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Alissa Yancey

Professor McGriff

ENC1102

3 December 2018

Why PTSD Needs More Research Done to Better Understand the Mental Illness:

A Research Paper

Post-traumatic stress disorder, or PTSD, is a mental disorder that affects a large

population of Americans. PTSD sets in after a traumatic event and can take weeks, or years to

develop. There is a decent amount of research; however, there is still a large gap of knowledge

of what exactly causes the illness chemically, and why some people develop PTSD. Doing more

research and studies can help the general population further understand the mental disorder, and

provide more efficient resources to those suffering from PTSD. Despite the increasing rates of

individuals suffering from PTSD every year, there still is much research needed; furthering the

United States awareness would create more efficient methods of treating the illness, develop a

higher understanding of what events are more likely to cause PTSD, as well as provide relief

and assistance to families.

PTSD can be traced back to 2100 B.C., T​he Epic of Gilgamesh​ tells the story of a man

who witnessed his close friends’ death and is suffering from the trauma of his friend dying.

Stories about this condition have been around for centuries; Hippocrates was known to write

about PTSD, and it’s also referenced in an Indian epic poem called ​Ramayana. ​In the 1600s, Dr.
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Johannes Hofer, a Swiss physician, had soldiers who were suffering from homesickness,

anxiety, and sleeplessness. He began using the term “nostalgia” to describe these patients.

During the era of the Civil War (1861-1865), records show that it was prominent throughout

European populations and the “disease” had reached the United States. The diagnosis became

very popular during this time, many of the military doctors viewed it as a sign of weakness and

believed public ridicule could cure nostalgia. After the war, Jacob Mendez Da Costa, an

American physician who served as a surgeon in the Civil War, did a study with veterans and

noticed they all had a commonality of physical issues that weren’t related to wounds. All of the

soldiers exhibited symptoms related to the heart, so he decided to name it ‘soldier’s heart’. Then

came World War I, post-traumatic stress became a large scale issue with military members, at

the time it was referred to as “shell shock” due to PTSD’s high frequency in war veterans. The

same pattern occurred in World War II, it was most common in those with long deployments;

the National Center for PTSD believes half of those who were discharged during the war may

have been because of shell shock. In the 1980s, the term “PTSD” was coined by the American

Psychiatric Association (PTSD and Shell Shock). PTSD has always been misunderstood,

although we have become more aware of mental health’s importance through scientific research

and studies, there are still many obstacles to overcome, as we diminish the stigma surrounding

mental illness.

In the United States “seventy percent” of adults have experienced some sort of trauma,

“twenty percent of those people will go on to develop PTSD” (PTSD Statistics). There are many

reasons for PTSD to begin development. Since no two people are the same, different events can

affect people differently. According to the Mayo Clinic, the most common events that cause
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PTSD are combat exposure, childhood physical abuse, sexual violence, physical assault, being

threatened with a weapon, and an accident. There are also events such as natural disasters,

kidnapping, medical diagnosis and other extreme events that cause PTSD (Mayo Clinic Staff).

Not everyone who experiences these tragic events develops PTSD. Every human is different, so

different events can trigger different reactions varying from person to person. Some careers also

carry a higher likelihood of employees developing PTSD, such as military (more common in

infantry units), police officers, firefighters, healthcare, and journalists (7). These careers, for the

most part, are high-stress occupations and have the most instances of life-threatening

experiences. Currently, the military provides assistance to veterans with PTSD. They may be

able to receive an honorable discharge from service with this condition, but the United States

Department of Veteran Affairs (VA) provides therapy sessions to those who have PTSD.

Scientists are still unsure of what exactly occurs in the brain, however, recent research has

shown that there is an “imbalance between two neurochemical systems in the brain is

linked...the greater the imbalance, the more serious the symptoms” (Nauert). ​Based off of the

data that has been presented concerning PTSD, and how it is affecting the brain, it is clear that

it is imperative that there should be a focus on understanding what causes PTSD to develop

chemically, and how we can treat these individuals effectively.

When a loved one is diagnosed with PTSD it can take a toll on their families, their

children especially. ​Due to the fact that children took towards their parental figures for growth 

and absorb information from them, with a parent with PTSD, this can include their memories of

the incident that gave them the condition. Judith Shulevitz is a journalist who explored the

effects of PTSD on offspring. In her writing, she told the stories of survivors of Cambodians
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from the Khmer Rouge. The woman describes her children as hostile and difficult and goes on

to explain how their parents' trauma from the events they lived through have carried onto them

and have been absorbed through their stories. She also references the work of Yehuda, she was

going to do a study on Holocaust survivors since she grew up in a primarily Jewish

neighborhood. She opened a clinic for Holocaust refugees and received many calls from their

children, she would turn them down when they called, but one convinced her that they should

have a conversation to see how it has affected children of Holocaust survivors as well. There

also has been research done showing that it is possible that those children may be born with the

lessened ability to metabolize stress (Schulevitz). Not only do the symptoms of PTSD affect

offspring, it is very possible that they are affected genetically. The study Yehuda performed

with Halligan and Bierer shows that there is a correlation between parents having PTSD, as well

as their offspring. Their abstract states:

The findings demonstrate a specific association between parental PTSD and the

occurrence of PTSD in offspring. Additionally, parental trauma exposure, more than

parental PTSD, was found to be significantly associated with lifetime depressive

disorder. The identification of parental PTSD as a risk factor for PTSD in offspring of

Holocaust survivors defines a sample in which the biological and psychological

correlates of risk for PTSD can be further examined. (Yehuda, et al.)

Her findings did not settle well with her colleagues, as they believed that the idea that the

“vulnerability to PTSD” being passed through lineage was not possible. Since then her thesis

has gained more support as other scientists performed their own research on the subject

(Schulevitz). Even though the offspring may have not been the one to go through the trauma, it
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is important to not overlook them and give them options to cope with their situation. Seeing a

parent or guardian go through the effects of PTSD, or hearing them recall their experience can

present other mental illnesses such as anxiety and depression. These mental issues can become

serious and symptoms should not be ignored.

A person’s life is ultimately surrounded by obtaining an occupation, so they can feel as

though they are providing for their families or so they can support themselves. Individuals who

suffer from the conditions of PTSD face more difficulty in obtaining a job or career. This is

often because of their frequent absences from work, need for medical care, or need

accommodations. Those with PTSD are known to be underpaid, or unemployed, more so than

the general population (Posttraumatic Stress Disorder). Employers can help by finding out what

their triggers may be and helping create an environment for them where they can work and

function the best. It is also important to be understanding of their absences if they must go to the

doctor or simply have a harder day. Other things that the employer can do, which may help

provide relief and lessen the likelihood of triggers are keeping the area well-lit, allow them to

use earbuds, or perform non-stress tasks. Since the severity can vary between people, it is not

fair to judge how they will behave before allowing them the chance to work.

Another issue some families may have to overcome is substance use disorder, or SUDS,

and suicide. An abstract from the Current Directions in Psychological Science states that

“Among individuals seeking treatment for SUDS, approximately 36% to 50% meet criteria for

lifetime PTSD” (Brady, et al.). While genetic and environmental conditions do have a

correlation with substance use disorder, it shows that around half of those seeking help suffer

from PTSD. This is a high rate, and can cause issues at home since consuming alcohol can
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make the individual violent, or lethargic. Many people use alcohol to cope with stress, even

though it isn’t the safest or best solution to their problems. The American Addiction Centers

published an article concerning the co-existence of PTSD and addiction they stated:

Alcohol and drugs may provide a temporary respite from PTSD symptoms…..Drug

withdrawal symptoms can exacerbate PTSD symptoms, worsening the disorder and

making it more difficult to stop using drugs. In a similar fashion, abusing drugs or

alcohol...delays treatment progress and may make PTSD symptoms last longer...Studies

of inpatient substance abuse treatment centers have found that half of all of those

receiving treatment for addiction also suffered from simultaneous PTSD. (The Link)

This shows that using these substances make the problem worse, and offer a temporary solution

to their condition. As the excerpt states, it can make the condition worsen as the substance can

take away the issues and feelings they are dealing with for the time being, which causes a cycle

of using it, and ultimately leads to abuse. It can cause further damage to the individual as well

as the family as a whole, such as in health with their liver and with their self-image. This can

cause heightened stress at home and issues with employment. As well as issues with substance

abuse, there is also a high percentage of those who have attempted suicide or have suicidal

thoughts. A study was done with civilian PTSD patients to determine how strong the correlation

between suicide and PTSD, out of the ninety-four participants “56.4% reported ​some aspect of

suicidality with 38.3% reporting ideation, 8.5% reporting suicide plans and 9.6% had made

suicide attempts since the trauma. Of the nine participants who reported suicide attempts, six

had mad more than one” (Tarrier, N., and L. Gregg.)... Although the sample group is small, it

shows that there is a high percentage of suicidal thoughts when coping with the effects of
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PTSD. Considering PTSD and depression or anxiety usually coexist, and the symptoms such as

anger, and impulse control can make these thoughts and ideas more prevalent. Suicide rates are

increasing every year, and have been since 1999 (Suicide). This is a large issue because no one

wants to see anyone hurting like this, and it is global. Furthering our understanding of PTSD

and the mental illness that typically occur with it with help in the future, and help those who

suffer from these illnesses get the proper care that they need.

PTSD is now treated through therapy and medication. The treatments work differently

for everyone, so they should be open to trying both or either option. One of the forms of therapy

used, which is also deemed to be the most effective is cognitive behavior therapy or CBT. It is a

psychotherapy that focuses on the traumatic events that sparked the PTSD. Its focus is to find

the root of the issue, and change behaviors, or feelings towards the event. The patient must be

active going to their appointments as well as working on developing their skills outside.

Therapy usually goes over a course of 12-16 weeks. The two main parts of CBT are exposure

therapy and cognitive restructuring. Both are similar, where you try and find the exact memory

and bringing it to light. Exposure focuses more on having them view pictures or visit places that

relate to their trauma to lessen their sensitivity, restructuring helps to recall the memory and

make sense of what happened and what it really is, it helps them come to a realistic memory and

perspective of their trauma. There are also forms of CBT, that essentially do the same things.

The therapies main goal is to expose the patient to their trauma, and recall the memory to

remember it correctly or reconstruct it (Treatment). There are also medications available that

can help improve the symptoms of PTSD. Antidepressants such as serotonin reuptake inhibitors,

Zoloft, and Paxil are approved for PTSD, there are also anti-anxiety medications but typically
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are used temporarily because they have the potential of abuse. There is also prazosin, and there

are studies that show that it can reduce nightmares in some, but other studies have shown that

there is no benefit of it over a placebo (​Posttraumatic Stress Disorder (PTSD)​). There are also

other methods of treating PTSD being researched in hopes it can help provide more relief. One

of them is called deep brain stimulation of the amygdala, in 2014 physicians at the VA Greater

Los Angeles Healthcare System performed their first test. They are still testing it and are

looking for people to perform the procedure on. The outcomes are still unknown since it is still

fairly new and they haven’t been able to see the long-term effects of it. There is also another one

called the stellate ganglion block, in this procedure, they inject a local anesthetic into nerve

tissue in the neck, their hope is it may be able to stop nerve impulses that trigger anxiety in

PTSD patients. They also have an ongoing study to determine whether it is effective or not, and

safe as the VA urged further research to be done on the procedure (Posttraumatic Stress

Disorder (PTSD)).

Furthering understanding is important because it is a progressing issue in our country

and around the world, even if people don’t develop PTSD from events, it can bring on similar

feelings and treatment for PTSD can help them as well. Rates of substance abuse and suicide

would likely go down as well if more advanced treatments could be developed, or if we

understood more of what they are experiencing. Since PTSD was coined as a term in the

medical world only thirty-eight years ago, there is still an immense amount to learn about this

mental illness. It will aid many people now, as well as in the future and their families cope with

the overall effects of PTSD and what it really means to develop it.
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Work Cited

"7 High-Risk Professions That Can Lead to PTSD." ​Desert Hope,​

deserthopetreatment.com/ptsd-substance-abuse/high-risk-professions/. Accessed 14 Oct. 2018.

Brady, Kathleen T., Back, Sudie E., Coffey, Scott F. "Substance Abuse and Posttraumatic Stress

Disorder."​Current Directions in Psychological Science ,​ vol. 13, no. 5, 1 Oct. 2004, pp.

206-209. ​SAGE Journals ,​ journals.sagepub.com/doi/abs/10.1111/j.0963-7214.2004.00309.x.

Mayo Clinic Staff. "Post-traumatic stress disorder (PTSD)." ​Mayo Clinic,​

/www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-

20355967. Accessed 14 Nov. 2018.

Nauert, Rick. "Neurochemical Imbalance Linked with Susceptibility to PTSD." ​PsychCentral,​

psychcentral.com/news/2015/12/02/neurochemical-imbalance-linked-with-susceptibility-to-ptsd

/95635.html. Accessed 14 Nov. 2018.

"PTSD and Shell Shock." ​HISTORY,​ A&E Television Networks , 21 Aug. 2018,

www.history.com/topics/inventions/history-of-ptsd-and-shell-shock.

"PTSD Statistics ." ​PTSD United,​ www.ptsdunited.org/ptsd-statistics-2/. Accessed 14 Nov. 2018.

"Posstraumatic Stress Disorder." ​Partnership for Workplace Mental Health ​,

workplacementalhealth.org/Mental-Health-Topics/Posttraumatic-Stress-Disorder. Accessed 7

Nov. 2018.

"Posttraumatic Stress Disorder (PTSD)." ​U.S. Department of Veterans Affairs,​

www.research.va.gov/topics/ptsd.cfm#research. Accessed 16 Nov. 2018.

Schulevitz, Judith. "The Science of Suffering." ​The New Republic ,​ 16 Nov. 2014,

newrepublic.com/article/120144/trauma-genetic-scientists-say-parents-are-passing-ptsd-kids.
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"Suicide." ​National Institute of Mental Health​, May 2018,

www.nimh.nih.gov/health/statistics/suicide.shtml#part_154968.

Tarrier, N., and L. Gregg. "Suicide risk in civilian PTSD patients." ​Social Psychiatry and Psychiatric

Epidemiology,​ vol. 39, no. 8, Aug. 2004, pp. 655-661. ​Springer Link​,

link.springer.com/article/10.1007/s00127-004-0799-4#citeas.

"The Link between PTSD and Substance Abuse/Addiction." ​American Addiction Center,​ 14 Nov. 2018,

americanaddictioncenters.org/ptsd.

"Treatment for PTSD." ​Anxiety and Depression Association of America​,

adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment. Accessed 15 Nov.

2018.

Yehuda, R., Halligan, SL., Bierer LM. "Relationship of parental trauma exposure and PTSD to PTSD,

depressive and anxiety disorders in offspring." ​Journal of Psychiatric Research​, vol. 35, no. 5,

Fall 2001, pp. 261-270. ​https://www.ncbi.nlm.nih.gov/pubmed/11591428​, The National Center

for Biotechnology Information.