morphine, beat it, went back in, got
shot again and finally made his way home. Along the way, he was field promoted
from Sergeant to LT simply because everybody above him kept getting killed.
Other than 2 or 3 stories he told me once, he doesn't really talk about it.
PTSD wasn't a word back then, so he went entirely untreated. Decades later
when it was finally understood to be a thing the stigma meant he never sought
treatment (in fact he avoids all things military, won't use VA benefits, or
hang out at the VFA, that's how he's been treating his PTSD all these years,
avoidance). My father doesn't display really any of the daytime symptoms,
irritability, chest pain, hyper-vigilance, etc. But my mother tells me that
he's always had night issues. Waking up screaming, reliving nightmares in his
sleep, sleep walking. It settled down over the years till it was just a rare
occasional thing. My mother tells me that when I announced my engagement to my
South Korean wife, his PTSD came back in full force. But then as he got to
accept her, it went away just as quickly. I found him one day looking at some
old National Geographic Magazines one day, looking at pictures of Korea from
around the time of the war, then looking at pictures of Korea from today --
this is the first time he's ever looked at anything Korean since the war. My
mother says his night issues appear to have gone away completely.

When I was very young, I got to know Nguyễn Ngọc Loan [1][2] quite well. He
was a local businessman near D.C. after the Vietnam war. And my family had
gotten to know him and his family well and we frequented his restaurant at the
local shopping mall. His kids worked summer jobs for my parent's business and
watched me from time to time and I think my father and him even did some
business together. Obviously he saw, experienced and participated in some
pretty brutal stuff. Little known is that he also lost one of his legs in the
war so he got as good as he gave. He complained every once in a while about
phantom pain in his leg, but AFAIK didn't suffer from PTSD.

I worked another time with a recent Vet or the Iraq War, his unit was blown up
in an IED explosion in Iraq, he was a few meters from the blast and was
violently thrown to the side with just a few bruises. A couple soldiers in his
unit were not so lucky. The VA classified him as partially disabled with
Traumatic Brain Injury and PTSD. He said he had nightmares from the incident
and trouble sleeping. To treat his PTSD they put him on some kind of
medication, which caused him to balloon in weight, but didn't appear to have
resolved his night issues. Which lingered on several years later. Other former
soldiers who had seen it worse (some with and without PTSD diagnoses) gave him
endless grief over his PTSD diagnosis and his weight gain. He felt like he
didn't deserve it and it led to lots of depression and social issues. His
symptoms sounded almost exactly like mine, only they hadn't gone away, and
being a vet, he was part of a social circle that should have given him more
sympathy or understanding, but didn't.

It seems that to me that PTSD shows up in many many forms, and it's very
complicated. I think it's likely that we'll start to identify patterns in it
and produce some finer grained group of related diagnoses: high stress short-
term sensitivity, chronic long term hyper-vigilance, etc. And we'll get to
know this family of recognized issues and "PTSD" will seem like a brutish and
ignorant way of calling all these different and discrete issues.

1 -
[http://news.google.com/newspapers?nid=950&dat=19781102&id=MW...](http://news.google.com/newspapers?nid=950&dat=19781102&id=MWJQAAAAIBAJ&sjid=4lgDAAAAIBAJ&pg=2672,489627)

2 -
[https://en.wikipedia.org/wiki/General_Loan](https://en.wikipedia.org/wiki/General_Loan)

------
harimau
For a historical view of PTSD and warfare, I recommend Lt. Dave Grossman's "On
Killing".

I don't agree with his conclusions about video games and violence, but the
picture he draws of how soldiers used to demobilize, and how that adjustment
period related to coping with PTSD, in different eras can provide some insight
into some of the extenuating circumstances around the issue.

Essentially, the speed with which a soldier comes back from combat to the
'real world' (such as a flight from Kabul-Dubai-USA) might exacerbate
disorientation and adjustment in our current era. Similar, to a very small
degree, to reverse culture shock, etc.

~~~
fapjacks
FWIW, I have heard recommendations for this book as well. Actually, it was
recommended to me by my good friend and former commanding officer, whom I
consider to be the best officer I've ever served with.

------
polarix
Say we do consider all suffering mental illness, what then?

Surely not all suffering precipitates PTSD, but why not make the broader
category of mental illness categorically equivalent to unnecessarily prolonged
suffering?

------
aosmith
@bane is right. I had similar experiences. Is it something you can get over?
Sure. Is it something you want to get over? Maybe not. I still feel "numb" in
day to day life.

------
dreen
very interesting and eye opening read

