HOW COMMON IS PTSD?

Years ago post traumatic stress disorder [PTSD] was only used for combat veterans. However, it is now considered much more common as it is recognized that a number of different experiences may lead to PTSD. What increases the likelihood that PTSD will develop?

So, what is the significance of more people developing PTSD? One thing is the percent of people with PTSD who are not diagnosed. Another is the apparent lack of effective treatments. Finally, there are people with PTSD who are misdiagnosed as having depression or OCD or other anxiety disorders, etc.

Studies have shown that PTSD is likely especially with repeated exposure to direct and indirect traumas. This is more important when there is an increased likelihood of being exposed to multiple traumas with the impact of climate change and increasing violence in the world.

The American Psychiatric Association’s Diagnostic and Statistical Manual 5-Tr [Diagnostic and Statistical Manual of Mental Disorders. Dilip V. Jeste, Jeffrey A. Lieberman, David Fassler, et al. American Psychiatric Association (2022)] defines PTSD as occurring after exposure to one or more traumatic events involving actual or threatened death, serious injury or sexual violence. Exposure can be direct or witnessing in person or learning that the event involved a close family member or friend, or repeated indirect exposure to upsetting details of the event with the response being more severe if the stressor is interpersonal or intentional.

The severity of the exposure seems to determine the likelihood that PTSD will develop as the frequency of PTSD with more severe exposure or repeated exposure jumps from 4-6% to 25-35% of the 70% of the population who experience traumatic events! Therefore, if we as a global population are at significantly greater risk of repeated exposure to traumatic events this could increase the percent of the population who develop PTSD. For instance, the population of the US is 342.6 million and if 70% of the population experiences a traumatic event and the percent who devlop PTSD increases to say 15%, this would represent over 51 million people. This would very likely place a burden on treatment services assuming that those with PTSD could be identified, certainly creating a health crisis.

I have been aware of the increase in PTSD diagnoses and this is one of the reasons that I have been alert to identify medications that can provide relief from PTSD symptoms. These include: propranolol er; low dose lithium, prazosin and low dose naltrexone. The response to these medications has been promising and yet I have what is called anecdotal evidence of their efficacy. I am hoping to encourage researchers to look into these treatments in a more systematic manner.