Post-traumatic stress disorder (PTSD) is a mental health condition caused by exposure to a discrete traumatic event. Individuals often develop PTSD due to distressing events such as abuse, sexual or physical assault, accidents, serious health problems, childbirth experience, war events, or torture. The majority of trauma-exposed individuals manage to return to pre-trauma health shortly after the traumatic event.
However, Fink et al. (2018) report that 3.6% to 25.6% of affected people suffer from significant post-traumatic stress symptoms that warrant the intervention of caregivers. The full diagnostic criteria for PTSD include the presence of traumatic events in a patient’s life, re-experiencing flashbacks/nightmares, hyperarousal symptoms, and avoidance of particular places, people, or situations (Fink et al., 2018). PTSD has high comorbidity with other mental issues and may cause depressive symptoms in the future.
Most PTSD symptoms originate from instinctive survival mechanisms intended to prepare an individual for a similar crisis in the future. Zayfert and Becker (2019) reveal that an abnormal level of stress hormones is related to hyperarousal and the numbed emotions. What is more, changes in the hippocampus may explain failed memory processing that elicits continuous fear and anxiety. People with PTSD usually experience depression, impairment, family/social dysfunction, and suicidal ideation.
PTSD can co-occur with or lead to other disorders such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), specific phobias, panic disorder (PD), and social anxiety disorder. For instance, GAD, characterized by excessive worry for an extended period, may coincide with PTSD in at least one out of six affected individuals (Tull, 2020). People with PTSD often suffer from a social anxiety disorder that makes them avoid feared social situations. They feel intense fear of being exposed to places, situations and being negatively evaluated by other people. Leichsenring and Leweke (2017) report high socioeconomic costs of social anxiety disorder manifested in mild and severe psychosocial impairments. For instance, people with this condition may be less productive at work, have inferior socioeconomic status, and lower quality of life.
There is a high comorbidity between PTSD and depression resulting in more significant cognitive, occupational, and social impairment. According to Holland (2019), almost half of women and men with PTSD experience depressive disorder and require complex treatment. In such cases, practitioners’ treatment options include psychotherapy, lifestyle improvements, talk therapy, and medications prescription. People who earlier had PTSD are three to five times more likely to develop depression in the future (Reisman, 2016). In combination, these mental health conditions can lead to addiction, suicidal thoughts, and other serious consequences.
One of the fundamental theories that explain PTSD is a cognitive behavioral model developed by Ehler and Clark. Researchers state that trauma memories have a sensory, here-and-now nature and can be involuntarily triggered by other thoughts or events (Goodal et al., 2017). For that reason, people with PTSD fail to perceive a particular adverse event as a time-limited one; instead, they negatively appraise the trauma producing a sense of current threat.
These individuals make overestimations of similar event prevalence and, consequently, future risks. Such misappraisals result in avoidance strategies individuals apply to address their fear of recurring possible events (Goodal et al., 2017). Safety behaviors usually are counterproductive because they prevent change like the trauma memory and its negative appraisals. Those with PTSD also tend to misinterpret words or actions of people around as confirmation of their guilt or internal detriment leading to social withdrawal.
Moreover, under the dual presentation theory, traumatic experiences form two different memory representations: Verbal Accessible Knowledge (VAM) and Situationally Accessible Knowledge (SAM). The first is the conscious system that contains the understanding of the traumatic event, sensory information, and psychological reactions related to the negative experiences (McCallum, 2018). On the contrary, SAM is processed unconsciously and cannot be voluntarily recalled. The theory proposes that the VAM system is impaired due to extensive focus on threat-related information (McCallum, 2018). Thus, various triggers evoke automatic recall of vivid sensory information stored by the SAM system. In other words, this theory explains the nature of nightmares and flashbacks.
The core belief regarding the issue is that PTSD leads to other conditions such as depression. It is also essential to make a precise diagnosis and devise an appropriate treatment package. There is a strong relationship between depression and PTSD in many ways. As mentioned earlier, people who have PTSD tend to avoid specific situations and places (Fink et al., 2018). This behavior usually puts strain on an individual’s relationships with friends and families, leading to impaired social life and isolation that contributes to depressive symptoms. The high number of stress hormones and physiological changes to the brain spotted during PTSD contribute to the chemical imbalance that causes depression (Zayfert & Becker, 2019). These physical and social reasons explain why veterans with PTSD tend to mitigate their mental health issues by using drugs and drinking alcohol. To avoid unhealthy coping strategies, the appropriate treatment is needed, including support groups and nutrition education.
To conclude, PTSD is a serious mental health condition caused by a distressing event that requires complex treatment. It often co-occurs and leads to other anxiety disorders such as GAD, OCD, PD, and depressive symptoms. The cognitive behavioral model explains that PTSD is related to the specific nature of trauma memories and negative appraisal of the traumatic events. The reviewed literature supports the core belief that PTSD may cause depression. Both physical and social consequences of PTSD contribute to the successful development of depression; thus, it requires timely treatment.
References
Fink, D. S., Gradus, J. L., Keyes, K. M., Calabrese, J. R., Liberzon, I., Tamburrino, M. B., Cohen, G. H., Sampson, L., & Galea, S. (2018). Subthreshold PTSD and PTSD in a prospective‐longitudinal cohort of military personnel: potential targets for preventive interventions. Depression and Anxiety, 35(11), 1048-1055. Web.
Goodall, B., Chadwick, I., McKinnon, A., Werner‐Seidler, A., Meiser‐Stedman, R., Smith, P., & Dalgleish, T. (2017). Translating the cognitive model of PTSD to the treatment of very young children: A single case study of an 8‐year‐old motor vehicle accident survivor. Journal of Clinical Psychology, 73(5), 511-523. Web.
Holland, K. (2019). PTSD and depression: How are they related? Healthline. Web.
Leichsenring, F., & Leweke, F. (2017). Social anxiety disorder. New England Journal of Medicine, 376(23), 2255-2264. Web.
McCallum, K. (2018). Does PTSD predict institutional violence within a UK male prison population? The Journal of Forensic Practice, 20(4), 229-238. Web.
Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10), 623-634.
Tull, M. (2020). How PTSD may lead to anxiety disorders. Verywell Mind. Web.
Zayfert, C., & Becker, C. B. (2019). Cognitive-behavioral therapy for PTSD: A case formulation approach (2nd ed.). The Guilford Press.