Once called “battle fatigue” or “shell shock,” posttraumatic stress disorder (PTSD) is a health risk for veterans, but many other types of people can be affected, and at any age. PTSD is an extreme reaction to extreme circumstances - either experiencing or witnessing a traumatic situation.

Individuals may develop PTSD directly by experiencing events such as combat, violent personal assault (including rape or physical attack), being kidnapped or taken hostage, going through a terrorist attack, experiencing torture, living through a natural disaster, or many other traumatic events.

Others may experience trauma indirectly, by observing someone else being attacked or killed, witnessing an accident, war, or disaster, or unexpectedly seeing a dead body, as well as other events.

Whatever event triggers the PTSD, it is something that causes extreme fear, helplessness, or horror.

Characteristically, the individual with PTSD repeatedly relives the traumatic event, with troubling recollections during the day and sleep disturbances, including nightmares, at night.

Some people with PTSD feel detached or numb. They may have symptoms of depression, losing interest in activities they once enjoyed, and having difficulty displaying affection. There also may be increased irritability and anger, and sometimes violence.

Reminders of the traumatic incident may be intensely distressing, and a person with PTSD may try to avoid reminders of the trigger situation, such as anniversaries. Sometimes, even ordinary events serve as triggers, and may cause flashbacks, intrusive images, or loss of touch with reality. A person having a flashback may believe the event is occurring all over again.

Those with PTSD often have symptoms of heightened arousal, such as an exaggerated startle response, hypervigilance, difficulty concentrating, irritability or outbursts of anger, and trouble falling or staying asleep.

PTSD can occur at any age, even during childhood, but there are certain groups with higher risk. The Diagnostic and Statistical Manual of Mental Disorders lists high-risk groups as combat veterans, victims of volcanic eruptions, and those who have experienced criminal violence. Among these high-risk individuals, prevalence ranges from 3 percent to 58 percent.

PTSD can develop months or years after the event. In this case, it is called “PTSD with delayed onset.”

PTSD is considered an anxiety disorder, and treatment often involves medication and such therapies as cognitive-behavioral therapy and cognitive therapy.

According to The Oregonian, treatment is vital. At least 122 soldiers who served in Iraq and Afghanistan have been charged in or convicted of a killing since those wars began. A 2009 Army study of 11 killings committed by members of one Fort Carson, Colo., regiment concluded that those soldiers were affected by combat in Iraq, alcohol and drug abuse, previous mental health issues and PTSD.

In Oregon, two recent homicides have been linked to military veterans with PTSD. However, neither had served in the current wars.

For further information:

• Portland VA Medical Center
• Post Traumatic Stress Disorder Research Fact Sheet (NIMH)
• Links to PTSD Resources
• PTSD Policemen: My Dogface Brothers in Blue, by Dr. Phillip Leveque (Salem-News.com)
• Quiz: Do I Need Psychotherapy?
   

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