Suicide - Different Traumas Make PTSD Triggers and Symptoms A Vanilla Canvas

Suicide

By Lynn Patton  Matthew Patton Foundation

Different Traumas Make PTSD Triggers and Symptoms A Vanilla Canvas

This article is fourth in a series about stigma and mental health, so we can talk about mental health issues as easily as we talk about ice cream. This month’s topic is Post Traumatic Stress Disorder (PTSD) with a focus on Military Sexual Trauma (MST) to recognize April as MST awareness month.

PTSD is an anxiety disorder that may develop in those who experience, witness, or hear about a life-threatening event that induces terror and fear of physical harm or death. Reactions to trauma within the first 72 hours are normal; however, since we cannot accurately predict who will develop PTSD, even with known predisposing risk factors, everyone should receive crisis management within hours after a trauma and therapy within the first 30 days to normalize symptoms. If symptoms persist after 30 days, clinicians should screen/test for PTSD, so treatment begins before acute PTSD becomes chronic.

I chose vanilla ice cream to represent PTSD because it is a plain flavor (symbolizing pre-trauma states) that we can add toppings to that represent the various traumas and personalized experiences trauma victims face that may be further complicated by their unique genetics, comorbidities, and risk factors (symbolizing post-trauma states). In some cases, the entire scoop becomes so engulfed with toppings that the taste of vanilla is gone, just like the essence of who each person was before their trauma occurred. Treatment and emphasizing protective factors; however, will help remove each topping one-by-one until trauma victims return to a state as close as possible to their pre-trauma self and vanilla ice cream flavor.

From here, this article will focus on MST-related PTSD using an actual experience (you can find more information about PTSD at matthewpattonfoundation.org).

Military Sexual Trauma refers to sexual assault or repeated, threatening sexual harassment that occurs while serving in the military. Although the military is working hard to stop MST, studies firmly conclude there is substantial prevalence of MST across a range of settings and populations. Dana (a gender-neutral alias to protect identity) was assaulted while serving in the military. Dana invited a friend over. After talking for hours, Dana fell asleep only to awake during a sexual assault. Dana sent the perpetrator home and went on with life.

MST continues for many reasons, for example, military cultures value masculinity, power, and control within an inherently aggressive climate. Then our good “friend” STIGMA plays a role. Many will not report MST because they do not want to be labeled weak or pitiful, and worse, ostracized for informing on a fellow unit member. Thus, they suffer in silence, perhaps still working alongside their perpetrator. Dana did not report the MST because of stigma. Dana saw what happened to others who did. They were targeted and harassed by unit members, eventually assaulted again, and unfortunately, some committed suicide. This is why PTSD is the major outcome of MST, although other comorbidities like depression and anxiety generally develop as well.

A PTSD diagnosis requires 6 of 20 known symptoms from four clusters that last for at least 30 days. Cluster 1 (intrusion symptoms) and cluster 2 (avoidance symptoms) require only one symptom each. Dana has multiple intrusive and avoidance symptoms— bad memories, nightmares, triggers, flashbacks, isolation, and avoidance behaviors (e.g., thoughts and feelings about the MST). Cluster 3 (changes in cognition) and cluster 4 (alterations in arousal/reactivity) require two symptoms each and again Dana has multiple symptoms—fear, guilt, self-blame, paranoia, hypervigilance, disliking large crowds, keeping his/her back to walls, increased startle response, inability to remember parts of the MST, alcohol abuse directly after the MST, and one suicide attempt. Dana more than fits the criteria for a PTSD diagnosis. Luckily, there are treatments available that are proven to control, if not cure PTSD down the line. The two A treatments that show great promise are Post-Exposure Therapy (PET) and Cognitive Behavior Therapy (CBT). Dana is in treatment, but unfortunately because Dana did not report the MST there is no VA rating or compensation, which unfortunately will continue as risk factors for Dana and hinder complete recovery.

Important: Men in the military experience MST as well. It is important to watch male victims of MST because evidence-base research indicates that men resort to successful suicide as a direct result of MST.

You can find more in-depth information about PTSD along with credible resources at matthewpattonfoundation.org under the facts tab.